A lot of emphasis is often placed on the difference in presentation of cardiac disease between women and men. Research tells us that the vast majority of people - some 90 per cent of patients with a heart attack will indeed present with chest pain or discomfort. However some patients present without typical chest pain. What is not clear is if identifying sex-specific alternate symptoms is possible to help physicians differentiate women with heart attack from women with other causes of chest pain.
 
This study looked at whether sex-specific chest pain characters (CPCs)  would let physicians make that differentiation.
 
2,475 patients (796 women and 1,679 men) who presented with acute chest pain at nine emergency departments from April 2006 through August 2012 were studied.  Acute heart attack was the final diagnoses in 143 women (18 per cent) and 369 men (22 per cent). Researchers examined 34 chest pain complaints, including location, onset and pain radiation to other parts of the body.
 
The study found that most chest pain complaints were reported with similar frequency in women and men, although some were reported more frequently in women. Most of the CPCs studied by the researchers also did not differentiate heart attack from other causes of acute chest pain. Only three CPCs (related to pain duration and decreasing pain intensity) appeared related to sex-specific diagnostic use, which researchers acknowledge could be the result of chance.
 
The study showed that chest pain complaints are not powerful enough to be used as a single tool in the diagnosis of AMI and need to be used always in conjunction with the ECG [electrocardiogram] and cTn [cardiac troponin, which are cardiac markers] test results in the diagnosis of heart attack.

In an editorial it is noted that the question,  whether detection of sex-specific chest pain characteristics (CPCs) would allow emergency department physicians to diagnose AMI in women more accurately.
 
The study revealed that none of the CPCs were more useful at enhancing the posttest probability of AMI in women compared with men. The study clarifies that presentation of chest pain between men and women is not as different as commonly thought and provides new knowledge on the value and limitation of chest pain in making a diagnosis of AMI in women as well as in men.