R. Goldberg et al., Age and sex differences in presentation of symptoms among patients with acute coronary disease: the REACT trial, CORON ART D, 11(5), 2000, pp. 399-407
Background There are few data on possible age and sex differences in presen
tation of symptoms for patients with acute coronary disease.
Objective To investigate demographic differences in presentation of symptom
s at the time of hospital presentation for acute myocardial infarction (AMI
) and unstable angina.
Methods The medical records of patients who presented with chest pain and w
ho also had diagnoses of AMI (n = 889) or unstable angina (n = 893) on disc
harge from 43 hospitals were reviewed as part of data collection activities
of the Rapid Early Action for Coronary Treatment trial based in 10 pair-ma
tched communities throughout the USA.
Results Dyspnea (49%), arm pain (46%), sweating (35%), and nausea (33%) wer
e commonly reported by men and women of all ages in addition to the present
ing complaint of chest pain. After we had controlled for various characteri
stics through regression modeling, older persons with AMI were significantl
y less likely than were younger persons to complain of arm pain and sweatin
g, and men were significantly less likely to report vomiting than were wome
n. Among persons with unstable angina, arm pain and sweating were reported
significantly less often by elderly patients, Nausea and back, neck, and ja
w pain were more common complaints of women.
Conclusions Results of this study suggest that there are differences betwee
n symptoms at presentation of men and women, and those in various age group
s, hospitalized with acute coronary disease. Clinicians should be aware of
these differences when diagnosing and managing patients suspected to have c
oronary heart disease. Coron Artery Dis 11:399-407 (C) 2000 Lippincott Will
iams & Wilkins.