Gender Differences in Delay Seeking Treatment and Related Experiences in Patients with Acute Myocardial Infarction

Abstract

Purpose: This comparative descriptive study was to identify gender differences in delay seeking treatment and related experiences in patients with acute myocardial infarction (AMI). Methods: Ninety-seven participants were recruited from a tertiary hospital. Results: Mean age of 47 women was 71.5±13.3 while that of men was 55.0±10.9 (p<.001). More women lived alone and were jobless, less educated, and poorer than men. Men were likely to be 'current smokers' and drink alcohol, however viewed themselves healthier than women (p=.030). Women's hospital stay was 9.23±21.04 days while men's was 4.86±2.72 days (p=.014). More women had been diagnosed with hypertension (p=.040). Women appeared to report significantly less pain (6.46±3.1) than men (8.44±1.8). More men described their pain as sudden onset (p=.015) and chest pain as major symptom (p=.034) than women. More women were found alone upon onset of symptoms (p=.023) and had important reasons for delay seeking treatment (p=.021) than men. Median time from onset of symptoms to seeking medical service was 1.5 hours for men and 5.1 hours for women (p=.003). Median time taken from onset of symptoms to hospital for therapy was 3.5 hours for men and 9.1 hours for women (p=.019). Conclusion: This study findings that women reported less pain and delayed in seeking treatment, suggest needs for strategies targeting women at risk of AMI.

Factors affecting awareness of myocardial infarction symptoms among the general public

“…On the other hand, young adults aged 19-39 years tend to lack the time and need for MI education [ 21 ] and thus had low levels of symptom recognition. Finally, individuals aged 60 years or older lack understanding of MI symptoms, likely due to aging [ 5 ].…”

Blood Pressure Awareness and Knowledge of Cardio-Cerebrovascular Diseases in South Korean Women with Hypertension

“…These findings suggested the general public has low awareness of faint or radiating pain caused by heart attacks. Patients do not experience all symptoms during a heart attack and may complain of syncope, weakness [ 12 , 13 , 43 ], or arm and shoulder pain or discomfort [ 44 ]. In particular, women reported milder symptoms [ 1 ] and complained more about back pain and shoulder blade pain or discomfort [ 17 , 44 ].…”

“…In particular, women reported milder symptoms [ 1 ] and complained more about back pain and shoulder blade pain or discomfort [ 17 , 44 ]. Also, atypical symptoms such as abdominal discomfort, fatigue, cough, fever, and nausea/vomiting were observed [ 1 , 12 , 13 , 43 ]. In our study, 11.8% of participants were unaware of any warning signs, and 52.4% were aware of all stroke signs.…”

“…Despite the importance of visiting a hospital for rapid treatment in South Korea, the delay rate of emergency medical centers within the ideal timeframe (within 2 h) after acute myocardial infarction onset was 56.0%, and 1.35 times higher in women than men [ 12 ]. The main reason for delayed hospital arrival in women was a lack of warning sign recognition and understanding of atypical symptoms without typical symptoms such as chest pain [ 12 , 13 , 14 ]. In this regard, Woodward referred to the female disadvantage [ 8 ].…”

“…However, previous studies showed that less than half the people (15.6% to 48.8%) were aware of all the warning symptoms [ 15 , 16 , 17 , 18 ]. As mentioned above, women are more prone to lack recognition of knowledge of CVDs warning signs (KCVDs) because of experiencing atypical symptoms; this was reported as the cause of increased treatment delay among women [ 12 , 13 ]. Considering the increased prevalence of HTN, a prominent risk factor for CVDs, among South Korean women [ 5 ], it is necessary to evaluate the level of KCVDs and its associated factors in women with HTN.…”