Women are less likely to receive lifesaving treatment for cardiogenic shock than men, according to research presented today at ESC Acute CardioVascular Care 2022, a scientific congress of the European Society of Cardiology (ESC).
Cardiogenic shock (CS) is a prevalent cause of death, and despite advances in therapeutic alternatives, care remains difficult. CS is characterized by significant myocardial dysfunction, which leads to decreased cardiac output, end-organ hypoperfusion, and hypoxia. Clinically, this manifests as hypotension that is resistant to volume resuscitation and has end-organ hypoperfusion symptoms that necessitate pharmacological or mechanical intervention. In CS, 81 percent of patients have an acute myocardial infarction (MI).
Cardiogenic shock is a life-threatening disorder in which the heart stops pumping enough blood to deliver enough oxygen to the body’s organs. A heart attack causes it, and only half of those who have one will survive. Women were much more likely than males to be admitted to a local hospital at the outset (41 percent versus 30 percent), and men arrived with out-of-hospital cardiac arrest. Following a heart attack, women are less likely than males to survive in the short and long term. Only 38 percent of women remained alive 30 days after the event, compared to 50 percent of men.
“The women and men in our study had similar clinical characteristics when they developed cardiogenic shock after a heart attack,” said study author Dr. Sarah Holle of Copenhagen University Hospital, Rigshospitalet, Denmark. “This was a retrospective study so it is difficult to know why clinicians made certain treatment decisions. But the findings indicate that greater awareness among health professionals that women have heart attacks and may develop cardiogenic shock could be a step towards equitable management and outcomes.”
Photo by Jair Lázaro