Abstract 14813: Knowing and Going: the Perfect Combination for Women Experiencing Symptoms of Acute Coronary Syndrome
Background: Most studies show that women with symptoms of acute coronary syndrome (ACS) delay seeking care longer than men. A major issue for women is that they are more likely to experience atypical symptoms, to experience symptoms that do not match their expectations, and to attribute symptoms to a non-cardiac cause. Moreover, women are more likely than men to keep symptoms to themselves and to minimize symptoms until they become incapacitating because of competing obligations.
Purpose: This study built on the author’s prior research with prehospital delay to refine a conceptual model which explained how women recognize, interpret, and act on symptoms of ACS.
Methods: This qualitative study used in-depth semi-structured interviews with 18 women diagnosed with ACS to confirm variations in how women recognized, interpreted, and acted on symptoms. An interview guide developed from the initial research was used to provide structure for the process.
Results: All 18 women interviewed went through a process of recognizing, interpreting, and acting on their symptoms. Eight women had symptoms arise abruptly; two more had symptoms start slowly, converting unexpectedly to more acute symptoms. All 10 women with acute symptoms labeled the event as serious, often as cardiac in origin. However, despite labeling symptoms as serious, 4 of the 10 women delayed telling others about symptoms and/or avoided moving towards care due to the competing obligations. For the 8 remaining women with evolving symptoms, half were unable to form a symptom pattern, resulting in incorrect symptom interpretation. In all 4 cases, the women did not discuss symptoms with others and continued with activities until symptoms became incapacitating.
Conclusion: Interventions aimed towards enabling women to recognize bodily cues, to form a coherent symptom pattern, and to correctly interpret symptoms more efficiently are needed, especially for those with less discrete symptoms. However, accurate symptom recognition and interpretation only partially addresses prehospital delay. Interventions should also target counseling women about the importance of notifying others earlier about symptoms and prioritizing care-seeking over ongoing responsibilities deemed important to their identity.
Author Disclosures: L.L. Davis: Research Grant; Modest; partially supported by P20MD002289 grant from the National Institute for Minority Health and Health Disparities/National Institutes of Health. Other Research Support; Modest; New Faculty Grant UNCG.
- © 2014 by American Heart Association, Inc.