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Gender Differences and Symptom Presentation in Noncardiac Chest Pain
The Female Patient, 10/07/09

Carmin CN – Gender differences are of considerable importance in understanding the ways in which patients experience and report diagnostically overlapping symptoms. Several studies have shown that women and men who have had an acute myocardial infarction report different symptoms. Early investigations of noncardiac chest pain utilizing coronary angiography with male patients routinely showed that chest pain without CHD was indicative of a diagnosis of panic disorder. A more recent study of men and women using EBT, with a large sample that allowed for CHD risk stratification, underscored that if health care professionals focus solely on the symptom of chest pain and not the full constellation of CHD and anxiety–type symptoms, anxiety may be overlooked as a possible diagnostic consideration in their female patients. Contemporary data suggest that for women, in the absence of CHD, symptoms such as palpitations/heart flutter, shortness of breath, and lightheadedness are significantly related to the presence of anxiety. Health care professionals are encouraged to inquire about these symptoms and to consider anxiety as part of their diagnostic work–up.

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