Many Heart Attacks Go Undiagnosed

Over 40% of heart attacks go undiagnosed at the time of occurrence, with a higher incidence rate in women, according to a new study.

Dutch researchers at Erasmus Medical Center (Rotterdam, The Netherlands) analyzed data collected in the Rotterdam Study, a prospective population study investigating chronic disabling diseases. A total of 5,148 participants with no evidence of prevalent myocardial infarction (MI) were enrolled from 1990-1993. They underwent a base-line electrocardiogram (ECG) and examination. Data from clinically recognized MIs in these participants over the years that followed were analyzed. Of these, 4,187 participants out of those who had at least one repeat ECG during two rounds of follow-up assessment were analyzed for clinically unrecognized MIs, or heart attacks not diagnosed at the time of occurrence.

The results showed that one-third of the male heart attacks, more than half of the female heart attacks, and a total of 43% of the total heart attacks had been clinically unrecognized, revealing that women have a higher incidence of unrecognized MIs than men. The findings were published in the February 2006 edition of the European Heart Journal.

"Women may hold back from reporting symptoms and doctors may also be in doubt whether or not to consider heart disease as a source of the complaints,” said Dr. Eric Boersma, associate professor of clinical cardiovascular epidemiology at Erasmus Medical Center and co-author of the study. "It is also a problem that women and their doctors have traditionally worried more about death from breast and gynecologic cancer than from heart disease.

The authors suggest that although the study was conducted in the Netherlands, the results were likely to be equally applicable to any other developed country, and they noted that the role of ECGs in existing cardiovascular-prevention programs should be evaluated.




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