Younger women with an acute coronary syndrome have slightly lesser likelihood than men to present with the classic symptom of chest pain, reported a study published inĀ JAMA Internal Medicine. As a result, they often fail to receive a correct diagnosis in the emergency department.

Khan and colleagues prospectively evaluated data from over 1,000 ACS patients aged 55 or younger (30% women), participating in the GENESIS PRAXY study.

In these younger patients women had lesser odds of having chest pain, compared to men (19% of women versus 13.7% for men, p = 0.03). Additionally, women were more likely than men to have a non-ST-segment elevation myocardial infarction (37.5% vs 30.7%; p = 0.03).

Multivariate analysis revealed that women and patients with tachycardia had a lesser likelihood of having chest pain. The absence of chest pain did not indicate any change in the type or severity of the ACS.

Diagnosis of any disease with a lower prevalence but higher mortality, such as coronary artery disease in younger women, is more challenging.

Public health messages should focus on both men and women regarding ACS symptom presentation with or without chest pain in order to encourage earlier and more widespread access to lifesaving care.