Top Doc: Is It a Heart Attack?

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: How does a woman's experience of heart attack differ from a man's?

Marianne Legato, MD
Twenty percent of women will not have the same symptoms from a heart attack that a man has, and instead of the classic, there's an elephant on my chest or chest pain radiating into the neck and down the left arm, which is thought to be the classic picture, and what I was taught in medical school. Fully 20%, that's one out of 5 women will have instead epigastric pain or feeling of indigestion, which may or may not radiate to her back. She will become very short of breathe and nauseated and you can imagine when a woman like that, who is not assertive, comes into an ER room and she meets an uniformed triage nurse or physician, she can be sent for an upper GI series or a gallbladder series because she's having a quote gallbladder attack and given valium for her hyperventilation, when in fact, she's having a heart attack. One of my favorite stories is that I appeared in the emergency room to see a patient of mine who had reported herself to the emergency room with just those symptoms, and I walked in to see her, and my intern said to me, not knowing who I was, now you have to be very careful not to misdiagnose this, because 20% of women have just these symptoms when they have a heart attack. I said is that right, I'm very glad to hear you say that. So at least at the level of the young trainee, I think we are making a good impact.