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Chest pain in women in the emergency room: management and evolution

OBJECTIVE: To evaluate the diagnosis of chest pain in women receiving medical care in the emergency room in relation to follow-up, as well as describing its influence on the therapeutic management when compared to men. METHODS: A current cohort study compared 67 patients of ages ranging from 50 to 65 years (35 women and 32 men) with chest pain, consecutively examined in the emergency room and followed up for 120 days. The outcomes assessed were: acute myocardial infarction, unstable angina, stable angina, cerebral ischemia, myocardial revascularization surgery, angioplasty, death and hospitalization. RESULTS: During diagnostic investigation of chest pain in the emergency room, no significant gender related difference was perceived. However, proportionally, women were given less cardiologic medication and more tranquilizers. Women were less likely to be referred for hospitalization than men (p=0.02). As for the occurrence of acute myocardial infarction, unstable angina, stable angina, cerebral ischemia, myocardial revascularization surgery, angioplasty and death, no differences between genders were noted during follow-up. CONCLUSION: Comparing the diagnostic accuracy of chest pain in the emergency room between women and men, there was no significant difference in relation to the number of tests. Nevertheless, women were less often referred for hospitalization and their therapeutic cardiologic management was less aggressive. The follow-up presented the same rate of outcome for both genders, therefore attention must be given to the chest pain symptom irrespective of gender.

Chest pain; Emergency service; Hospital; Women


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