Women and Chest Pain

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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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Ian L., Dr -

In JAMA 2000 28 June Canto JG et al reported on 434,000 patients with confirmed myocardial infarction and found one third 142,445 did not have Chest pain Jaw Pain Neck Pain or Arm Pain but Dyspnea nausea and vomiting syncope or cardiac arrest They tended to be seven years older (74.2 vs 66.9 ) with a higher proportion of women (49.0 vs 38.0 % ) had diabetes mellitus (32.6 vs 25.4 % ) or a prior history of heart failure (26.4 vs 12.6 ) . The article seemed to warn to be wary of non -pain presentations of Myocardial Infarction particularly in patients that are older and have greater comorbidity .

Richard H. -

Wondering if dissection causes pain the same way aortic or vertebral artery dissections do or if it is just the subsequent myocardial ischemia that causes the pain. If the former can the nature of the pain at onset suggest SCAD vs typical CAD? Thx

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