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

Linda L Coventry, Judith Finn, Alexandra P. Bremner

Research output: Contribution to journalReview ArticleResearchpeer-review

72 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)477-491
Number of pages15
JournalHeart and Lung
Issue number6
Publication statusPublished - Nov 2011
Externally publishedYes


  • Acute myocardial infarction
  • Meta-analysis
  • Sex differences
  • Symptom presentation
  • Systematic review

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