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dc.contributor.authorCanto, John G.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorHand, Mary M.
dc.contributor.authorBonow, Robert O.
dc.contributor.authorSopko, George
dc.contributor.authorPepine, Carl J.
dc.contributor.authorLong, Terry
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:34Z
dc.date.available2022-08-23T17:15:34Z
dc.date.issued2007-12-12
dc.date.submitted2010-05-27
dc.identifier.citationArch Intern Med. 2007 Dec 10;167(22):2405-13. <a href="http://dx.doi.org/10.1001/archinte.167.22.2405">Link to article on publisher's site</a>
dc.identifier.issn0003-9926 (Linking)
dc.identifier.doi10.1001/archinte.167.22.2405
dc.identifier.pmid18071161
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47197
dc.description.abstractBACKGROUND: Optimal diagnosis and timely treatment of patients with an acute coronary syndrome (ACS) depends on distinguishing differences between popular "myths" about ischemic symptoms in women and men. Chest pain or discomfort is regarded as the hallmark symptom of ACS, and its absence is regarded as "atypical" presentation. This review describes the presenting symptoms of ACS in women compared with men and ascertains whether women should have a symptom message that is separate or different from that for men. METHODS: MEDLINE (1970-2005), bibliographies of articles, and pertinent abstracts were reviewed, focusing on studies of ACS presentation, especially those reporting differences in symptoms by sex. This analysis included 69 of 361 possible studies. Data regarding symptom presentation were recorded. RESULTS: The published literature lacks standardization in characterizing ACS presentation, data collection, and reporting of symptoms. Approximately one-third of patients in the large cohort studies and one-quarter of patients in the smaller reports and direct patient interviews presented without chest pain or discomfort. The absence of chest pain or discomfort with ACS was noted more commonly in women than in men in both the cumulative summary from large cohort studies (37% vs 27%) and the single-center and small reports or interviews (30% vs 17%). CONCLUSIONS: Women are significantly less likely to report chest pain or discomfort compared with men. These differences, however, are not likely large enough to warrant sex-specific public health messages regarding the symptoms of ACS at the present time. Further research must systematically investigate sex differences in the clinical presentation of ACS symptoms and must include standardized data collection efforts.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=18071161&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/archinte.167.22.2405
dc.subjectAcute Disease
dc.subjectAge Factors
dc.subjectChest Pain
dc.subject*Coronary Disease
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHumans
dc.subjectPrevalence
dc.subjectRisk Factors
dc.subjectSex Factors
dc.subject*Women's Health
dc.subjectWorld Health
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleSymptom presentation of women with acute coronary syndromes: myth vs reality
dc.typeJournal Article
dc.source.journaltitleArchives of internal medicine
dc.source.volume167
dc.source.issue22
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/342
dc.identifier.contextkey1333095
html.description.abstract<p>BACKGROUND: Optimal diagnosis and timely treatment of patients with an acute coronary syndrome (ACS) depends on distinguishing differences between popular "myths" about ischemic symptoms in women and men. Chest pain or discomfort is regarded as the hallmark symptom of ACS, and its absence is regarded as "atypical" presentation. This review describes the presenting symptoms of ACS in women compared with men and ascertains whether women should have a symptom message that is separate or different from that for men.</p> <p>METHODS: MEDLINE (1970-2005), bibliographies of articles, and pertinent abstracts were reviewed, focusing on studies of ACS presentation, especially those reporting differences in symptoms by sex. This analysis included 69 of 361 possible studies. Data regarding symptom presentation were recorded.</p> <p>RESULTS: The published literature lacks standardization in characterizing ACS presentation, data collection, and reporting of symptoms. Approximately one-third of patients in the large cohort studies and one-quarter of patients in the smaller reports and direct patient interviews presented without chest pain or discomfort. The absence of chest pain or discomfort with ACS was noted more commonly in women than in men in both the cumulative summary from large cohort studies (37% vs 27%) and the single-center and small reports or interviews (30% vs 17%).</p> <p>CONCLUSIONS: Women are significantly less likely to report chest pain or discomfort compared with men. These differences, however, are not likely large enough to warrant sex-specific public health messages regarding the symptoms of ACS at the present time. Further research must systematically investigate sex differences in the clinical presentation of ACS symptoms and must include standardized data collection efforts.</p>
dc.identifier.submissionpathqhs_pp/342
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages2405-13


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