Acute coronary syndrome in women from the theory of symptom management
Abstract
Objective: To identify the risk factors for cardiovascular disease and the experience of the symptom of Acute Coronary Syndrome (ACS) in women, according to the theory of Symptom Management.
Method: Observational cross-sectional study, 81 women with ACS attended at a University Hospital in Colombia participated. Sociodemographic variables, risk factors for cardiovascular disease, response actions to symptoms and perception, evaluation and response to symptoms were analyzed through the instrument application on the Experience of the Symptom in Women with ACS.
Results: Of participants 80% were over 60 years old, the majority with a low level of education and urban residence. The main risk factor was hypertension and more than 50% of them reported sedentary lifestyle, dyslipidemia, and an unhealthy diet. Women presented an average of 10 atypical symptoms for each event, highlighting chest pain or discomfort in 85%. 66.3% defined the origin of the symptom as an extra-cardiac conditions and 4 out of 10 patients considered the manifestations as insignificant. 16% of the participants took home remedies and 25% of them waited the symptoms to improve without request professional attention. The relationship between time in attending medical consultation and ignoring the symptoms presents statistical significance (p = 0.000).
Conclusions: Women with ACS presented a variety of symptoms, do not perceive the severity of its manifestations, and generally respond late to symptoms, a relevant factor for timely care and treatment.
Downloads
References
Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, et al. Acute Myocardial Infarction in Women : A Scientific Statement from the American Heart Association. Vol. 133, Circulation. Lippincott Williams and Wilkins; 2016. p. 916–47.
Wang H, Naghavi M, Allen C, Barber RM, Carter A, Casey DC, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1459–544.
Organizacion Mundial de la Salud. OMS | Enfermedades no transmisibles [Internet]. Who. 2015 [cited 2019 Jul 18]. p. Notas Descriptivas. Available from: https://www.who.int/es/news-room/fact-sheets/detail/noncommunicable-diseases
World Health Congress of Cardiology and Cardiovascular. El costo de las enfermedades cardiacas en América Latina. In: El costo de las enfermedades cardiacas en América Latina. Mexico City; 2016. p. 3.
Social M de S. Análisis de Situación de Salud. Colombia, 2017 [Internet]. Imprenta Nacional de Colombia. 2018 [cited 2020 Mar 29]. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-nacional-2017.pdf
Lobos Bejarano JM, Brotons Cuixart C. Factores de riesgo cardiovascular y atención primaria: evaluación e intervención. Aten Primaria. 2011 Dec 1;43(12):668–77.
Rhee E-J. Prevalence and Current Management of Cardiovascular Risk Factors in Korean Adults Based on Fact Sheets. Endocrinol Metab [Internet]. 2020 Mar 1 [cited 2020 Mar 28];35(1):85. Available from: https://synapse.koreamed.org/DOIx.php?id=10.3803/EnM.2020.35.1.85
Murphy E. Estrogen signaling and cardiovascular disease. Vol. 109, Circulation Research. NIH Public Access; 2011. p. 687–96.
Kane AE, Howlett SE. Differences in cardiovascular aging in men and women. In: Advances in Experimental Medicine and Biology. Springer New York LLC; 2018. p. 389–411.
López Martínez T, Prieto García E, de Dios del Valle R. MUJERES Y HOMBRES FRENTE AL SÍNDROME CORONARIO AGUDO. Enfermería en Cardiol. 2012;57(57):33–9.
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, et al. Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction. Circulation [Internet]. 2018 Feb 20 [cited 2019 Jan 2];137(8):781–90. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.031650
Björck L, Nielsen S, Jernberg T, Zverkova-Sandström T, Giang KW, Rosengren A. Absence of chest pain and long-term mortality in patients with acute myocardial infarction. Open Hear. 2018 Nov 1;5(2).
Bernal Cárdenas CY, Céspedes-Cuevas VM, Sanhueza-Alvarado OI. Modelo conceptual del manejo del síntoma: evaluación y crítica. Aquichan [Internet]. 2018 [cited 2020 Mar 25];18(3):311–26. Available from: https://aquichan.unisabana.edu.co/index.php/aquichan/article/view/8574/4846
Céspedes Cuevas VM. Atypical nature of coronary artery disease in women: a proposal for measurement and classification. Av en Enfermería [Internet]. 2015 Aug 5 [cited 2020 Mar 26];33(1):10–8. Available from: https://revistas.unal.edu.co/index.php/avenferm/article/view/47855
Olivencia Peña L, Bueno Cavanillas A, Soto Blanco JM, Yuste Ossorio ME, Barranco Ruiz F. Síndrome coronario agudo en la mujer. Diferencias de género. Med Clin (Barc) [Internet]. 2011 Nov [cited 2018 Oct 10];137(14):623–30. Available from: http://linkinghub.elsevier.com/retrieve/pii/S002577531100830X
Noureddine S, 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 [Internet]. 2008 Jan 1 [cited 2019 Jan 3];17(1):26–35. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18158386
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2015 update : A report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29–39.
Yusuf PS, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet [Internet]. 2004 Sep [cited 2018 Dec 30];364(9438):937–52. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673604170189
Reynolds HR, Shaw LJ, Min JK. Association of Sex With Severity of Coronary Artery Disease , Ischemia , and Symptom Burden in Patients With Moderate or Severe Ischemia Secondary Analysis of the ISCHEMIA Randomized Clinical Trial. JAMA cardiol. 2020;
Saldarriaga CI, Franco G, Garzón AM, García I, Mejía N, Restrepo A. Factores de riesgo para la enfermedad coronaria temprana en mujeres. Biomédica [Internet]. 2010 Mar 3 [cited 2018 Dec 30];30(4):559–66. Available from: http://www.revistabiomedica.org/index.php/biomedica/article/view/294
Parvand M, Rayner-Hartley E, Sedlak T. Recent Developments in Sex-Related Differences in Presentation, Prognosis, and Management of Coronary Artery Disease. Can J Cardiol. 2018;34(4):390–9.
Isiadinso I, Shaw LJ. Diagnosis and risk stratification of women with stable ischemic heart disease. J Nucl Cardiol. 2016;23(5):986–90.
Kirchberger I, Heier M, Golüke H, Kuch B, Von Scheidt W, Peters A, et al. Mismatch of presenting symptoms at first and recurrent acute myocardial infarction. from the MONICA/KORA Myocardial Infarction Registry. Eur J Prev Cardiol [Internet]. 2016 Mar 20 [cited 2019 Jan 2];23(4):377–84. Available from: http://journals.sagepub.com/doi/10.1177/2047487315588071
Smith R, Frazer K, Hyde A, O’Connor L, Davidson P. “Heart disease never entered my head”: Women’s understanding of coronary heart disease risk factors. J Clin Nurs. 2018;27(21–22):3953–67.
Lichtman JH, Leifheit EC, Safdar B, Bao H, Krumholz HM, Lorenze NP, et al. Sex Differences in the Presentation and Perception of Symptoms Among Young Patients With Myocardial Infarction. Circulation [Internet]. 2018 Feb 20 [cited 2019 Jan 3];137(8):781–90. Available from: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.031650
An L, Li W, Shi H, Zhou X, Liu X, Wang H, et al. Gender difference of symptoms of acute coronary syndrome among Chinese patients: a cross-sectional study. Eur J Cardiovasc Nurs [Internet]. 2018 Dec 17 [cited 2019 Jan 2];147451511882048. Available from: http://journals.sagepub.com/doi/10.1177/1474515118820485
Løvlien M, Schei 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 [Internet]. 2007 Dec 23 [cited 2018 Dec 30];6(4):308–13. Available from: http://journals.sagepub.com/doi/10.1016/j.ejcnurse.2007.03.002
Bjørnnes AK, Parry M, Leegaard M, Ayala AP, Lenton E, Harvey P, et al. Self-Management of Cardiac Pain in Women: A Meta-Summary of the Qualitative Literature. Qual Health Res. 2018;28(11):1769–87.
Padilla García CI, Sáenz Montoya X. Respuestas de la mujer frente a los síntomas de Síndrome Coronario Agudo basados en el Modelo Conceptual del Manejo de los Síntomas. Av en Enfermería. 2014;32(1):102–13.
Soto MA. Factores que intervienen en la demora de la solicitud de atención médica o de enfermería en mujeres que presentan dolor torácico de origen coronario. Av enferm [Internet]. 2007 [cited 2020 Apr 2];25(2):58–64. Available from: https://www.researchgate.net/publication/282315871_Factores_que_intervienen_en_la_demora_de_la_solicitud_de_atencion_medica_o_de_enfermeria_en_mujeres_que_presentan_dolor_toracico_de_origen_coronario
Sarı İ, Acar Z, Özer O, Erer B, Tekbaş E, Üçer E, et al. Factors associated with prolonged prehospital delay in patients with acute myocardial infarction Akut miyokard infarktüslü hastalarda hastaneye geç geliş ile ilişkili faktörler [Internet]. Vol. 36, Türk Kardiyol Dern Arş-Arch Turk Soc Cardiol. 2008 [cited 2019 Jan 3]. Available from: https://www.journalagent.com/tkd/pdfs/TKDA_36_3_156_162.pdf
Lichtman JH, Leifheit-Limson EC, Watanabe E, Allen NB, Garavalia B, Garavalia LS, et al. Symptom recognition and healthcare experiences of young women with acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2015;8:S31–8.
McSweeney JC, Cleves MA, Fischer EP, Pettey CM, Beasley B. Using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey to Predict the Occurrence of Short-Term Coronary Heart Disease Events in Women. Women’s Heal Issues. 2017;27(6):660–5.
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
