Tuesday, October 14, 2008

I'm not anxious - I'm having a heart attack!

There is a certain amount of overlap between the symptoms of coronary heart disease (CHD) and anxiety which can both cause chest pain, shortness of breath and an irregular heartbeat. Researchers in the U.S. used clinical vignettes (fictional case studies) to see how these symptoms were interpreted by health professionals and found that if a patient was a woman their symptoms were more likely to be interpreted as anxiety than as CHD. The doctors read four vignettes about a 56-year-old woman and a 47-year-old man (the risk of CHD is the same for both). There were two vignettes each about the man and the woman; one in which they had recently experienced a certain amount of stress, the other in which they hadn't. There was no evidence of bias when the vignettes were presented without the stress but in the vignettes which included stress women were much less likely to receive a CHD diagnosis (15% vs 56%), a referral to a cardiologist (30% vs 62%) or a prescription for cardiac medication (13% vs 47%).

You can read more about this research at


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