initial presentation of MI in women and older patients

30 Jul

Canto et al:

Question: Is there actually a difference in initial presentation of MI among women and older patients?

Methods: Observation study from the National Registry Myocardial Infarction of 1,143,513 patients from 1994-2006

Results: Proportion of female patients who presented without chest pain (42%) was significantly higher than men (30.7%) P<0.001. Absence of chest pain was also correlated with increased mortality (due to delay in recognition of MI).

Teaching points: Have a high index of suspicion for women with vague complaints as a ~40% of female MI patients will not have chest pain.

Submitted by W. Rushton.

Reference(s): Canto et al, “Association of Age and Sex with MI Symptom Presentation and In-Hospital Mortality” JAMA February 22 Vol 307 No 8; picture

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