Cardiogenic shock is a very serious, potentially lethal occurrence. And it must be addressed with the utmost urgency. Suddenly the heart loses its ability to push the blood needed by the body. Estimates say that about one in ten people with a particularly devastating heart attack can develop this complication, which is fatal in nearly one in two people.
Too many differences between men and women in life-saving treatments
To deal with it, a series of urgent treatments must be put in place. And precisely on this front, there would still be a difference between men and women, also linked to the fact that frequently the symptoms of a female heart attack are more vague and less precise than the classic picture that occurs in men.
Research conducted in Denmark sets the picture that shows women are less likely to receive life-saving treatment for cardiogenic shock than men.
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The study was presented at the congress ESC Acute CardioVascular Care 2022scientific event of the European Society of Cardiologyand was conducted on a population with similar characteristics at the time of cardiogenic shock after heart attack.
According to the author of the research, Sarah Holle dell’University Hospital of Copenhagen “The findings indicate that there is increased awareness among health care professionals that women have heart attacks and may develop them shock cardiogeno it could be a step towards fair management and results. “
Gender differences in a Danish study
The study looked at all adults (over 1700 people, 26% women) admitted between 2010 and 2017 in two highly specialized centers for the treatment of cardiogenic shock and they follow about two thirds of the Danish population. All data on treatment and 30-day mortality as well as long-term risk of death were evaluated.
In the population examined, women at the time of heart attack had a higher average age (71 years compared to 66 for men) and were more often hypertensive. But that’s not the only difference. In terms of emergency treatment, for example, women had a greater chance of being admitted to a small hospital (41% women versus 30% men).
Same clinical conditions but different treatment
Coming to the actual clinical picture, at the time of cardiogenic shock women and men had comparable clinical parameters such as pressure, heart rate, blood lactate (this marker indicates oxygen levels in the organs) and a similar ability to “push” the blood by the left ventricle (left ventricular ejection fraction). Well, despite this situation of almost absolute “parity” in clinical conditions, only 19% of women against 26% of men, treatments such as angioplasty or by-pass to restore blood flow in blocked arteries (83% women against 88% men) and respiratory assistance with mechanical ventilation (67% women versus 82% men).
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The consequences on the chances of survival
Result: women were significantly less likely to survive in the short and long term than men. At 30 days after the cardiac event, only 38% of the women were alive compared to 50% of the men. At 8 and a half years after cardiogenic shock, 27% of women were alive compared to 39% of men.
Non-specific symptoms can be underestimated
According to the expert, even the symptoms of this serious situation can be deceiving. “There is mounting evidence that women with acute heart problems are more likely than men to have it non-specific symptoms such as shortness of breath, nausea, vomiting, coughing, fatigue and pain in the back, jaw or neck – Holle says. This may be one of the reasons why more women than men in our study were initially admitted to a local, rather than specialized, hospital. Greater recognition that women may have symptoms other than chest pain could minimize delays in diagnosis and treatment and potentially improve prognosis. ”
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