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Member Research & Reports

Member Research & Reports

Yale Finds Younger Women and Heart Attacks; Unrecognized Symptoms and Delays in Seeking Help

Younger women may ignore or dismiss the earliest symptoms of an impending heart attack, such as pain and dizziness, and they tend to delay seeking emergency medical care. Such factors potentially contribute to disproportionally high death rates of young women as compared to similarly aged men.

[Photo: Dr. Judith Lichtman]

New research led by the Yale School of Public Health, and published today in the journal Circulation: Cardiovascular Quality and Outcomes, examined the experiences of women ranging in age from 30 to 55 years old who were hospitalized with acute myocardial infarction (AMI). Using in-depth interviews with these young women, the nine-member research team explored how they responded during the crucial period when their first symptoms manifested and they were deciding to seek medical care.

The researchers found that among the women studied, initial symptoms varied widely in both nature and duration; patients inaccurately assessed their personal risk of heart disease; in some cases external factors (such as work and family) influenced the decision to seek emergency medical help; not all patients received a prompt or complete workup for their AMI symptoms or a formal diagnosis; and they did not routinely access primary care, including preventive care for heart disease.

“Young women with multiple risk factors and a strong family history of cardiac disease should not assume they are too young to have a heart attack,” said lead researcher Dr. Judith Lichtman, associate professor and chair of the Department of Chronic Disease Epidemiology. “Participants in our study said they were concerned about initiating a false alarm in case their symptoms were due to something other than a heart attack. Identifying strategies to empower women to recognize symptoms and seek prompt care without stigma or perceived judgment may be particularly critical for young women at increased risk for heart disease.”

Dr. Leslie Curry, senior research scientist at the Yale Global Health Leadership Institute and senior author on the paper, noted that the study results suggest that more needs to be done by the health care system to educate women about the early symptoms of a heart attack and to change the way that both women and health care providers respond to the symptoms.

Each year, in the United States alone, more than 15,000 women under age 55 die from heart disease, ranking it as a leading cause of death for this age group.

Identifying factors that promote better cardiovascular knowledge, improved preventive health care, and prompt care-seeking behaviors represent important targets for this younger population of women with heart disease, Lichtman said.

The Fannie E. Rippel Foundation and grants from the National Heart, Lung, and Blood Institute funded the study.

Other Yale researchers involved in the study include Dr. Erica Leifheit-Limson, associate research scientist in the department of chronic disease epidemiology, Ms. Emi Watanabe and Dr. Harlan Krumholz, the Harold H. Hines, Jr. Professor of Medicine and Professor of Health Policy, as well as researchers from Northwestern University, Saint Luke’s Mid America Heart Institute, and the University of Missouri-Kansas City.