Women take an average of 37 more minutes to call the doctor when they have a heart attack, according to a Swiss study published by the European Society of Cardiology. Although the work refers to a center in that country, the Spanish Society of Cardiology confirms that this happens the same in Spain. Data, for example, from Breton Regional Observatory on Myocardial Infarction (ORBI), indicate that they take an average of 60 minutes to call the emergency department when they have a heart attack; they do it at 44.
The delay is obviously harmful for those affected since the time it takes to restore blood flow is essential for recovery after a heart attack. Once the warning is given, the attention is the same for both sexes.
Among the reasons for this difference, the authors of the Swiss paper pick up a fundamental one: in the popular imagination, the infarction is associated with men, when it also affects women. In fact, in Spain, according to data from the National Institute of Statistics, in 2016, diseases of the circulatory system caused the death of 64,471 women (of whom, 5,899 due to heart attack), ahead of tumors (44,320 deaths).
What is a fact is that there are differences between both sexes. In general, women have heart attacks later, about 10 years later, because female hormones have a cardioprotective effect that is lost, logically, with menopause.
Further, the symptoms may be different. Faced with the classic pattern of pressure in the chest and pain in the left arm, typical in men, in women often the oppression is taken by anxiety or digestive problems. Other associated symptoms are also more frequent, such as shortness of breath, nausea, vomiting, and back or jaw pain. "Women and men suffer the same intensity of pain during a heart attack, but the location may be different," explains Matthias Meyer, a cardiologist at the Triemli Hospital in Zurich and author of the work. "People with pain in the chest and left arm think before about a heart attack, and those are common symptoms in men. Women often have back, shoulder or stomach pain. "
But this misinterpretation does not happen only among patients. The article states that the professionals who care for them "may have a lower tendency to attribute symptoms to cardiac causes".
In the work, Meyer has reviewed 16 years of clinical records of his hospital, with 4,360 patients (967 women and 3,393 men). And one of its conclusions is that although the whole population better detects the symptoms of a heart attack, the difference between men and women has been maintained from 2000 to 2016, which is the period analyzed.
There is also a difference in mortality: it is 5.9% among women and 4.5% among men. But the authors of the work do not attribute it directly to the delays from their data, since they affirm that other indicators influence more. Meyer leaves the door open to both interpretations: "As expected, it is the serious complications of cardiac events that determine the mortality of hospitalized patients rather than the delays, but we know from previous studies that delays predict long-term mortality "
The Swiss doctor concludes: "Every minute counts when you have a heart attack. You should watch if you have moderate to severe discomfort such as pain in your chest, throat, neck, back, stomach or shoulders that last more than 15 minutes. Often there will also be nausea, cold sweat, weakness, shortness of breath or anguish. "
Informing women that they can also have a heart attack is the goal of the campaign Women for the Heart, an initiative of the National Center for Cardiovascular Research (CNIC), directed by Valentín Fuster, with the participation of the Mapfre Foundation, HM Hospitals, the Spanish Heart Foundation and the Community of Madrid, says Leticia Fernández-Friera, cardiologist of the CNIC-HM Hospitals and very involved in the initiative.
"That the heart attack is male is a myth, cardiovascular diseases are the leading cause of death for women in the world in general and in Spain in particular," says the doctor. "The problem is that the symptoms are a little different, and they appear after menopause, if in men the heart attacks start around 50 years old, in women they do it about 8 or 10 years later," says Fernández-Friera.
Part of the campaign, apart from advertising with buses and media, have been the 134,000 checks that have been made to measure the cardiovascular risk of women who have participated. "We do not talk about whether salt or tobacco, prevention is a matter of lifestyles, and women have assumed that of men," he says. "The risk factors are the same (diet, exercise, smoking)."