Recognizing and Treating Heart Attacks in Transgender Populations

Recognizing and Treating Heart Attacks in Transgender Populations
Time is muscle. That is the motto when dealing with potential heart attacks. This means we want to quickly recognize the potential signs of a heart attack and get the patient diagnosed and treated as soon as possible.

The symptoms of a heart attack vary between men and women. While most are familiar with this fact, it is essential to remember when treating patients who don’t always present with their biological gender. While we want to recognize and respect their personal choices, when assessing someone for healthcare issues, one question we must ask is their gender assigned at birth. This will allow us to recognize symptoms that aren’t presenting aligned with their gender identity, which could lead to loss of muscle and delayed treatment.

Male Heart Attack Presentation	Female Heart Attack Presentation
Chest Pain	Nausea and Vomiting
Left Arm Pain	Shortness of breath
Shortness of breath	General Upper body pain
General Upper body pain	General upper body pain

Someone in the US has a heart attack every 40 seconds. In addition, the transgender population faces several barriers, as identified by the Mayo Clinic:

• 19% are uninsured
• 19% have been refused care due to their gender non-conforming status creating a lack of trust
• 28% have postponed necessary medical care due to discrimination by medical providers
• 50% reported teaching their medical providers about transgender care.

This is a significant barrier to timely treatment and effective management of cardiovascular issues. It is crucial when patients present for treatment that you assess both their current gender presentation and preferences, their symptoms, and their gender assigned at birth to ensure you are not missing signs that could be indicative of a heart attack. Don’t be afraid to ask. In numerous sources and interviews with transgender individuals, they would prefer a caring conversation aimed at providing them the best care possible, which creates trust, then have a careful discussion that leads to misinterpretation of data and failure to treat appropriately.

References:
Heart Attack Facts, Signs and Symptoms and Resources available at www.heart.org. Warning Signs of a Heart Attack | American Heart Association

Transforming cardiovascular treatment for the transgender population. (2021). Mayo Clinic. Retrieved February 7, 2023, from Transforming cardiovascular therapy for the transgender population – Mayo Clinic