Women, Black Patients With Chest Pain Wait Longer in ERs

WEDNESDAY, May 4, 2022 (HealthDay News) — Women and people of color with chest pain — the most common symptom signaling a heart attack — face longer waits in U.S. emergency departments than men and white people do, new research reveals.

For the study, researchers analyzed data on more than 4,000 patients, aged 18 to 55, seen for chest pain at emergency departments nationwide between 2014 and 2018.

The investigators found that: women waited nearly 11 minutes longer to be seen by a health care provider than men (48 minutes versus 37 minutes, respectively); women were less likely to have an electrocardiogram to check the heart’s electrical activity than men (74% versus nearly 79%, respectively); and women were less likely to be admitted to the hospital or an observation unit than men (12% versus nearly 18%, respectively).

Compared with white women, women of any other race/ethnicity waited 15 minutes longer for their initial evaluation (58 minutes versus 43 minutes, respectively), and men of any other race/ethnicity waited 10 minutes longer than white men (44 minutes versus 34 minutes, respectively).

Once they were evaluated, people of color received similar evaluation and treatment for chest pain as white patients, the findings showed.

Black people accounted for 89% of the people of color in the study published May 4 in the Journal of the American Heart Association.

“Chest pain is the most common symptom of heart attack in adults of all ages. Despite a decline in the number of overall heart attacks, this number is rising among young adults. Young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults,” said study author Dr. Darcy Banco, chief resident for safety and quality at the NYU Grossman School of Medicine, in New York City.

“Whether or not the differences in chest pain evaluation directly translate into differences in outcomes, they represent a difference in the care individuals receive based on their race or sex, and that is important for us to know,” Banco explained in a journal news release.

“We anticipated we might see differences later on in care (such as calling in a specialist or admitting someone to the hospital), rather than in the early evaluation (such as time to first physician contact and electrocardiogram ordering),” Banco said. “We were also surprised to find differences in wait time by race, as the rate of heart attack among Black adults versus white adults is similar.”

Chest pain accounts for more than 6.5 million ER visits each year in the United States, along with nearly 4 million outpatient visits.

According to senior study author Dr. Harmony Reynolds, director of the Sarah Ross Soter Center for Women’s Cardiovascular Research at NYU Grossman, “Minutes count when someone has a heart attack. Calling an ambulance is also helpful because emergency medical technicians can treat chest pain and heart attack right away. People who arrive to the ER by ambulance often receive urgent care and attention sooner compared to people who arrive to the ER on their own.”

More information

There’s more on chest pain at Harvard Medical School.