Using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey to Predict the Occurrence of Short-Term Coronary Heart Disease Events in Women

Abstract

Background Few instruments capture symptoms that predict cardiac events in the short-term. Aims To examine the ability of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey to predict acute cardiac events within three months of administration and to identify the prodromal symptoms most associated with short-term risk in women without known coronary heart disease. Methods The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey was administered to 1097 women referred to a cardiologist for initial coronary heart disease evaluation. Logistic regression models were used to examine prodromal symptoms individually and in combination to identify the subset of symptoms most predictive of an event within three months. Results Fifty-one women had an early cardiac event. In bivariate analyses, four of 30 prodromal symptoms were significantly associated with event occurrence within 90 days. In adjusted analyses, women reporting arm pain/discomfort and unusual fatigue were more likely (OR=4.67; 95% CI=2.08, 10.48) to have a cardiac event than women reporting neither. Conclusions The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey may assist in predicting short-term coronary heart disease events in women without known coronary heart disease.

“Heart disease never entered my head”: Women's understanding of coronary heart disease risk factors

“…This raises the question about awareness and how the message needs to be communicated to women. Symptom awareness is an essential precursor to early interventions that can either prevent or delay progression of CHD (McSweeney et al., ). Mosca et al.…”

“…'s () longitudinal cohort study to gage the assessment of measuring prodromal symptoms using the “McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey” (MAPMISS) demonstrated the myriad of symptom presentation. The MAPMISS was judged as a valid and reliable tool for predicting coronary events in women, and in further tests, the instrument detected critical prodromal symptoms before the occurrence of a CHD event (McSweeney et al., ).…”

“…() suggest that this can contribute to greater disability and mortality for women after a CHD event. It is vital to that women who experience nonchest pain symptoms that are associated with risk of progressing to an ACS event undergo appropriate diagnostic testing (McSweeney et al., ).…”

“…While chest pain is the most common symptom of CHD in both women and men, women are more likely to have atypical or prodromal symptoms such as nausea, diaphoresis, fatigue and arm or back pain and as a result women may be less likely than men to seek prompt treatment (Lichtman et al., ; McSweeney et al., ). Kuhn, Page, and Worrall‐carter () reported women's tendency to experience atypical ACS symptoms, such as unusual fatigue, dyspnoea, dizziness, cold sweats, nausea, weakness and indigestion.…”

A qualitative exploration of prodromal myocardial infarction fatigue experienced by women

“…In the future, fatigue, or one or more subdimensions of fatigue, may be included in cardiovascular risk stratification instruments to assist clinicians in clinical decision-making. Indeed, prodromal MI symptoms as a whole have already been shown to be predictive of cardiovascular events (McSweeney et al, 2014;McSweeney, Cleves, Fischer, Pettey, & Beasley, 2017).…”