Wednesday, March 22, 2006

Angina missed in women

Women with chest pains may be dying of heart disease unnecessarily because doctors underestimate the severity of their condition, research suggests.

A team from University College London found that angina - often the first sign of heart disease - affected women at the same rate as men. They studied the records of over 100,000 angina patients aged 45-89 years.

Researchers determined that women diagnosed with angina were less likely to be given follow-up tests to confirm their condition, such as angiograms or treadmill exercise electrocardiograms (ECGs). Without these tests patients do not qualify for surgical treatments, such as bypass operations.

The study also uncovered evidence that even when women were sent for ECG tests, the scans sometimes failed to pick up abnormalities.

"As women tend to be protected from angina until after the menopause, it has traditionally been thought of as a predominantly male affliction. This study confirms that after the age of 45 years women get as much angina as men but worryingly, they tend to fare worse than men when they get it. Women with angina should receive prompt and appropriate treatment to reduce their risk of suffering a heart attack."

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Most patients with angina complain of chest discomfort rather than actual pain. The discomfort is usually described as a pressure, heaviness, squeezing, burning, or choking sensation. Anginal pain may be localized primarily in the epigastrium (upper central abdomen), back, neck, jaw, or shoulders. Typical locations for radiation of pain are arms, shoulders, and neck. Angina typically is precipitated by exertion or emotional stress, and exacerbated by having a full stomach or cold temperatures (the "4 Es": exertion, emotion, eating and extreme temperature). Pain may be accompanied by sweating and nausea in some cases. It usually lasts for about 1 to 5 minutes, and is relieved by rest or specific anti-angina medication. Chest pain lasting only a few seconds is normally not angina.

Get treatment if you have any of these symptoms. Pain is a wonderful warning system. Unfortunately, denial is often the first response to these symptoms...and it could be your last.

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