Why heart attack symptoms aren’t always noticed

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  • Carolyn Thomas says:

    Excellent overview on heart attack symptoms, Paul – both typical and atypical.

    Recognizing cardiac symptoms is important. Seeking timely help when those symptoms hit is more important. But nothing is more urgently important than being correctly diagnosed once you arrive at the ER. A delayed response in seeking help is especially common in women, but tragically a delayed response in being correctly diagnosed and treated compared to our male counterparts is just as dangerous – yes, even when we present to Emergency Department (as I did) with textbook “Hollywood heart attack” symptoms.

    We know that women are under-diagnosed compared to our male counterparts, and under-treated even when appropriately diagnosed. When I attended the Canadian Cardiovascular Congress in 2011 to interview researchers working on women’s heart health issues, I was gobsmacked to learn that out of 700 scientific papers presented, just four had anything even remotely to do with women’s cardiac symptoms, diagnostics or treatment. Last year, things at the CCC were only marginally better: about one dozen this time. This has to change. As U.S. cardiologist Dr. Nieca Goldberg warned about this gender gap in cardiology: “Women are not just small men.” More on this at:

    Awareness of heart attack symptoms is important, but as last week’s Institute of Medicine’s new report “Improving Diagnosis in Health Care” warned: “Urgent change is warranted to address misdiagnosis.”

    • Paul Taylor says:

      Thanks for your comments.

      There is actually a very effective blood test for determining if a patient is having a heart attack. It’s often done when patients arrive at the ER with heart-attack-like symptoms. Most important, it takes the guess work out of diagnosing vague symptoms. And it puts both women and men on the same playing field when in comes to the rapid diagnosis of a heart attack – regardless of their symptoms.

      A substance called troponin is released into the blood stream when the heart muscle is injured.

      Levels of troponin can become elevated in the blood within 3 or 4 hours after heart injury and may remain elevated for 10 to 14 days.


Paul Taylor


Paul Taylor is a health journalist and former Patient Navigation Advisor at Sunnybrook Health Sciences Centre, where he provided advice and answered questions from patients and their families. Paul will continue to write occasional columns for Healthy Debate.

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