Sex differences in symptoms experienced, knowledge about symptoms, symptom attribution, and perceived urgency for treatment seeking among acute coronary syndrome patients in Karachi Pakistan

Document Type



School of Nursing and Midwifery, Pakistan; Cardiology


Background: Patients' experience of acute coronary syndrome (ACS) symptoms is important in determining their prehospital delay.
Objective: To explore gender differences in acute symptoms of ACS, knowledge about the symptoms, their attribution, and perception of urgency, among Pakistani ACS patients.
Methods: Comparative, cross-sectional study design with 249 ACS patients.
Results: The most commonly reported symptoms were ghabrahat (fidgetiness), chest pain, and chest heaviness. Most atypical symptoms were experienced more by women, such as nausea/vomiting (p < 0.001), backache (p < 0.001), palpitations (p = 0.004), and epigastric pain (p = 0.005). Chest pain and palpitations were the symptoms most commonly attributed to cardiac causes, whereas epigastric pain was most commonly attributed to non-cardiac causes by both men and women. Significantly more women than men perceived dyspnea (p = 0.026), nausea/vomiting (p = 0.027), sweating (p = 0.014), and palpitations (p = 0.01) as symptoms not at all urgent for treatment.
Conclusions: Gender disparity in symptom experience along with the women's perception of non-urgency for their symptoms, could lead to delayed care seeking.


Heart & Lung