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Women's Chest Pain Unreliable Sign of Heart Attack?

Scientific tools, not patient complaints, needed for accurate diagnosis, expert says
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WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

MONDAY, Nov. 25, 2013 (HealthDay News) -- Chest pain is not a symptom that doctors can use to accurately diagnose a woman suffering a major heart attack, according to new research.

A survey of about 800 women and 1,700 men found that women tend to suffer the same types of chest pain as men during a heart attack, Swiss researchers from the University Hospital Basel said.

However, most of the chest pain symptoms reported by women could not be used to tell a heart attack from some other cause of severe chest pain.

Doctors said the study, which was published Nov. 25 in the journal JAMA Internal Medicine, provides further evidence that emergency-room doctors should use concrete heart tests to diagnose a heart attack.

These tests include the electrocardiogram (EKG), which checks the heart's electrical activity, and the cardiac troponin test, which is a blood test that checks for proteins called troponins that are released when the heart muscle is damaged.

"Doctors must be much more aggressive in trying to diagnose heart disease through EKG and troponins, because without those objective data it's very hard to tell it's a woman's heart," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "The symptoms aren't going to tell us. We have to use the diagnostic tools we have."

Some physicians, however, expressed concern that these findings, while important to doctors, would prompt some women to ignore chest pain that otherwise would have sent them to the hospital for testing.

"We use symptoms to try to drive people to the hospital, but we would never diagnose a heart attack by symptoms alone," said Dr. Nieca Goldberg, a cardiologist and medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center in New York City. "If you are experiencing chest pain, the most important thing is you get to the hospital as soon as possible. If any of the symptoms of heart attack come on all of a sudden, don't just ignore it."

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