Physiological and anatomical bases for sex differences in pain and nausea as presenting symptoms of acute coronary syndromes

Heart and Lung: Journal of Acute and Critical Care

Volumn 39, Issue 5, 2010, Pages 386-393

  Arslanian Engoren, Cynthia ^a   Engoren, Milo ^b  

^a UNIVERSITY OF MICHIGAN   (United States)

^b MEDICAL COLLEGE OF OHIO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ENDORPHIN; NEUROKININ 1 RECEPTOR;

ACUTE CORONARY SYNDROME; ANATOMICAL VARIATION; COMORBIDITY; CORONARY ARTERY; CORONARY ARTERY ATHEROSCLEROSIS; DIABETES MELLITUS; DIABETIC NEUROPATHY; GROUPS BY AGE; HEART NERVE; HUMAN; HYPERTENSION; NAUSEA; NOCICEPTION; NONHUMAN; PRIORITY JOURNAL; REVIEW; SEX DIFFERENCE; THORAX PAIN; TISSUE DISTRIBUTION;

ACUTE CORONARY SYNDROME; CHEST PAIN; CORONARY VESSELS; FEMALE; HUMANS; MALE; MODELS, THEORETICAL; NAUSEA; PAIN; RECEPTORS, NEUROKININ-1; RISK FACTORS; SEX FACTORS;

EID: 77956450242     PISSN: 01479563     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.hrtlng.2009.10.013     Document Type: Review

References (90)

1. Gibler W.B., Armstrong P.W., Ohman E.M., Weaver W.D., Stebbins A.L., Gore J.M., et al. Persistence of delays in presentation and treatment for patients with acute myocardial infarction: the GUSTO-I and GUSTO-III experience. Ann Emerg Med 2002, 39(2):123-130.
2. Yarzebski J., Col N., Pagley P., Savageau J., Gore J., Goldberg R. Gender differences and factors associated with the receipt of thrombolytic therapy in patients with acute myocardial infarction: a community-wide perspective. Am Heart J 1996, 131:43-50.
3. American Heart Association. Heart attack, stroke, and cardiac arrest warning signs. Available at: Accessed September 5, 2009. http://www.americanheart.org/presenter.jhtml?identifier=3053.
4. National Heart Lung Blood Institute. Women and heart attack. Available at: Accessed September 5, 2009. http://www.nhlbi.nih.gov/actintime/hasw/women.html.
5. Hasdai D., Porter A., Rosengren A., Behar S., Boyko V., Battler A. Effect of gender on outcomes of acute coronary syndromes. Am J Cardiol 2003, 91:1466-1469.
6. Kudenchuk P.J., Maynard C., Martin J.S., Wirkus M., Weaver W.D. Comparison of presentation, treatment, and outcome of acute myocardial infarction in men versus women (the Myocardial Infarction Triage and Intervention Registry). Am J Cardiol 1996, 78:9-14.
7. Selker H.P., Beshansky J.R., Griffith J.L., Aufderheide T.P., Ballin D.S., Bernard S.A., et al. Use of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) to assist with triage of patients with chest pain or other symptoms suggestive of acute cardiac ischemia. A multicenter, controlled clinical trial. Ann Intern Med 1998, 129:845-855.
8. Boufous S., Kelleher P.W., Pain C.H., Dann L.M., Ieraci S., Jalaludin B.B., et al. Impact of a chest-pain guideline on clinical decision-making. Med J Aust 2003, 178:375-380.
9. Dodd M., Janson S., Facione N., Froelicher E.S., Lee K., Miaskowski C., et al. Advancing the science of symptom management. J Adv Nurs 2001, 33:668-676.
10. Larson P.J., Carrieri-Kohlman V., Dodd M.J., Douglas M., Faucett J., Froelicher E., et al. A model for symptom management. Image 1994, 26:272-276.
11. Arslanian-Engoren C. Gender and age differences in nurses' triage decisions using vignette patients. Nurs Res 2001, 50:61-66.
12. Arslanian-Engoren C. Gender and age bias in triage decisions. J Emerg Nurs 2000, 26:117-124.
13. Arslanian-Engoren C. Do emergency nurses' triage decisions predict admission or discharge diagnoses for acute coronary syndromes?. J Cardiovasc Nurs 2004, 19:280-286.
14. Brieger D., Eagle K.A., Goodman S.G., Steg P.G., Budaj A., White K., et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events. Chest 2004, 126:461-469.
15. Vaccarino V., Rathore S.S., Wenger N.K., Frederick P.D., Abramson J.L., Barron H.V., et al. Sex and racial differences in the management of acute myocardial infarction, 1994 through 2002. N Engl J Med 2005, 353:671-682.
16. Arslanian-Engoren C., Patel A., Fang J., Armstrong D., Kline-Rogers E., Duvernoy C.S., et al. Symptoms of men and women presenting with acute coronary syndromes. Am J Cardiol 2006, 98:1177-1181.
17. Dey S., Flather M.D., Devlin G.P., Brieger D., Gurfinkel E.P., Steg P.G., et al. Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes. The Global Registry of Acute Coronary Events. Heart 2009, 95:20-26.
18. Meshack A.F., Goff D.C., Chan W., Ramsey D., Linares A., Reyna R., et al. Comparison of reported symptoms of acute myocardial infarction in Mexican Americans versus non-Hispanic Whites (the Corpus Christi Heart Project). Am J Cardiol 1998, 82:1329-1332.
19. Chen W., Woods S.L., Wilkie D.J., Puntillo K.A. Gender differences in symptom experiences of patients with acute coronary syndromes. J Pain Symptom Manage 2005, 30:553-562.
20. DeVon H.A., Ryan C.J., Ochs A.L., Shapiro M. Symptoms across the continuum of acute coroanry syndromes: differences between men and women. Am J Crit Care 2008, 17:14-24.
21. Milner K.A., Vaccarino V., Arnold A.L., Funk M., Goldberg R.J. Gender and age differences in chief complaints of acute myocardial infarction (Worchester Heart Attack Study). Am J Cardiol 2004, 93:606-608.
22. Everts B., Karlson B.W., Währborg P., Hedner T., Herlitz J. Localization of pain in suspected acute myocardial infarction in relation to final diagnosis, age, and sex, and site and type of infarction. Heart Lung 1996, 25:430-437.
23. Milner K.A., Funk M., Arnold A.L., Vaccarino V. Typical symptoms are predictive of acute coronary syndromes in women. Am Heart J 2002, 143:283-288.
24. Zucker D.R., Griffith J.L., Beshansky J.R., Seller H.P. Presentations of acute myocardial infarction in men and women. J Gen Intern Med 1997, 12:79-87.
25. Herlitz J., Starke M., Hansson E., Ringvall E., Karlson B.W., Waagstein L. Characteristics and outcome among women and men transported by ambulance due to symptoms arousing suspicion of acute coronary syndrome. Med Sci Monit 2002, 8:CR251s-CR256s.
26. Noureddine D., Arevian M., Adra M., Puzantian H. Response to signs and symptoms of acute coronary syndrome: differences between Lebanese men and women. Am J Crit Care 2008, 17:26-35.
27. Løvlien H.L., Schrei B., Hole T. Prehospital delay, contributing aspects and responses to symptoms among Norwegian women and men with first time acute myocardial infarction. Eur J Cardiovasc Nurs 2007, 6:308-313.
28. Omran S., Al-Hassan M. Gender differences in signs and symptoms presentation and treatment of Jordanian myocardial infarction patients. Int J Nurs Pract 2006, 12:198-204.
29. Tunstall-Pedoe H., Morrison C., Woodward M., Fitzpatrick B., Watt G. Sex differences in myocardial infarction and coronary deaths in the Scottish MONICA population of Glasgow 1985 to 1991. Presentation, diagnosis, treatment, and 28-day case fatality of 3991 events in men and 1551 events in women. Circulation 1996, 93:1981-1992.
30. Srichaiveth B., Ruengsakulrach P., Visudharom K., Sanguanwong S., Tangsubutr W., Insamian P. Impact of gender on treatment and clinical outcomes in acute ST elevation myocardial infarction patients in Thailand. J Med Assoc Thai 2007, 90(Suppl 1):65-73.
31. Culić V., Mirić D., Eterović D. Correlation between symptomatology and site of acute myocardial infarction. Int J Cardiol 2001, 77:163-168.
32. Meller S.T., Gebhart G.F. A critical review of the afferent pathways and the potential chemical mediators involved in cardiac pain. Neuroscience 1992, 48:501-524.
33. Brown A.M. Excitation of afferent cardiac sympathetic nerve fibers during myocardial ischaemia. J Physiol (London) 1967, 190:35-53.
34. Foreman R.D. Viscerosomatic convergence onto spinal neurons responding to afferent fibers located in the inferior cardiac nerve. Brain Res 1977, 137:164-168.
35. Abrahamsson H., Thorén P. Vomiting and reflex vagal relaxation of the stomach elicited from heart receptors in the cat. Acta Physiol Scand 1973, 88:433-439.
36. Ammons W.S., Blair R.W., Foremand R.D. Vagal afferent inhibition of spinothalamic cell responses to sympathetic afferents and bradykinin in the monkey. Circ Res 1983, 53:603-612.
37. 5 medial spinothalamic cells. Am J Physiol 1985, 249:R147-R152.
38. Person R.J. Somatic and vagal afferent convergence on solitary tract neurons in cat: electrophysiological characteristics. Neuroscience 1989, 30:283-295.
39. Barron K.W., Bishop V.S. Reflex cardiovascular changes with veratridine in the conscious dog. Am J Physiol 1982, 242:H810-H817.
40. Kositskiǐ G.I., Mikhaǐlova S.D., Semushkina T.M. Unit activity of the ganglion nodosum in myocardial ischemia. Bull Exp Med Biol 1984, 98:1622-1624.
41. Baker D.G., Coleridge H.M., Coleridge J.C., Nerdrum T. Search for a cardiac nociceptor: simulation by bradykinin of sympathetic afferent nerve endings in the heart of the cat. J Physiol (London) 1980, 306:519-536.
42. Adgey A.A., Geddes J.S., Mulholland H.C., Keegan D.A., Pantridge J.F. Incidence, significance and management of bradyarrhythmia complicating acute myocardial infarction. Lancet 1968, 2:1097-1101.
43. Malliani A., Peterson D.F., Bishop V.S., Brown A.M. Spinal sympathetic cardiothoracic reflexes. Circulation Res 1972, 30:158-166.
44. Thames M.D., Klopfenstein H.C., Abboud F.M., Mark A.L., Walker J.L. Preferential distribution of inhibitory cardiac receptors with vagal afferents to the inferoposterior wall of the left ventricle activated during coronary occlusion in the dog. Circ Res 1978, 43:512-519.
45. Brown A.M., Malliani A. Spinal sympathetic reflexes initiated by coronary receptors. J Physiol (London) 1971, 212:675-705.
46. Naerantzis C.E., Papachristos J.C., Gribizi J.E., Voudris V.A., Infantis G.P., Koroxenidis G.T. Functional dominance of the right coronary artery: incidence in the human heart. Clin Anat 1996, 9:10-13.
47. Dodge J.E., Brown B.G., Bolson E.L., Dodge H.T. Intrathoracic spatial location of specified coronary segments of the normal human heart. Circulation 1988, 78:1167-1180.
48. Chaitman B.R., Bourassa M.G., Davis K., Rogers W.J., Tyras D.H., Berger R., et al. Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS). Circulation 1981, 64:360-367.
49. Kyriakidis M., Petropoulakis P., Androulakis A., Antonopoulos A., Apostolopoulos T., Barbetseas J. Sex differences in the anatomy of coronary artery disease. J Clin Epidemiol 1995, 48:723-730.
50. Boucek R.J., Romanelli R., Willis W.H., Mitchell W.A. Sex differences in obstructive coronary artery disease in patients 65 years of age or older with angina pectoris. Circulation 1982, 66:926-929.
51. Darabian S., Amirzadegan A.R., Sadeghian H., Sadeghian S., Abbasi A., Raeesi M. Ostial lesions of left main and right coronary arteries: demographic and angiographic features. Angiology 2008, 59:682-687.
52. Beghi E., Monticelli M.L. Chronic symmetric symptomatic polyneuropathy in the elderly: a field screening investigation of risk factors for polyneuropathy in two Italian communities. Italian General Practitioner Study Group (IGPST). J Clin Epidemiol 1998, 51:697-702.
53. Mold J.W., Vesely S.K., Keyl B.A., Schenk J.B., Roberts M. The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients. J Am Board Fam Pract 2004, 17:309-318.
54. Tesfaye S., Chaturvedi N., Eaton S.E., Ward J.D., Manes C., Ionescu-Tirgoviste C., et al. Vascular risk factors and diabetic neuropathy. N Engl J Med 2005, 352:341-350.
55. Kaye J.M., Corrall R.J., Lightman S.L. A new test for autonomic cardiovascular and neuroendocrine responses in diabetes mellitus: evidence for early vagal dysfunction. Diabetologia 2005, 48:180-186.
56. Leopold C., Schandry R. The heartbeat-evoked brain potential in patients suffering from diabetic neuropathy and in healthy control persons. Clin Neurophysiol 2001, 112:674-682.
57. Marchant B., Umachandran V., Stevenson R., Kopelman P.G., Timmis A.D. Silent myocardial ischemia: role of subclinical neuropathy in patients with and without diabetes. J Am Coll Cardiol 1993, 22:1433-1437.
58. Bierhaus A., Haslbeck K.M., Humpert P.M., Liliensiek B., Dehmer T., Morcos M., et al. Loss of pain perception in diabetes is dependent on a receptor of the immunoglobulin superfamily. J Clin Invest 2004, 114:1741-1751.
59. DeVon H.A., Penckofer S.M., Zerwic J.J. Symptoms of unstable angina in patients with and without diabetes. Res Nurs Health 2005, 28:136-143.
60. Hikita H., Kurita A., Takase B., Nagayoshi H., Uehata A., Nishioka T., et al. Usefulness of plasma beta-endorphin level, pain threshold and autonomic function in assessing silent myocardial ischemia in patients with and without diabetes mellitus. Am J Cardiol 1993, 72:140-143.
61. Douglas H., Kitchen I. Mechanisms involved in the cardiovascular responses to opioid products of proenkephalin in the anaesthetised rat. Gen Pharmacol 1992, 23:269-277.
62. 2]-methionine enkephalinamind (DALA) in the rat. Pharmacol Biochem Behav 1988, 30:65-72.
63. Craft R.M., McNiel D.M. Agonist/antagonist properties of nalbuphine, butorphanol and (-)-pentazocine in males vs. female rats. Pharmacol Biochem Behav 2003, 75:235-245.
64. al'Absi M., Wittmers L.E., Ellestad D., Nordehn G., Kim S.W., Kirschbaum C., et al. Sex differences in pain and hypothalamic-pituitary-adrenocortical responses to opoid blockade. Psychosom Med 2004, 66:198-206.
65. Akhan S.E., Gürel T., Has R., Iyibozkurt A.C., Turfanda A. Effects of long-term oral hormone replacement therapy on plasma nitric oxide and beta-endorphin levels in postmenopausal women. Gynecol Obstet Invest 2002, 54:196-200.
66. Fillingim R.B., Maixner W., Girdler S.S., Light K.C., Harris M.B., Sheps D.S., et al. Ischemic but not thermal pain sensitivity varies across the menstrual cycle. Psychosom Med 1997, 59:512-520.
67. Sadigh B., Berglund M., Fillingim R.B., Sheps D., Sylvén C. Beta-endorphin modulates adenosine provoked chest pain in men, but not in women-a comparison between patients with ischemic heart disease and healthy volunteers. Clin J Pain 2007, 23:750-755.
68. Krzanowska E.K., Ogawa S., Pfaff D.W., Bodnar R.J. Reversal of sex differences in morphine analgesia elicited from the ventrolateral periaqueductal gray in rats by neonatal hormone manipulations. Brain Research 2002, 929:1-9.
69. Robinson M.E., Riley J.L., Myers C.D., Papas R.K., Wise E.A., Waxenberg L.B., et al. Gender role expectations of pain: relationship to sex differences in pain. J Pain 2001, 2:251-257.
70. Andrews P.L.R. Towards an understanding of the mechanism of PONV. The effective management of postoperative nausea and vomiting 1999, 13-30. Aesculapius Medical Press, London. L. Strunin, D. Rowbotham, A. Miles (Eds.).
71. Hesketh P.J. Chemotherapy-induced nausea and vomiting. N Engl J Med 2008, 358:2482-2494.
72. Fukuda H., Koga T. Non-respiratory neurons in the Bötzinger complex exhibiting appropriate firing patterns to generate the emetic act in dogs. Neurosci Res 1992, 14:180-194.
73. Koga T., Fukuda H. Neurons in the nucleus of the solitary tract mediating inputs from emetic vagal afferents and the area postrema to the pattern generator for the emetic act in dogs. Neurosci Res 1992, 14:166-179.
74. Fillingim R.B., Ness T.J., Glover T.L., Campbell C.M., Hastie B.A., Price D.D., et al. Morphine responses and experimental pain: sex differences in side effects and cardiovascular responses but not analgesia. J Pain 2005, 6:116-124.
75. Stadler M., Bardiau F., Seidel L., Albert A., Boogaerts J.G. Difference in risk factors for postoperative nausea and vomiting. Anesthesiology 2003, 98:46-52.
76. Zun L.S., Downey L.V., Gossman W., Rosenbaumdagger J., Sussman G. Gender differences in narcotic-induced emesis in the ED. Am J Emerg Med 2002, 20:151-154.
77. Zacny J.P. Morphine responses in humans: a retrospective analysis of sex differences. Drug Alcohol Depend 2001, 63:23-28.
78. Fabling J.M., Gan T.J., Guy J., Borel C.O., el-Moalem H.E., Warner D.S. Postoperative nausea and vomiting: a retrospective analysis in patients undergoing elective craniotomy. J Neurosurg Anesthesiol 1997, 9:308-312.
79. Myles P.S., Hunt J.O., Moloney J.T. Postoperative "minor" complications: comparison between men and women. Anaesthesia 1997, 52:300-306.
80. Myles P.S., McLeod A.D., Hunt J.O., Fletcher H. Sex differences in speed of emergence and quality of recovery after anaesthesia: cohort study. Br Med J [Clin Res] 2001, 322:710-711.
81. Cepeda M.S., Farrar J.T., Baumgarten M., Boston R., Carr D.B., Strom B.L. Side effects of opioids during short-term administration: effect of age, gender, and race. Clin Pharmacol Ther 2003, 74:102-112.
82. Edstein M.D., Nasveld P.E., Kocisko D.A., Kitchener S.J., Gatton M.L., Rieckmann K.H. Gender differences in gastrointestinal disturbances and plasma concentrations of tafenoquine in healthy volunteers after tafenoquine administration for post-exposure vivax malaria prophylaxis. Trans R Soc Trop Med Hyg 2007, 101:226-230.
83. Klosterhalfen S., Kellermann S., Pan F., Stockhorst U., Hall G., Enck P. Effects of ethnicity and gender on motion sickness susceptibility. Aviat Space Environ Med 2005, 76:1051-1057.
84. Ladwig K.H., Marten-Mittag B., Formanek B., Dammann G. Gender differences of symptom reporting and medical health care utilization in the German population. Eur J Epidemiol 2000, 16:511-518.
85. Abramhamsson H., Thoren P. Reflex relaxation of the stomach elicited from receptors located in the heart. An analysis of the receptors and afferents involved. Acta Physiol Scand 1972, 84:197-207.
86. Nyman M.J., Eskola O., Kajander J., Vahlberg T., Sanabria S., Burns D., et al. Gender and age affect NK1 receptors in the human brain-a positron emission tomography study with [18F] SPA-RQ. Int J Neuropsychopharmacol 2006, 10:219-229.
87. Elliott J.C., Wagner A.F., Lysle D.T. Neurokinin 1 receptor signaling mediates sex differences in mu and kappa opioid-induced enhancement of contact hypersensitivity. J Neuroimmunol 2006, 18:100-105.
88. Oh E.J., Thompson L.P., Weinreich D. Sexually dimorphic regulation of NK-1 receptor-mediated electrophysiological responses in vagal primary afferent neurons. J Neurophysiol 2000, 84:51-56.
89. Khasar S.G., Green P.G., Gear R.W., Isenberg W., Levine J.D. Gonadal hormones do not account for sexual dimorphism in vagal modulation of nociception in the rat. J Pain 2003, 4:190-196.
90. Khasar S.G., Dina O.A., Green P.G., Levine J.D. Estrogen regulates adrenal medullary function producing sexual dimorphism in nociceptive threshold and beta-adrenergic receptor-mediated hyperalgesia in the rat. Eur J Neurosci 2005, 21:3379-3386.