JUNE 10, 2005 | Not only do men and women experience different symptoms prior to a heart attack, but preliminary data for a research study to be conducted by the University of Arkansas for Medical Sciences (UAMS) suggests that women of various ages and racial backgrounds may experience different symptoms as well.

Jean McSweeney, Ph.D., R.N., professor in the UAMS College of Nursing, recently received a $2.3 million grant from the National Institutes of Health to study these differences. The project will follow as many as 1,700 women in Arkansas and Kentucky who have been referred to a cardiologist and document cardiac symptoms – called prodromal symptoms – they may develop over a two-year period. The women will be of various ages and racial backgrounds so scientists can determine if there are trends within the symptoms they experience.

"The increasing number of coronary heart disease (CHD) deaths in younger women, plus the projected increase of it in older women paints a bleak picture. To reverse this trend, we need to be able to detect it in its early stages, but diagnosing CHD in women is challenging since they don’t experience the same symptoms typically associated with heart disease in men," McSweeney said.

In previous studies by McSweeney, it was discovered that 97 percent of women with acute heart disease reported prodromal symptoms more than a month before a heart attack. Both black and white women have reported these symptoms, including unusual fatigue, sleep disturbance, shortness of breath, indigestion and anxiety. Black women have typically reported even more varying symptoms, including frequent headaches, vision changes, appetite changes, aching arms and heart racing episodes.

"In the previous study, 40 percent of the women – even during a heart attack – didn’t have chest pain," McSweeney said.

The women who volunteer for the study will be followed through their medical records and by telephone survey. They will be contacted every three months to report their symptoms over a two year period. If they have a heart attack, they will be asked to describe any symptoms they felt before the attack. McSweeney said she hopes that by the end of the five-year study, scientists will be able to come up with a list of predictable symptoms in both black and white women that strongly indicate that heart disease is present and that a heart attack may be imminent.

Once the information is compiled, McSweeney said, she plans to create an educational campaign for physicians, patients and insurance providers. Many insurance providers won’t cover the cost of diagnostic testing for CHD unless the patient has symptoms similar to those usually present in men with the disease, namely, chest pain.

"We have to do something to get women the diagnostic evaluations they need and determining women’s most important symptoms of heart disease is an important first step," she said of the problem of insurance coverage.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, five centers of excellence and a statewide network of regional centers. UAMS has more than 2,200 students and 660 residents and is the state’s largest public employer with almost 9,000 employees. UAMS and its affiliates have an economic impact in Arkansas of $4.1 billion a year.

UAMS centers of excellence are the Arkansas Cancer Research Center, Harvey and Bernice Jones Eye Institute, Donald W. Reynolds Institute on Aging, Myeloma Institute for Research and Therapy and Jackson T. Stephens Spine and Neurosciences Institute.