Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis

Heart Lung. 2011 Nov-Dec;40(6):477-91. doi: 10.1016/j.hrtlng.2011.05.001.


Background: Recognition of sex differences in symptom presentation of acute myocardial infarction (AMI) is important for timely clinical diagnosis. This review examined whether women are equally as likely as men to present with chest pain.

Methods: We conducted a systematic review and meta-analysis of English language research articles published between 1990 and 2009.

Results: Meta-analysis showed women with AMI had lower odds and a lower rate of presenting with chest pain than men (odds ratio .63; 95% confidence interval, .59-.68; risk ratio .93; 95% confidence interval, .91-.95). Women were significantly more likely than men to present with fatigue, neck pain, syncope, nausea, right arm pain, dizziness, and jaw pain.

Conclusion: Health campaigns on symptom presentation of AMI should continue to promote chest pain as the cardinal symptom of AMI, but also reflect a wider spectrum of possible symptoms and highlight potential differences in symptom presentation between men and women.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Arthralgia
  • Chest Pain*
  • Dizziness
  • Fatigue
  • Female
  • Humans
  • Male
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / pathology
  • Nausea
  • Neck Pain
  • Risk Assessment
  • Sex Factors
  • Syncope
  • Time Factors
  • Western Australia / epidemiology