Published online before print November 3, 2003, doi: 10.1161/01.CIR.0000097116.29625.7C
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(Circulation. 2003;108:2619.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Women’s Early Warning Symptoms of Acute Myocardial Infarction
From the College of Nursing (J.C.M.), College of Medicine (M.C.), and Office of Educational Development (P.O.), University of Arkansas for Medical Sciences, Little Rock; East Carolina University, Greenville, NC (K.E.); University of Kentucky, Lexington (D.K.M.); and School of Nursing, Ohio State University, Columbus (B.J.G.).
Correspondence to Jean C. McSweeney, College of Nursing, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot 529, Little Rock, AR 72205. E-mail jcmcsweeney{at}uams.edu
Received May 16, 2003; revision received August 25, 2003; accepted August 26, 2003.
Background— Data remain sparse on women’s prodromal symptoms before acute myocardial infarction (AMI). This study describes prodromal and AMI symptoms in women.
Methods and Results— Participants were 515 women diagnosed with AMI from 5 sites. Using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, we surveyed them 4 to 6 months after discharge, asking about symptoms, comorbidities, and demographic characteristics. Women were predominantly white (93%), high school educated (54.8%), and older (mean age, 66±12), with 95% (n=489) reporting prodromal symptoms. The most frequent prodromal symptoms experienced more than 1 month before AMI were unusual fatigue (70.7%), sleep disturbance (47.8%), and shortness of breath (42.1%). Only 29.7% reported chest discomfort, a hallmark symptom in men. The most frequent acute symptoms were shortness of breath (57.9%), weakness (54.8%), and fatigue (42.9%). Acute chest pain was absent in 43%. Women had more acute (mean, 7.3±4.8; range, 0 to 29) than prodromal (mean, 5.71±4.36; range, 0 to 25) symptoms. The average prodromal score, symptom weighted by frequency and intensity, was 58.5±52.7, whereas the average acute score, symptom weighted by intensity, was 16.5±12.1. These 2 scores were correlated (r=0.61, P<0.001). Women with more prodromal symptoms experienced more acute symptoms. After controlling for risk factors, prodromal scores accounted for 33.2% of acute symptomatology.
Conclusions— Most women have prodromal symptoms before AMI. It remains unknown whether prodromal symptoms are predictive of future events.
Key Words: angina • myocardial infarction • women
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