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Women more likely to get wrong diagnosis after MI

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Women have a 50% higher chance than men of receiving the wrong initial diagnosis following a heart attack, according to a UK study.

Overall, it found almost a third of myocardial infarction patients had an initial diagnosis that differed from their final one. The research, carried out by researchers at the University of Leeds, used the UK national heart attack register MINAP2.

“This new study highlights the current scale of the issue”

Mike Knapton

It looked at the two main types of heart attack – STEMI, which occurs when there is a total blockage of the main artery that pumps oxygenated blood around the body, and NSTEMI, which is more common and is a partial blockage of one or more arteries.

The study found that women who had a final diagnosis of STEMI had a 59% greater chance of a misdiagnosis, compared with men.

Women who had a final diagnosis of NSTEMI had a 41% greater chance of a misdiagnosis, when compared with men.

Women who were misdiagnosed had about a 70% increased risk of death after 30 days compared with those who had received a consistent diagnosis. The same was the case for men.

The findings, published today in the European Heart Journal Acute Cardiovascular Care, looked at nearly 600,000 heart attack patients over the course of nine years.

Between April 2004 and March 2013, the researchers studied 243 hospitals in England and Wales that provided care for patients between the ages of 18-100 at the time of hospital admission.

The number of patients who were initially misdiagnosed was 198,534.

Study author Dr Chris Gale, associate professor of cardiovascular health sciences at Leeds University, said: “This research clearly shows that women are at a higher risk of being misdiagnosed following a heart attack than men.

“We need to work harder to shift the perception that heart attacks only affect a certain type of person,” he said.

University of Leeds

Chris Gale

Chris Gale

“Typically, when we think of a person with a heart attack, we envisage a middle aged man who is overweight, has diabetes and smokes,” he said. “This is not always the case; heart attacks affect the wider spectrum of the population – including women.”

The British Heart Foundation, which helped fund the study, urged healthcare professionals to be more aware of the signs and symptoms of a heart attack, to avoid mistakes being made in diagnosis.

It also called for more research to further improve tests for diagnosing heart attacks in both men and women.

Dr Mike Knapton, associate medical director at the charity, noted that another study in Edinburgh had suggested a reason for the difference in misdiagnoses.

“When different limits are applied to the troponin test, a routine test for a heart attack, more women receive a correct diagnosis of heart attack,” he said.

“However, this new study highlights the current scale of the issue and confirms more research is urgently needed into tests that will enable earlier and more accurate diagnosis of a heart attack.”

 

Case study

Alison Fillingham, 49, a nurse from Bolton, had a heart attack on her way to work.

Ms Fillingham, who had been a nurse for 24 years, says: “I had pain in my collarbone and neck but I just thought it was because I’d had a hectic few days. I went to work as normal and hoped the pain would go away.

“Two days later the pain was really excruciating and had spread to my jaw, so my sister made me call an ambulance. When the paramedics arrived they told me I was just having a panic attack, so I was taken to the hospital with no urgency. It was only when I was seen hours later that I was diagnosed as having had a heart attack.

“Knowing how much this delayed diagnosis could have put my life at risk, I wish I’d recognised the symptoms and called the ambulance immediately.

“I’m now more aware that heart disease can affect anyone at any time – but at the time a heart attack was the last thing I thought could be happening to me.”

 

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Readers' comments (1)

  • Thank you for publicising this study. We lost my 53 year old sister because of misdiagnosed heart problems. She was initially treated for gall stones with diet and weight control despite being average weight for height. When finally her heart problem was diagnosed she had no specific tests and was discharged with advice to take care and expect to live the life of a semi invalid.

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