Increasing literature over recent years has demonstrated that young women (1) DO have MIs, (2) present more atypically than men, and (3) are more often misdiagnosed than men. Two recent trials have now also confirmed that young women have a higher in-hospital mortality compared to men, even when properly diagnosed. They may be due to lack of aggressive workups or treatment, or perhaps other as-yet unidentified factors.
The takeaway points are simple: be very wary when women (incuding young women) present with any cardiopulmonary complaints or anginal equivalent-type symptoms; and treat them aggressively.
References
1. Zhang Z, et al. Age-specific gender differences in in-hospital mortality by type of acute myocardial infarction. Am J Cardiol 2012;109:1097-1103.
2. Canto JG, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012;307:813-822.
