Gender differences on chest pain perception associated with acute myocardial infarction in Chinese patients: a questionnaire survey

Aims. To investigate gender differences in chest pain perception among Chinese patients with acute myocardial infarction. Background. Thrombolytic therapy is beneficial to outcomes of acute myocardial infarction if administered within 12 hours from the onset of chest pain. However, cardiac symptom interpretation may impact time of presentation to hospital. Differences in cardiac symptom reports by gender partly explain misdiagnoses and delays in treatment, particularly among women. Whether, such trends apply to Chinese patients with myocardial infarction is unknown. Design. A descriptive prospective study. Methods. Using questionnaires, data on demographic variables, the number of patients reporting chest pain and other chest sensations at the onset of acute myocardial infarction and chest pain intensity, description, location and radiation across the chest were collected. Results. A total of 128 participants equally divided by gender were recruited. Chest pain was more prevalent among men than women (84 center dot 37% vs. 67 center dot 19%, p < 0 center dot 05). Although no statistical significance was found, Chinese men had higher mean chest pain intensity scores (7 center dot 54 SD 2 center dot 35 vs. 7 center dot 51 SD 2 center dot 25) and reported less atypical chest pain (0 center dot 00% vs. 9 center dot 3%) compared with women. Men had more upper right sided chest pain (40 center dot 74% vs. 20 center dot 93%, p = 0 center dot 038) whereas women experienced increased neck pain and pain to the upper central chest, middle central chest, upper central back, middle central back and middle right back regions. Conclusions. Discreet gender differences in chest pain perceptions exist between Chinese men and women, with the latter group, who may be considered as a high-risk group for missed and delayed diagnosis from myocardial infarction, reporting more atypical presentations. Relevance to clinical practice. Irrespective of culture, women with myocardial infarction tend to present with atypical chest pain symptoms and therefore they should be aggressively investigated.