Differences in the symptoms of myocardial infarction by sex and gender identity
Myocardial infarction (MI) is a leading cause of death in women in the United States and is responsible for the death of 234,088 (49.2 percent) women per year (American Heart Association, 1998). The symptoms defining the typical MI presentation are based upon research with male samples yet are generalized to females. Gender identity has also been shown to influence symptoms. Masculinity, one dimension of gender identity, has been reported as a predictor of post MI chest pain (Helgeson, 1991).
The purpose of this study was to describe the symptoms experienced during an MI and to analyze potential differences in the symptoms experienced by sex and gender identity. A theoretical framework to logically support the need for examining biological sex and gender identity as related to the symptoms of an MI was taken from the Unpleasant Symptoms Model (Lenz, Suppe, Gift, Pugh, & Mulligan, 1995). A nonexperimental, cross sectional research design was used. The sample was a nonprobability, convenient sample obtained at three Mid-Atlantic Hospitals with two groups—one male and one female. The total sample size consisted of 101 subjects, 59 males (58.4%) and 42 females (41.6%). Measures included the Adapted Myocardial Infarction Symptoms Questionnaire (adapted from the MI Symptoms Questionnaire, Johnson, 1995, unpublished instrument used with permission) and the Bem. Sex Role Inventory (Bem, 1981). Hypothesis testing was conducted using Chi-Square statistic, independent t-tests, one-way analysis of variance, and logistic regression. Exploration of the symptoms experienced during an MI is imperative to accurate and prompt clinical diagnosis and meaningful public education campaigns.