Abstract
Background: An interplay exists between gender and sex differences in the management of Acute Coronary Syndrome that has a bearing on outcomes for women. In the past, Acute Coronary Syndrome was seen as primarily a man's disease; this in part stems from the use of the terms "typical" and "atypical" symptoms in chest pain presentations. Most medical research has been carried out on men; thus, the symptoms men experience are seen as the standard upon which a diagnosis is made. Women have unique physiological and psychosocial differences compared to men and as a result are often misdiagnosed and undertreated for Acute Coronary Syndrome. Critical secondary prevention opportunities are missed, thus leading to increased future cardiovascular event risk and higher mortality rates.
Aim: To investigate whether women presenting to the Emergency department with Acute Coronary Syndrome have worse cardiovascular health outcomes due to gender bias.
Method: An integrative review guided by Whittemore and Knafl (2005) including a thematic analysis underpinned by Braun and Clarke's (2006) framework.
Results: Women are older and have a higher burden of comorbidities, and psychosocial risk factors when presenting to the Emergency Department with Acute Coronary Syndrome. Although overall awareness about cardiovascular disease in women has increased during the past decade, most healthcare professionals and women underestimate cardiovascular risk.
Discussion: Awareness campaigns have paid little attention to the role of physicians in assessing risk, and while understanding sex differences in cardiovascular disease is paramount, it is only part of the story, and gender differences must be considered. More systems are needed at all levels of care to ensure that women receive equitable care.