November 29, 2004

Most Women Would Not Seek Emergency Care for Common Warning Signs of Heart Disease, Survey Finds

When women experience head, neck, back and jaw pain, a common symptom of a heart attack, only 47 percent of women would call their doctor and just 35 percent would call 911 or visit an emergency department, a national survey conducted by the American College of Emergency Physicians (ACEP) reported.

The survey of more than 1,000 women over age 35 was conducted on behalf of ACEP by Opinion Research Company, Princeton, New Jersey, as part of its "Take it to Heart" campaign, which is devoted to empowering women and those who love them with information about the signs and symptoms of heart disease and how it may be diagnosed in the emergency department.

"Waiting to seek medical attention can mean the difference between life and death," said Dr. Linda Lawrence, MD, ACEP board member. "This information is particularly important as the holidays approach, because it is a stressful time and we are more likely to neglect our health due to the many distractions and obligations over the next several weeks."

Of the women who were surveyed on what action they would take if they were experiencing unexplained pain in their jaw, arm, neck or back:

-- 66 percent would take a pain reliever such as aspirin or ibuprofen;

-- 59 percent would lay down and rest;

-- 46 percent would wait 24 hours to see if the symptoms would go away.

Atypical Symptoms Ignored Even More

The vast majority of women surveyed said that they are not likely to seek medical attention when they experience flu-like symptoms such as nausea, clamminess or cold sweats, which are considered atypical symptoms of a heart attack. In fact, only 37 percent of women would call their doctor and only 10 percent would visit an emergency room or call 911 if they were experiencing flu-like symptoms, the survey found. Nearly 80 percent of those women surveyed said they would wait 24 hours to see if these flu-like symptoms go away.

Although chest pain is the second most common cause of emergency department visits, women may experience less common or more subtle symptoms that they may not associate with heart disease. In addition to flu-like symptoms, women later diagnosed with heart disease also report feelings of breathlessness; unexplained fatigue; feelings of anxiety, and weakness or dizziness. Women may experience these symptoms with or without the classic symptoms of chest, upper back, shoulders, neck or jaw pain.

"The 'Take it to Heart' campaign is ACEP's ongoing effort to make women more aware of signs and symptoms associated with heart disease, to help them determine when to seek medical care and to educate them about what to expect should they need to undergo diagnostic testing," said Dr. Lawrence.

Easing Anxiety of Diagnostic Testing

Physicians diagnose heart disease based on the patient's history of symptoms, physical exam and diagnostic tests. Some of these are more invasive than others. A basic electrocardiogram (ECG or EKG) is usually the first step. However, further tests will be done, if needed.

"We believe that if women know more about the diagnostic tools that emergency physicians may use to detect heart disease, they will be more prepared and less anxious about seeking emergency care and to ask their physicians questions about tests," said Dr. Lawrence.

The survey found women had varying knowledge of tests used to diagnose heart disease. More than 83 percent say they are very knowledgeable about blood tests and X-rays, and nearly 70 percent felt knowledgeable about electrocardiograph or EKGs. However, less than half of the women say they are very knowledgeable about angiographs, nuclear imaging and electron beam computed tomography.

Only 38 percent of women surveyed say they are very knowledgeable about cardiac catheterization or angiogram. During this test, a small catheter is inserted into an artery in your groin or arm and is threaded to your heart. Once in your heart, a small amount of dye is injected while a picture is taken with a large X-ray machine. Only 30 percent of women report being very knowledgeable about nuclear imaging, a specialized diagnostic test that simulates a stress test by injecting a liquid into your bloodstream while a special camera takes pictures of the heart, allowing doctors to look for blockages.

Each year, about 5 million Americans go to the emergency department with chest pain symptoms suspected to be caused by heart disease. About one-third of emergency room department patients with chest pain will be diagnosed with heart disease annually.

"Take it to Heart" resources are available at The campaign is supported with publicity that includes public service announcements, featuring four-time Grammy award-winning vocalist, Pat Benatar.

This survey was funded by an educational grant provided by Fujisawa Healthcare, Inc.

The American College of Emergency Physicians (ACEP) is a national medical specialty society representing emergency medicine with more than 23,000 members. ACEP is committed to improving the quality of emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. Additional information on ACEP's campaign can be found at