Do You Know Them When You See Them? Women's Prodromal and Acute Symptoms of Myocardial Infarction

Abstract

This study described women's prodromal and acute symptoms associated with myocardial infarction (MI) based on interviews with 76 women who had experienced an MI in the previous year. Sixty-eight women experienced prodromal symptoms including unusual fatigue (70%), shortness of breath (53%), and pain in the shoulder blade/upper back (47%). All women experienced acute symptoms including chest pain/discomfort (90%), unusual fatigue (59%), shortness of breath (59%), and shoulder blade/upper back discomfort (42%). Although women in this study reported numerous prodromal symptoms, none had received a new diagnosis of coronary heart disease (CHD) prior to MI. Practitioners must develop an awareness of and a more comprehensive approach to treating women at risk for CHD. Further research to elucidate prodromal and acute symptom clusters is needed to assist practitioners in early diagnosis of CHD in women.

Ischemic heart disease in women

“…It is precisely this lack of knowledge about CVRF that enhances low levels of risk perception in society in general and women in particular (5,(13)(14) ; to the extent that, despite high IHD mortality rates, news on these diseases are not the center of media attention (15) . Health professionals themselves face difficulties for correct AMI (Acute myocardial infarction) diagnosing in women or to identify its symptoms (11) .…”

“…Health professionals themselves face difficulties for correct AMI (Acute myocardial infarction) diagnosing in women or to identify its symptoms (11) . In addition, another aspect is that, traditionally, women have played an anecdotic role in research on IHD (14) ; and women start to be included in this type of studies as from the 1990's, which is why knowledge in this respect is relatively scarce.…”

“…of women who experience an AMI did not previously acknowledge the symptoms (14,16) . The consulted literature is rather uniform with regard to the symptoms women tend to experience more frequently during an AMI, despite differences among the distinct studies.…”

“…Women usually refer prodromal symptoms like migraine, shoulder problems and even temporary blindness episodes; nevertheless, the most frequent symptom is fatigue, which starts between 2-4 weeks before the AMI and continues after the acute episode (14) .…”

“…When women decide to seek specialized help, they indicate difficulties in the diagnostic process, and on many occasions are not taken seriously (24)(25) . They tend to be treated with anxiolytics or antidepressants, as care professionals mistakenly identify the symptoms they refer with anxious-depressive disorders (14) .…”