Women With Heart Attack Symptoms See Delays in Care

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About a quarter of patients with chest pain and half of those with heart attacks get to the hospital via EMS (emergency medical services), yet little is known about the timing of this journey.

The authors studied 5,887 calls made by people with suspected cardiac symptoms to EMS in 10 municipalities involving 29 hospitals and 98 EMS depots in Dallas County, Texas, in 2004. People with the symptoms were equally divided between men and women; half were white.

Women took an average of 2.3 minutes longer to get to the hospital than men, not considered a critical difference.

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One expert agreed that difference was minimal.

"I'm not sure there's much here. It's a study from what happened five years ago in one place," said Dr. Robert Greenberg, an assistant professor of emergency medicine at Texas A&M Health Science Center College of Medicine and vice chairman of emergency medicine at Scott & White in Temple. "When you cut to the bottom line, they're talking about a two-minute difference and that's not going to make any difference in patient care. The question would be why."

But about 11 percent of patients were delayed by 15 minutes or more, a window that could be critical. And women were 52 percent more likely than men to be delayed at least this long, regardless of other factors, including the demographics of the neighborhoods.

"We chose 15 minutes before even looking at the data set because clinical evidence suggests that if you are having a heart attack, 15 minutes is enough to cause significantly more cell death," Concannon said.

Gender-specific differences in cardiac symptoms could have other, far-reaching effects, an accompanying editorial stated. For instance, EMS personnel might need more time to diagnose the problem while on the scene.

And, if the onset of a heart attack was not recognized immediately, the EMS staff might not use sirens and lights, which have been linked to an increase in ambulance crashes.

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