Comparison of reported symptoms of acute myocardial infarction in Mexican Americans versus non-Hispanic whites (the Corpus Christi heart project)

Meshack, Angela; Goff, David C.; Chan, Wenyaw; Ramsey, David J.; Linares, Adriana; Reyna, Roy; Pandey, Dilip K.

doi:10.1016/s0002-9149(98)00636-5

Cited by 58 publications

(52 citation statements)

References 9 publications

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“…In line with the findings of Meshak, et al [3] who reported sex difference in presenting symptoms, we found that male patients had jaw pain and sweating more commonly than females. Women were more likely to describe experiencing fatigue, dyspnea, dizziness, upper back pain, palpitations and cough.…”

Section: Discussionsupporting

confidence: 92%

“…These differences emphasize the need to provide clearcut information for primary physicians and clinical cardiologists with better tools to facilitate early diagnosis and appropriate triage for further testing or urgent hospitalization. We took special note of the importance of atypical symptoms: in addition to classical symptoms, [3] which are often nonspecific. The current work also emphasizes the importance of less common yet more specific symptoms for CHD, such as jaw pain 11% and dyspnea 10%, and combinations of symptoms, such as chest pain + jaw pain 7% and dyspnea + sweating 3%.…”

Section: Discussionmentioning

confidence: 99%

“…In the Corpus Christi Heart Project [3], that compared symptoms of acute myocardial infarction between Mexican Americans and non-Hispanic whites found jaw+arm symptoms in 58% of the former and 65% in the latter. Our impression is that the incidence of jaw pain is underestimated by clinicians and this underlines the importance of taking a careful patient history [11].…”

Section: Discussionmentioning

confidence: 99%

“…The expression of symptoms related to CHD differs with age, gender and ethnicity [1][2][3]. For instance, Goldberg et al [1,2] reported that there were fewer "classical" complaints among women than in men.…”

Section: Introductionmentioning

confidence: 99%

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Streamlining Differential Diagnosis of Coronary Heart Disease in a Primary Care Clinic: Atypical and Typical Symptoms and Their Combinations

Charach¹,

Rabinovich²,

Weintraub³

2009

TOGMJ

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Background: We sought to identify the most predictive symptoms of coronary heart disease (CHD) in the setting of a very busy community primary care clinic. By examining the variability, distribution and frequency of symptoms singly and in combination we hoped to streamline the process of correctly identifying a patient presenting with CHD. Methods: All 449 patients suspected of having CHD by one primary physician (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) were evaluated by thallium scan, treadmill ergometry, and/or coronary angiography, as well as ECG and creatine phosphokinase /troponin levels. Group 1 included 216 subjects (117 males, 98 females, mean age 69.7±11.2 years) diagnosed as having acute coronary syndrome, stable angina pectoris or acute myocardial infarction. Group 2 included 233 (126 males, 108 females, mean age 65.2±12.1 years) subjects whose comprehensive evaluations ruled out CHD. Results: The leading symptom in Groups 1 and 2 was chest pain [80%] vs [80.3%] (NS). Dyspnea was present in 10% and 5%; (p<0.037) patients, and jaw pain in 11% and 1% (p<0.0001) patients. The symptom combinations found more frequently in Group 1 were chest pain+jaw pain (7% vs 1. 04%; p<0.0001) and dyspnea+sweating (2.8% vs 0%, p<0.01). Conclusion: Isolated symptoms (jaw pain, dyspnea) and combined symptoms (chest pain+jaw pain, dyspnea+sweating) were more specific for CHD than classical chest pain.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Streamlining Differential Diagnosis of Coronary Heart Disease in a Primary Care Clinic: Atypical and Typical Symptoms and Their Combinations

Charach¹,

Rabinovich²,

Weintraub³

2009

TOGMJ

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“…3 Despite these findings, it is widely perceived that women, [4][5][6] South Asian people [7][8][9] and other ethnic minorities with suspected ischemia are more likely than white men to report atypical features of pain. 10,11 This has been attributed to vasospastic and microvascular angina in women 12 and to the higher prevalence of diabetes mellitus 13 and socio-economic deprivation 7 among South Asian people. Both women 14,15 and South Asian 16,17 patients are less likely than men and white people in general to undergo invasive management of angina.…”

mentioning

confidence: 99%

Presentation of stable angina pectoris among women and South Asian people

Zaman¹,

Junghans²,

Chen

et al. 2008

Canadian Medical Association Journal

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Symptom Presentation of Women With Acute Coronary Syndromes

et al. 2007

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Background: Optimal diagnosis and timely treatment of patients with an acute coronary syndrome (ACS) depends on distinguishing differences between popular "myths" about ischemic symptoms in women and men. Chest pain or discomfort is regarded as the hallmark symptom of ACS, and its absence is regarded as "atypical" presentation. This review describes the presenting symptoms of ACS in women compared with men and ascertains whether women should have a symptom message that is separate or different from that for men. Methods: MEDLINE (1970-2005), bibliographies of articles, and pertinent abstracts were reviewed, focusing on studies of ACS presentation, especially those reporting differences in symptoms by sex. This analysis included 69 of 361 possible studies. Data regarding symptom presentation were recorded. Results: The published literature lacks standardization in characterizing ACS presentation, data collection, and reporting of symptoms. Approximately one-third of patients in the large cohort studies and one-quarter of patients in the smaller reports and direct patient interviews presented without chest pain or discomfort. The absence of chest pain or discomfort with ACS was noted more commonly in women than in men in both the cumulative summary from large cohort studies (37% vs 27%) and the single-center and small reports or interviews (30% vs 17%). Conclusions: Women are significantly less likely to report chest pain or discomfort compared with men. These differences, however, are not likely large enough to warrant sex-specific public health messages regarding the symptoms of ACS at the present time. Further research must systematically investigate sex differences in the clinical presentation of ACS symptoms and must include standardized data collection efforts.

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Comparison of reported symptoms of acute myocardial infarction in Mexican Americans versus non-Hispanic whites (the Corpus Christi heart project)

Cited by 58 publications

References 9 publications

Streamlining Differential Diagnosis of Coronary Heart Disease in a Primary Care Clinic: Atypical and Typical Symptoms and Their Combinations

Streamlining Differential Diagnosis of Coronary Heart Disease in a Primary Care Clinic: Atypical and Typical Symptoms and Their Combinations

Presentation of stable angina pectoris among women and South Asian people

Symptom Presentation of Women With Acute Coronary Syndromes

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