LOS ANGELES, CA (Catholic Online) - Dr. John Canto, director of the chest pain center at Lakeland Regional Medical Center, working with his team reviewed data on more than 1.1 million heart attack patients to find the answer. As reported in the Journal of the American Medical Association, the group says that the differences have to do with both gender and age.

Their studies proved that when women show up at the hospital after a heart attack, they are less likely to report chest symptoms. While the sharp, consistent chest pains that typically signal heart attack in most men, or 69 percent do also appear in the majority of women, 58 percent, women are more likely than men to suffer no chest discomfort at all. In fact, 35 percent of all the patients in the study reported no chest-related symptoms, and more of them were women at 42 percent than men at 30.7 percent.

Canto and his colleagues analyzed the data further to find out whether the heart attack differences between men and women were also influenced by age. Researchers found that women younger than 55 were more likely to have atypical heart attack symptoms than either older women or men of the same age.

These findings may result in delays in life-saving care at the hospital, which help explains why younger women were two to three times more likely to die of their heart attack than men of the same age who experienced chest pains. "That's a huge finding," says Canto. "We're trying to better understand what influences age has when looking at differences in gender presentation and mortality."

Overall, nearly 15 percent of women died in the hospital after their heart attack, compared with about 10 percent of men.

Canto says that the findings will refine doctors' still crude understanding of how heart disease differs between men and women.

It has been known for years that more women may not experience the classic chest pains that men do during heart attack. However, the tendency to pigeonhole men and women into different symptom categories is misguided.

Currently, "the message on heart attack symptoms is that one size fits all, which is that one set of heart attack symptoms are the same for men and another are the same for all women," Canto says. "We are challenging that conventional wisdom and I believe that the message should be tailored to high-risk young women who are at the highest risk of dying if they have a heart attack."

Women are typically older than men when they suffer first heart attack; in the study, the age difference was about 7 years, 74 versus 67. Before menopause, women may be protected by estrogen, which can counter the formation of plaques in heart arteries.

Heart attacks that strike younger women, Canto says, may be biologically different from those that occur in older women and younger men. Women under 55 are more prone to clot-based heart attacks, or those triggered by spasm of the heart vessels that can block the flow of blood. That may be because they are more likely to be using oral birth control, which can increase the risk of clot formation.

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