GENDER DIFFERENCES IN REPORTED SYMPTOMS FOR ACUTE MYOCARDIAL-INFARCTION - IMPACT ON PREHOSPITAL DELAY-TIME INTERVAL

A retrospective observational study using database registry of consecu tive patients admitted to 16 King County hospital Coronary Care Units (CCU) was conducted to assess gender differences in symptom presentati on for acute myocardial infarction (AMI) and investigate how symptom p resentation relates to prehospital delay time interval from acute symp tom onset to emergency department (ED) presentation. Between January 1 991 and February 1993, 4,497 patients were admitted to the CCUs with d iagnosed AMI. Accredited record technicians abstracted age, gender, ra ce, transport method, symptom presentation (chest pain, sweating, naus ea, shortness of breath, epigastric pain, and fainting), delay time in terval between acute symptom onset and presentation to hospital ED, an d discharge diagnosis from the patients' medical records, After adjust ing for age and history of diabetes, no gender differences remained fo r frequencies of chest pain, fainting, or epigastric pain, Women repor ted more nausea and shortness of breath but less sweating than men as symptoms of AMI. Chest pain, sweating, and fainting were associated wi th decreasing delay time intervals. Age, gender, histories of AMI and diabetes, and transport choice were also significantly related to dela y time interval. These results show that gender differences occur in A MI symptom experience. However, how symptoms relate to the gender gap in delay time interval is not clear. These findings suggest that healt h care professionals need to tailor information about possible symptom s of AMI to the patient's gender, age, and medical history. (Am J Emer g Med 1998;16:363-366. Copyright (C) 1998 by W.B. Saunders Company).