By Oscar Parry
A new study found that women are less comfortable calling triple-0 when experiencing symptoms of a heart attack, providing a possible reason why women who have heart attacks have a worse outcome than men.
The study by Monash University researchers involved more than 34,000 Australian men and women, questioning whether they would call triple-0 if they suspected they were having a heart attack and their actual use of these services.
Conducted by Monash University honours student Annie Shi and led by associate professor and former mobile intensive care paramedic of 25 years Kathryn Eastwood, the study found that while women were more likely to call triple-0 if experiencing heart attack symptoms, they were significantly less comfortable to make the call.
In their responses, over a third of women said they did not want to burden the ambulance service compared to a quarter of men.
More women than men said that they wanted to be certain that it was a heart attack before calling, preferring to instead contact their general practitioner.
Women were also more likely to hesitate calling because they believed that they were at low risk of having a heart attack.
Associate professor Eastwood said that for some women – especially older women – the fear of burdening the ambulance system is due to previous medical experience.
“There is plenty within the literature already around why women in particular feel like they might be a burden … when you think how some of the older women might have been treated in medical care in the past … according to the research, there’s a bit of a sense that they’ve been made to feel silly and that they’ve had a bad experience – ‘there, there, you’ll be OK, stop being hysterical,’” associate professor Eastwood said.
She said that symptoms of a heart attack in women can often be more subtle than those experienced by men.
“When a lot of research has been done in the past, it is generally done on men and that is just because they were concerned about causing any harm to women in terms of reproduction … so unfortunately when we’ve all been told what a heart attack is, we’ve been taught the more traditional male symptoms of a heart attack … the central chest pain, sudden onset crushing moving into the left arm, that sort of picture that you’ll see on TV,” she said.
“For women, chest pain can present in their back, not in their chest. It can present in between their shoulder blades … it can actually come on a little bit more slowly and just be a little bit less debilitating, and the problem with that is when things come on more slowly, you tend to acclimatise to them and tend not to register them.”
She clarified that these symptoms can also be experienced by men.
Associate professor Eastwood said she encourages people to “call first, and decide later” if they are having a heart attack when experiencing symptoms, adding that the symptom of chest pain can include more than just pain in the literal sense.
“[I was] an intensive care paramedic for 25 years, and when we’re talking about pain, we mean any funny feeling in the chest … if you’re asked about pain by a health professional, they’re using that as an umbrella term for anything different. Just report everything and let the health professional decide what’s important and what’s not.”
She said symptoms in women could include feeling sick for days, having no energy, sleeping on extra pillows because they find it hard to breathe, not being able to walk to the letterbox, back pain, palpitations or sinking feeling in the chest, dizziness, or shortness of breath – including mild shortness of breath.
She said that any cluster of these symptoms together would warrant receiving an electrocardiogram.
“Every minute that they delay, more of their heart can be damaged or even die. And if that happens to enough of the heart, then they will have permanent damage,” she said.
She said calling an ambulance means that paramedics can begin treatment before a person experiencing a heart attack arrives at hospital – helping to prevent the heart attack from advancing – and that the hospital can be notified and prepare for a patient’s arrival, ready to clear a blockage from the heart.
She said people can be proactive with their health by regularly visiting a general practitioner to test blood pressure, cholesterol levels, and have an electrocardiogram to have on file to compare and see what has changed in the case of a cardiac event.
