Gender Difference In Chest Pain Related Symptoms In Patients With Acute Myocardial Infarction

ObjectiveThis study was to investigate the characteristics of chest pain related symptoms and gender differences in this regard among patients with acute myocardial infarction(AMI).It would help health care workers to be clear about the gender difference in typical and atypical symptoms,contributing to better diagnosis,prognosis and public health education outcomes.MethodsA consecutive sampling strategy was use to recruit eligible AMI patients from the Chest Pain Center in the university affiliated tertiary hospital from August 2015 to September 2017.Three research nurses took turns to collect data around the clock using the predesigned case report form after the specific training and getting familiar with each item.The Form was consisted of four parts,a.basic information sheet,b.pre-hospital and initial contact details,c.AMI symptoms assessment,and d.examination and treatment in emergency.Descriptive analysis and Chi-square test were performed to analyze patients' background information,pain and other discomforts of relevancy in aspects of sites,nature,severity,atypical symptoms,as well as precipitating and relieving factors.ResultsA total of 685 case report forms were gathered,and all were valid.These AMI patients were65.3±11.9 years(x±s)old,and the ratio of male to female was 1.94:1(233:452).Gender differences were identified in aspects of health history,nature of chest pain,site of pain,atypical symptoms as well as precipitating and relieving factors.The following are details about these gender differences.1.Gender difference in health history:More male reported the history of percutaneous coronary intervention(PCI,17.7%male vs.10.3%female)and had the sign of over 50%stenosis in the angiographic examination(16.7%male vs.24.1%female).As to the comorbidity of diabetes(45.5%female vs.25.2%male)and hypertension(72.5%female vs.60%male)as well as the history of heart failure(6.9%female vs.2.2%male),more female patients reported the diseased conditions than male patients.The proportion of female smoking history is lower than that of males,only 8.6%of females have been or are smoking,but 64.2%of males have been or are smoking,this difference is statistically significant(P<0.05).2.Description of the chest pain:The first three most frequently reported perception of chest for male patients were oppressive pain(18.1%),squeezing pain(9.5%),and distending pain(7.7%);while that for female patients were oppressive pain(14.2%),distending pain(8.6%),and squeezing pain(7.3%).Slightly more than half of patients reported the moderate degree of such pain(55.8%female vs.54.8%male),but no significant difference was detected about the perception of chest pain(all P>0.05).More female patients reported the occurrence of radiant pain(41.6%female vs.29.2%male),while this gender difference is statistically significant(P<0.05).3.Site of pain:The first three most frequently reported site of pain for male patients were left chest(34.1%),middle chest(28.1%),and whole chest(6.6%),while that for female patients were middle chest(30.9%),left chest(29.6%)and whole chest(7.7%).The most frequently reported site of pain and discomfort outside the chest was the upper abdomen for both male and female patients.4.Atypical symptoms:The most frequently reported atypical symptom was the perception of chest tightness for both female and male(36.9%female vs.33.8%male).Gender difference(all P<0.05)were found in three atypical symptoms,that is,nausea(35.2%femalevs.18.4%male),vomiting(19.7%female vs.8.6%male)and dizziness(12%femalevs.6%male).5.Precipitating and relieving factors:the most common precipitating or aggravating factor is tiredness for both female and male patients(15.7%femalevs.16.7%male).The most common relieving factor for all patients was the use of quick acting Kyushin Pills(25.3%female vs.20.1%male).However no significant difference(all P>0.05)was identified in this regard.ConclusionsOn average female AMI patients were older than male patients.Significant gender difference was found in aspects of the comorbidity of diabetes and/or hypertension and theperception of atypicalsymptoms,but not on other aspects of chest pain.