Why do women who are having heart attacks wait so long to go to the hospital? Usually, the answer relies on the well-known variability and vagueness of heart attack symptoms in women. But researchers from the University of North Carolina in Greensboro and Chapel Hill and from the University of Kentucky in Lexington, may have hit on the real reason: Many women are behaving the way they feel they should.
The researchers compared 2 different groups of women that had symptoms of acute coronary syndrome. One group had “evolving symptoms” that were vague or nonspecific; the second group had symptoms that were readily identified as a serious cardiac problem needing medical attention.
Both groups delayed, the researchers note, but for different reasons. The women with “evolving symptoms” were usually uncertain or ambivalent about the nature of the symptoms. The women who had immediately recognizable myocardial infarction (MI) symptoms tended to overestimate the time they had to safely get their tasks done; based on experience, they felt they could predict the time they had, the researchers say. Even women who had already had a heart attack tended to delay getting help. If just 1 aspect of the current situation didn’t match their previous situation, it stopped them from seeing the pattern connecting the individual symptoms, which might have spurred them to get care.
The researchers found that women postponed medical care—even when they suspected they needed it—to finish household chores, to find people to take on tasks at work, and to pack appropriately for a hospital stay. Some women waited for someone else to validate their symptoms and worried more about others than about themselves. (“My feelings when I am going through this actually is more focused on my husband…It’s not really about me.”)
However, one of the most important findings was that women weren’t simply ignoring their symptoms, which other researchers have suggested. They were putting them aside for social and life responsibilities. Some women, the authors of this study note, continue with daily responsibilities that are “tightly linked to their personal integrity” despite correctly recognizing and interpreting their symptoms.
Women often said such things as “I just have this feeling” or “In the back of my mind I knew that this was something that really needed to be looked into,” but would also say “But see it wasn’t bad-bad.” These findings may help explain why educating women about MI symptoms is not enough, the researchers say—they also need to trust and act on their “feelings.” More important, perhaps, is they need to recognize that sometimes their health comes first.
Source
Davis LL, Mishel M, Moser DK, Esposito N, Lynn MR, Schwartz TA. Heart & Lung. 2013;42(6):428-435.
doi: 10.1016/j.hrtlng.2013.08.001.