Women are less likely to receive life-saving treatment for cardiogenic shock than men and thus, are more at risk of death, according to research.

Cardiogenic shock is a life-threatening condition in which the heart suddenly fails to pump enough blood to supply the body's organs with sufficient oxygen.

It is usually caused by a large heart attack. It is estimated that up to 10 per cent of patients with heart attacks affecting a large area of the heart also develop cardiogenic shock. Only half of patients who experience cardiogenic shock will survive.

Researchers from Copenhagen University Hospital in Denmark showed that significantly lower proportions of women received mechanical circulatory support (19 per cent women versus 26 per cent men), minimally invasive or surgical procedures to restore blood flow to blocked arteries (83 per cent women versus 88 per cent men), and mechanical ventilation (67 per cent women versus 82 per cent men).


Women were thus less likely than men to survive in the short- and long-term. At 30 days after the heart event, just 38 per cent of women were alive compared with 50 per cent of men.

At 8.5 years, 27 per cent of women were alive compared with 39 per cent of men.

"There is increasing evidence that women with acute heart problems are more likely than men to have non-specific symptoms such as shortness of breath, nausea, vomiting, coughing, fatigue, and pain in the back, jaw or neck," said Dr. Sarah Holle from the varsity.

"Increased recognition that women may have symptoms other than chest pain could minimise delays in diagnosis and treatment and potentially improve prognosis," she added.

The findings were presented at ESC Acute CardioVascular Care 2022, a scientific congress of the European Society of Cardiology (ESC).

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A total of 1,716 heart attack patients with cardiogenic shock were enrolled in the study, of which 438 (26 per cent) were women. The average age of women was 71 years compared with 66 years for men.

Lack of awareness

"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," Holle said. Often, lack of awareness led to many women ignore the signs of heart problems, reveals the study.

According to the research, women were more likely to be admitted initially at a local hospital (41% vs 30% men) and more men presented with out-of-hospital cardiac arrest (48% vs 25% women).

Regarding treatment and outcomes, the researchers found:

  • Women were less likely to receive mechanical circulatory support (19% vs 26%); acute revascularization, such as percutaneous coronary intervention and coronary artery bypass graft (83% vs 88%); and mechanical ventilation (67% vs 82%)
  • 30 days after the event, only 38% of women were alive vs 50% of men
  • 8.5 years after the event only 27% of women were alive vs 39% of men

"Treatment guidelines are based on studies which primarily enrolled men," Holle said. "Further research is needed to determine whether women and men with cardiogenic shock might benefit from different interventions."

The findings echo similar results from past research funded by the British Heart Foundation, which found that even when tests were boosted among women, they were still half as likely as men to receive recommended treatments.