Chest Pain: Men and women experience it, but is there truly a difference?

February 15, 2020

Chest Pain: Men and women experience it, but is there truly a difference?

The book by John Gray “Men are from Mars and Women are from Venus” highlights many fundamental differences between the sexes. This is not necessarily true when it comes to the presenting symptoms of acute coronary syndrome (ACS). The HERMES trial, a study out of Boston involving 637 patients (40% female and 60% male) used artificial intelligence to analyze how the patients described the symptoms of “chest pain” in their own words. Classical teaching is that women experience symptoms associated with ACS differently than men. The findings of this study indicate that this may not be the case. Women and men describe symptoms associated with ASC more similarly thandifferently.

Cardio-linguistics is a term coined and used for computer analysis of the natural language recordings of symptoms. These symptoms are then mapped to angiographic findings. This method avoids the use of leading questions that could cause bias, since actual recordings are made as patients describe their symptoms. Research indicates the two top symptoms for both sexes were chest pain and shortness of breath. On average, women reported 9 symptoms and men 7 symptoms.

It is time to abandon the terms typical angina and atypical angina. Coronary artery disease is the #1 killer in the US for both men and women. In the 20th century, most studies involved male patients and were interpreted by male physicians. The bottom line, women are likely to report multiple symptoms but the majority of women present just like men.

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