Title: age, gender, pain, and MI outcome
题目：年龄，性别，疼痛，和心肌梗塞的预后
Author 作者: Amal Mattu

A recent study in JAMA has provided further evidence regarding some key issues in ACS/MI presentations which seem to be commonly taught but often forgotten in actual practice.
最近在美国医学协会杂志（JAMA）发表的文章，对于我们通常学到的但在实践中经常被忽略的与急性冠状动脉综合症（ACS）／心肌梗塞（MI）临床表现相关的几个关键问题，提供了证据。
Here's just a few of the key findings from this study:
这是几个这篇文章中涉及的几个关键问题：
1. Generally speaking, women were more likely to present without chest pain than men, and the difference between the sexes was most apparent in the < 45yo groups. Overall, 42% of women presented with painless MIs. [remember from a recent prior cardiology pearl that painless MIs have a higher mortality as well]

一般来讲，与男性病人比，更多的女性会没有心绞痛，之间的差别在45岁以内最明显。42％的女性会出现无痛性心肌梗塞。（记住，我们的另外一个必知谈到，无痛性心肌梗塞的死亡率较高。）
2. Women had a higher mortality than men within the same age groups, and the difference between the sexes was most apparent in younger ages.
同样年纪的女性病人死亡率要比男性高，越年轻差别越明显。
3. Almost 1/5 of women < 45 yo with MI did not report chest pain. [We've always assumed it's just the older women that present with painless MIs....not true!]


1/5的45岁以内的女性心肌梗塞病人没有心绞痛。（以前我们总认为只有老年女性才会有无痛性心肌梗塞。。。是不正确的！）
A final point that should be re-stated: young women DO have MIs, they DO often present without pain, and they DO often die. Be wary.
最后，再次重申：年轻女性也会患心肌梗塞，她们经常会无痛，她们有较高的死亡率。要谨慎！

References 参考文献
Canto JG, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012;307:813-822.