Symptoms Suggestive of Acute Coronary Syndrome

DeVon, Holli A.; Burke, Larisa A.; Vuckovic, Karen M.; Haugland, Trude; Eckhardt, Ann L.; Patmon, Frances; Rosenfeld, Anne G.

doi:10.1097/jcn.0000000000000351

Cited by 33 publications

(31 citation statements)

References 50 publications

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“…Patients with ACS experience a variety of symptoms on the onset of the coronary event (Canto, Goldberg, & Sopko, 2012a). Although chest pain or discomfort are the most common symptoms of ACS, patients experience a wide variety of other symptoms, such as fatigue, shortness of breath, nausea, or back pain (DeVon et al, 2017;Wikman et al, 2012) and these symptoms are linked to clinical outcomes, such as the mortality rate or quality of life (El-Menyar et al, 2011;Spertus et al, 2004). Most studies have focused on the symptoms among patients with ACS during acute cardiac events and symptom differences according to age and sex (Canto et al, 2012b;DeVon et al, 2017;Fennessy et al, 2010;Rosenfeld et al, 2015).…”

Section: Factors That Influence Health-related Quality Of Life In Patmentioning

confidence: 99%

Determinants of health‐related quality of life among outpatients with acute coronary artery disease after percutaneous coronary intervention

Kim

Kang

et al. 2018

Japan Journal Nursing Sci

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This study proposes a comprehensive approach to health care that incorporates symptom experience, as well as the physiological, psychological, and situational aspects based on the theory of unpleasant symptoms, to improve the HRQoL among outpatients with ACS. Nurses should play a key role to help patients with ACS to deal with the symptoms, low-density lipoprotein cholesterol, and depression and to promote social support, particularly in less-educated patients, in order to improve their HRQoL.

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Section: Factors That Influence Health-related Quality Of Life In Patmentioning

confidence: 99%

Determinants of health‐related quality of life among outpatients with acute coronary artery disease after percutaneous coronary intervention

Kim

Kang

et al. 2018

Japan Journal Nursing Sci

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“…9 Furthermore, findings from a multicenter study of 1064 patients admitted to the emergency department for symptoms suggestive of ACS revealed that women with ACS were less likely than men to report chest pain as their chief complaint. 10 Studies have also shown that women are more likely to report a greater number of symptoms and more diverse symptoms at presentation. 9–16 In fact women are more likely than men to have back/neck/jaw or arm pain, shortness of breath, cough, or paroxysmal nocturnal dyspnea, nausea/vomiting/indigestion or lack of appetite, weakness, fatigue, dizziness, syncope, palpitations, and/or a sense of dread with their ACS event.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study of Symptom Experiences of Women With Acute Coronary Syndrome

Davis

2017

J Cardiovasc Nurs

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Background Most studies show that women with symptoms of acute coronary syndrome (ACS) delay seeking care longer than men. Contributing factors include that women are more likely to experience diverse symptoms, to experience symptoms that do not match pre-existing symptom expectations, to interpret symptoms as non-cardiac, and to minimize symptoms until they become incapacitating. Objective The aim of the study was to identify factors influencing women’s ability to recognize and accurately interpret symptoms of suspected ACS. Methods This qualitative study used in-depth interviews with 18 women diagnosed with ACS to determine how they recognized, interpreted, and acted on symptoms. An interview guide developed from the author’s initial research was used to provide structure for the process. Results All of the women went through a process of recognizing and interpreting their symptoms. Eight women had symptoms arise abruptly. Most of these women recognized a change immediately, “knew” to go for treatment, and did so quickly. Three women had vague symptoms which started slowly, converting unexpectedly to intense symptoms prompting them to seek care urgently. The remaining seven women had evolving symptoms, were more likely to interpret symptoms as unrelated to their heart, and avoided disclosing symptoms to others. Despite recognizing the situation may be serious, women with evolving symptoms adopted a wait-and-see approach. Conclusion Women with less severe, intermittent, or evolving symptoms are at an increased risk of delayed presentation, diagnosis, and treatment for ACS. These women should be targeted for educational and behavioral interventions.

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“…11 The investigation conforms with the principles outlined in the Declaration of Helsinki. 12 The Institutional Review Board (IRB) from the sponsoring institution and each clinical data collection site gave approval for the study prior to launch.…”

Section: Methodsmentioning

confidence: 96%

Impact of comorbidities by age on symptom presentation for suspected acute coronary syndromes in the emergency department

Burke

Rosenfeld

Daya

et al. 2017

European Journal of Cardiovascular Nursing

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Background It is estimated half of acute coronary syndrome (ACS) patients have one or more associated comorbid conditions. Aims Aims were to: 1) examine the prevalence of comorbid conditions in patients presenting to the emergency department with symptoms suggestive of ACS; 2) determine if comorbid conditions influence ACS symptoms; and 3) determine if comorbid conditions predict the likelihood of receiving an ACS diagnosis. Methods A total of 1064 patients admitted to five emergency departments were enrolled in this prospective study. Symptoms were measured on presentation to the emergency department. The Charlson Comorbidity Index (CCI) was used to evaluate group differences in comorbidity burden across demographic traits, risk factors, clinical presentation, and diagnosis. Results The most prominent comorbid conditions were prior myocardial infarction, diabetes without target organ damage, and chronic lung disease. In younger ACS patients, higher CCI predicted less chest pain, chest discomfort, unusual fatigue and a lower number of symptoms. In older ACS patients, higher CCI predicted more chest discomfort, upper back pain, abrupt symptom onset, and greater symptom distress. For younger non-ACS patients, higher CCI predicted less chest pain and symptom distress. Higher CCI was associated with a greater likelihood of receiving an ACS diagnosis for younger but not older patients with suspected ACS. Conclusions Younger patients with ACS and higher number of comorbidities report less chest pain, putting them at higher risk for delayed diagnosis and treatment since chest pain is a hallmark symptom for ACS.

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Symptoms Suggestive of Acute Coronary Syndrome

Abstract: Women and men evaluated for ACS reported similar rates of chest pain but differed on other classic symptoms. These findings suggest that women and men should be counseled that ACS is not always accompanied by chest pain and multiple symptoms may occur simultaneously.

Cited by 33 publications

References 50 publications

Determinants of health‐related quality of life among outpatients with acute coronary artery disease after percutaneous coronary intervention

Determinants of health‐related quality of life among outpatients with acute coronary artery disease after percutaneous coronary intervention

A Qualitative Study of Symptom Experiences of Women With Acute Coronary Syndrome

Impact of comorbidities by age on symptom presentation for suspected acute coronary syndromes in the emergency department

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