The symptoms of unstable angina: do women and men differ?

Research has shown that there are differences between women and men in the epidemiology, presentation, and outcomes of coronary heart disease.

The purpose of this study was to determine if there were sex differences in the symptoms of unstable angina (UA) and if so, to determine if these differences remained after controlling for age, diabetes, anxiety, depression, and functional status.

This descriptive study used a nonexperimental, quantitative design. A convenience sample of 50 women and 50 men, hospitalized with UA, were recruited from an urban and a suburban medical center. Instruments included the Unstable Angina Symptoms Questionnaire (UASQ), the Hospital Anxiety and Depression Scale (HADS), and the Canadian Cardiovascular Society (CCS) classification of angina.

Multivariate analysis indicated that women experienced significantly (p <.05) more shortness of breath (74% vs. 60%), weakness (74% vs. 48%), difficulty breathing (66% vs. 38%), nausea (42% vs. 22%), and loss of appetite (40% vs. 10%) than men. After controlling for age, diabetes, anxiety, depression, and functional status, women were still more likely than men to report weakness (p =.03), difficulty breathing (p =.02), nausea (p =.03), and loss of appetite (p =.02). Chi-square analysis of symptom descriptors revealed that women disclosed more (p <.05) upper back pain (42% vs. 18%), stabbing pain (32% vs. 12%), and knifelike pain (28% vs. 12%). Women also had a significantly higher incidence of depression (22% vs. 2%, p <.01).

Findings suggest that women and men have similar symptoms during an episode of UA, however, a higher proportion of women have less typical symptoms.