UMEM Educational Pearls

Category: Cardiology

Title: ACS in women

Keywords: acute coronary syndromes, gender, misdiagnosis (PubMed Search)

Posted: 1/24/2010 by Amal Mattu, MD (Updated: 1/26/2022)
Click here to contact Amal Mattu, MD

Women are more likely to be misdiagnosed than men when they present with acute coronary syndromes. There are several possible reasons for this:
1. Women are more often older and more often have diabetes, both of which are factors involved in atypical presentations.
2. Women present with chest pain less often than men. On the other hand, women are more likely to present with nausea, vomiting, indigestion, malaise, loss of appetitie, or syncope than men.
3. When women do have chest pain, they are more likely to report pain that has atypical features, such as radation to the right arm or shoulder, front neck, or back; and the pain is more often described as sharp, stabbing, or tansient.

The bottom line is something that I've believed since high school: women are confusing...!

[the references for this ACS information comes from many different sources, but if anyone needs a good review on this topic, just email me: amattu@smail.umaryland.edu]