Angina-type symptoms are remarkably similar among men and women with obstructive coronary artery disease (CAD), according to a new research letter mapping reported symptoms along a continuum based on sex and gender.

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The research letter, published on April 8 in JAMA Internal Medicine, "empirically demonstrates the substantial overlap of shared symptoms between men and women with obstructive CAD," according to study authors. Overall, the study found that the most common descriptors used by men and women with obstructive CAD included "chest pain" (71 of 87 [82 percent] vs. 42 of 50 [84 percent]; P=.72), "pressure" (47 of 87 [54 percent] vs. 29 of 50 [58 percent]; P=.65), and "tightness" (37 of 87 [43 percent] vs. 29 of 50 [58 percent]; P=.08), respectively. Men and women also reported pain in the same areas outside the chest region, including the arms, back and shoulders.

The authors did note that women used certain descriptors, such as discomfort, crushing, pressing or bad ache, twice as often as men, suggesting that "the choice of terms used to describe a symptom may be a function of gendered language rather than of conventionally portrayed biological sex difference." In contrast, they said, there were no observed differences between men and women in biological symptoms.

Moving forward, the authors suggest that this new data can help clinicians better contextualize symptoms associated with obstructive CAD rather than adhering to the conventional "typical" and "atypical" angina distinction.

"The study results reassure us that women and men are more alike than we think in presentation of CAD, and both are most likely to experience chest pain, pressure, and tightness," said Rita F. Redberg, MD, MSc, FACC, professor of medicine in the Division of Cardiology at the UCSF School of Medicine in an editorial comment. "These findings should be a great relief to the many women who have been concerned that they could be having a myocardial infarction unbeknownst to them because they would not get the typical warning symptoms of chest pain."

Keywords: Coronary Artery Disease, Myocardial Infarction, Chest Pain

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