Women under the age of 55 who have suffered a heart attack did not quickly seek treatment for a variety of reasons, including their uncertainty about whether non-traditional symptoms such as fatigue, indigestion, and shoulder and neck pain actually signal severe cardiovascular problems, Yale researchers report.

Researchers led by Judith Lichtman, associate professor of epidemiology at the Yale School of Public Health, conducted in-depth telephone interviews with 30 women, with an average age of 48, who recently had a heart attack. The interviews explored the women’s initial recognition and response to symptoms, their healthcare beliefs and their acute healthcare experiences.

The findings were presented on May 2 at the American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke in Baltimore.

Lichtman noted many of the women were surprised that their actual symptoms differed from the “Hollywood heart attack” that they would have expected.

“They wish that they had known that symptoms such as neck and shoulder pain, abdominal discomfort that was easy to mistake for indigestion or unusual fatigue could signal a heart problem,” she says. “They often said that TV doesn’t show examples of the symptoms they experienced. If they knew, they would have responded to the symptoms sooner.”

The researchers also described the often complex internal dialogue that led more than half of the women in the study to delay seeking treatment for more than hour after their heart attack began.

Many of the women interviewed were uncertain about their symptoms, preferred to take over-the-counter medications, were concerned about how they would be treated by healthcare providers, or cited competing time or family demands as more important than their own health needs. Many of these women said they experienced health system delays such as being triaged for non-cardiac conditions, even though many displayed typical heart disease symptoms.

While heart attacks among women under age 55 are responsible for less than 5% of the cases of heart diseases, they still account for 16,000 deaths and 40,000 hospitalizations annually.

Lichtman says, “There are large gaps in our understanding of the symptoms young women experience or reasons they delay seeking prompt care. Because heart disease is less common at this younger age, current media campaigns and prevention messages do not appear to be reaching this group.”

— By Bill Hathaway

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Campus Notes

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