Gender divides in the clinical profiles of patients with acute myocardial infarction at a tertiary care center in South India.

BACKGROUND: Early identification of myocardial infarction (MI) is a determinant in the provision of appropriate treatment modalities. The focus of the present study is on the identification of gender-based differences in risk factors, clinical manifestations, and coronary angiography findings in patients presenting with MI.

MATERIALS AND METHODS: A cross-sectional study was conducted among patients admitted with MI at a tertiary care center in South India during March 2016 to June 2017. Selected 120 male and 120 female consecutive patients admitted with acute MI, who had survived and been stabilized. Data was collected using a pre-tested structure data sheet. Appropriate parametric and nonparametric tests were used to analyze the data.

RESULTS: Participants were homogenous as regards age ( P < 0.107); majority of men and women were from the rural areas. About 32.5% of the men interpreted the pain as due to a cardiac problem or indigestion, whereas 60.8% of the women thought it was fatigue/muscle pain. The self-interpretation or perception of pain in both genders was statistically significant ( P < 0.001). Compared to the men, the females increasingly presented with atypical symptoms ( P = 0.005). Regarding ST-elevated MI, male preponderance was noted ( P = 0.004)). Considering the anatomical location of MI, the presentation of Inferior Wall Myocardial Infarction (IWMI) was predominant in females compared to men ( P = 0.003). The majority of men had increased presentation of single-vessel disease compared to women ( P = 0.02), whereas normal coronaries and double-vessel disease were found statistically significantly higher in females ( P = 0.03 and P = 0.008, respectively).

CONCLUSION: Public education is needed on the atypical presentations which are common with women than in men. The public should, therefore, be informed of those symptoms and how to recognize them so that they may seek medical care promptly.