Interpreting angina: symptoms along a gender continuum

Area of Science:

• Cardiology
• Gender Studies in Medicine
• Medical Sociology

Background:

• The terms 'typical' and 'atypical' angina are often gender-biased, with 'typical' symptoms attributed to men and 'atypical' to women, despite higher angina prevalence in women.
• This gendered distinction in symptom description contributes to controversy and potential disparities in cardiac care for women.
• Current classifications may misrepresent the diverse experiences of angina across genders.

Purpose of the Study:

• To qualitatively compare angina symptoms and patient experiences between women and men.
• To propose a novel, gender-centered construct for understanding angina that moves beyond traditional 'typical' and 'atypical' categorizations.
• To enhance the accuracy and inclusivity of angina diagnosis and care.

Main Methods:

• Semi-structured, in-depth interviews were conducted with 31 patients (13 men, 14 women with significant coronary artery disease) prior to their first angiogram.
• Interviews explored patients' subjective experiences and descriptions of angina symptoms.
• Verbatim transcripts were analyzed using a modified grounded theory approach to identify symptomatic subthemes and patterns.

Main Results:

• A 'gender continuum' model emerged, illustrating six symptomatic subthemes of angina.
• This continuum revealed significant overlap in angina symptoms experienced by both men and women, challenging the binary 'typical' vs. 'atypical' framework.
• Gender-specific symptoms were identified at the poles of the continuum, with a substantial central cluster of shared symptoms.

Conclusions:

• The 'gender continuum' provides a more nuanced understanding of angina experiences for patients undergoing angiography.
• It highlights greater commonality in angina symptoms between genders than conventionally acknowledged.
• This model offers a valuable tool for clinicians and researchers to contextualize patient reports, improving diagnostic accuracy and patient care by moving beyond outdated gendered classifications.