Women with myocardial infarction are less likely than men to experience chest symptoms

To assess similarities and differences between women and men regarding experience and interpretation of symptoms of acute myocardial infarction before hospital admission.

149 women and 384 men responded to a questionnaire two weeks after hospital discharge.

Men were more likely than women to report chest symptoms. Women were more likely to complain of nausea, palpitations, dyspnoea, fainting, pain in the back and pain between the scapulas than men. Irrespective of sex only half the patients interpreted their symptoms as cardiac. Early onset of chest symptoms, previously diagnosed angina, symptoms in accordance with expectations, symptoms stronger than expected and familiarity with symptoms, all contributed to a cardiac attribution among both sexes. A diagnosis of hypercholesterolemia and prescribed nitroglycerin was related to a cardiac attribution among men only.

Women were less likely to experience chest symptoms and more likely to experience atypical symptoms than men. Symptom experience and the patients' expectations of symptoms influenced interpretation and attribution among both sexes.