title: Age and sex differences in presentation of symptoms among patients with acute coronary disease: the REACT Trial. Rapid Early Action for Coronary Treatment.
abstract: BACKGROUND
  There are few data on possible age and sex differences in presentation of symptoms for patients with acute coronary disease.
  
  
  OBJECTIVE
  To investigate demographic differences in presentation of symptoms at the time of hospital presentation for acute myocardial infarction (AMI) and unstable angina.
  
  
  METHODS
  The medical records of patients who presented with chest pain and who also had diagnoses of AMI (n = 889) or unstable angina (n = 893) on discharge from 43 hospitals were reviewed as part of data collection activities of the Rapid Early Action for Coronary Treatment trial based in 10 pair-matched communities throughout the USA.
  
  
  RESULTS
  Dyspnea (49%), arm pain (46%), sweating (35%), and nausea (33%) were commonly reported by men and women of all ages in addition to the presenting complaint of chest pain. After we had controlled for various characteristics through regression modeling, older persons with AMI were significantly less likely than were younger persons to complain of arm pain and sweating, and men were significantly less likely to report vomiting than were women. Among persons with unstable angina, arm pain and sweating were reported significantly less often by elderly patients. Nausea and back, neck, and jaw pain were more common complaints of women.
  
  
  CONCLUSIONS
  Results of this study suggest that there are differences between symptoms at presentation of men and women, and those in various age groups, hospitalized with acute coronary disease. Clinicians should be aware of these differences when diagnosing and managing patients suspected to have coronary heart disease.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worcester 01655, USA.
authors.forename: R
authors.initials: R
authors.lastname: Goldberg
authors.forename: D
authors.initials: D
authors.lastname: Goff
authors.forename: L
authors.initials: L
authors.lastname: Cooper
authors.forename: R
authors.initials: R
authors.lastname: Luepker
authors.forename: J
authors.initials: J
authors.lastname: Zapka
authors.forename: V
authors.initials: V
authors.lastname: Bittner
authors.forename: S
authors.initials: S
authors.lastname: Osganian
authors.forename: D
authors.initials: D
authors.lastname: Lessard
authors.forename: C
authors.initials: C
authors.lastname: Cornell
authors.forename: A
authors.initials: A
authors.lastname: Meshack
authors.forename: C
authors.initials: C
authors.lastname: Mann
authors.forename: J
authors.initials: J
authors.lastname: Gilliland
authors.forename: H
authors.initials: H
authors.lastname: Feldman
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003325:Coronary Care Units; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D010351:Patient Discharge; D012727:Sex Characteristics; D014481:United States / Q000453:epidemiology