The Quality of Symptoms in Women and Men Presenting to the Emergency Department With Suspected Acute Coronary Syndrome

Mirzaei, Sahereh; Steffen, Alana; Vuckovic, Karen M.; Ryan, Catherine; Zègre‐Hemsey, Jessica; DeVon, Holli A.

doi:10.1016/j.jen.2019.01.001

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…Based on the pain location, it was found that males with ACS tend to experience pain in the left or middle chest compared to female patients, while females felt more pain in the chest area radiating to the neck and chin. This data is directly proportional to previous studies, [16][17][18] that demonstrated pain in the middle part of chest is more experienced by males with a p<0.01 and female patients experience pain in form of radiations to the neck, chin, and shoulder area with a p<0.01. The difference in symptomatic manifestation in males and females with ACS is due to the process of chest pain transmission mechanism mediated by sympathetic and vagal nerves activation.…”

Section: Resultssupporting

confidence: 80%

Characteristic Differences of Chest Pain in Male and Female Patients with Acute Coronary Syndrome: A Pilot Study

Sella

Manistamara

Apriliawan

et al. 2021

Journal of Public Health Research

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Background: The typical sign or main symptom in acute coronary syndrome (ACS) patients is chest pain, which is an initial benchmark or early sign for diagnosis. Certain factors, such as gender differences, the presence of diabetes mellitus or other clinical conditions, may make the patient not realize they have ACS. Therefore, this study aims to identify the characteristics of chest pain symptoms in male and female patients with ACS.Design and Methods: This is a non-experimental quantitative study, namely analytical observation using a cross-sectional approach within 4 months (January-April 2019). Furthermore, the samples were 53 ACS patients (28 male and 25 female).Results: The chest pain characteristics that have a significant relationship with gender differences in ACS patients are shown based on the aspects of location, pain duration and quality. Male patients are more likely to feel pain at the left or middle chest, the duration is between <20 to >20 min with moderate pain quality, which tends to become severe, while females are more likely to feel pain at the chest which radiates to the neck and chin, the duration is usually >20 min, with mild to moderate pain quality.Conclusions: The result showed a significant difference in chest pain characteristics in male and female patients with ACS. Regarding location, duration and quality of chest pain, male ACS patients mostly have more typical symptoms, while females’ symptoms are atypical.

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Section: Resultssupporting

confidence: 80%

Characteristic Differences of Chest Pain in Male and Female Patients with Acute Coronary Syndrome: A Pilot Study

Sella

Manistamara

Apriliawan

et al. 2021

Journal of Public Health Research

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“…ACS is a time-critical condition, which means delays in diagnosis and treatment of the disease can upsurge the risk of heart muscle damage, leading to increased morbidity and mortality [ 1 , 5 , 6 ]. Several patient and service level factors have been identified as affecting the timely diagnosis and treatment of ACS; among them are the patient’s hesitation and delay in seeking medical care is a key factor [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several patient and service level factors have been identified as affecting the timely diagnosis and treatment of ACS; among them are the patient’s hesitation and delay in seeking medical care is a key factor [ 7 ]. Mirzaei et al found that lack of recognition of ACS symptoms, the discrepancy between actual and expected symptoms, and discrepancy between current symptoms and previous experience of the disease are some factors contributing to delay in timely treatment seeking [ 6 ]. Also, a lack of previous experience of ACS affects how the symptoms are interpreted and acted upon by patients [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Symptom recognition and treatment-seeking behaviors in women experiencing acute coronary syndrome for the first time: a qualitative study

Asghari

Gholizadeh

Kazami³

et al. 2022

BMC Cardiovasc Disord

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Background Women are more likely to delay medical help-seeking for ACS symptoms. Understanding patients’ experience of the symptoms and their response is essential in improving help-seeking behaviors and timely diagnosis and treatment for ACS. This study aimed to explore women’s experience of ACS, their response to the symptoms, and treatment-seeking decisions. Methods This qualitative descriptive study was conducted in a tertiary referral specialized heart hospital affiliated with Tabriz University of Medical Sciences, Iran. Participants included 39 women who had experienced ACS for the first time. Results Four main themes emerged from the analysis of interview transcripts: (1) the onset of symptoms, (2) the types of symptoms, (3) response to symptoms and (4) arriving at the hospital. These themes and associated sub-themes explained women’s experience of ACS symptoms, their response to the symptoms, and decision to seek medical help. Conclusions This study identified and discussed factors contributing to the prehospital delay in women and their decision-making to seek medical care for ACS symptoms. The results are consistent with previous research indicating that ACS symptoms in women are somewhat different from men, and women tend to underestimate their symptoms and attribute them to non-cardiac causes. Women should be supported to develop awareness and understanding of ACS symptoms and appreciate the importance of early treatment-seeking in the disease outcomes.

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“…9,10 ACS is often an elusive and challenging diagnosis that depends on rapid assessment, triage, and risk stratification. 11 Emergency nurses are charged with identifying and recognizing quickly individuals who present with symptoms suggestive of ACS. Symptom recognition and timely reperfusion minimize ischemic time, salvage the myocardium, preserve left ventricular function, and improve survival.…”

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confidence: 99%

Optimizing Patient Outcomes in Emergency Cardiac Care Through Advances in Technology: Nurse Scientists in Action

Zègre‐Hemsey¹

2020

Journal of Emergency Nursing

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his issue of the Journal of Emergency Nursing (JEN) is focused on cardiovascular disease, a growing concern among our aging population and beyond. Cardiovascular disease is the top killer in the United States and worldwide, and cardiovascular emergencies account for approximately 10% of all ED visits in the US. 1,2 More than 8 million patients with chest pain and/or anginal equivalent symptoms (eg, shortness of breath and diaphoresis) present to emergency departments each year, accounting for the second most common cause of ED visits for adults. 2 In 2019 alone, it was estimated that every 40 seconds, 1 American would suffer from an acute myocardial infarction, nearly 720,000 would suffer from a new coronary event, and approximately 335,000 would have a recurrent cardiac event. 3 Emergency nurses are often the first point of contact for individuals presenting with cardiac symptoms. We are required to differentiate rapidly between life-threatening conditions and non-life-threatening ones and determine accurately which course of treatment will result in optimal patient outcomes. 4 Acute coronary syndrome (ACS) is a spectrum of clinical syndromes (ST-elevation myocardial infarction, non-ST elevation myocardial infarction, and unstable angina) reflecting the progression of coronary artery occlusion. 5 Time is of the essence as myocardial infarction ensues after 20 minutes, and complete necrosis of myocardial cells can occur after 2 to 6 hours with total artery occlusion. 6,7 Prolonged ischemic time (duration and extent of ischemia) is associated with poor outcomes (eg, death and heart failure). 8 Early symptom recognition and intervention to restore blood flow to the affected artery within 30 minutes have the potential to prevent or minimize these events. 9,10 ACS is often an elusive and challenging diagnosis that depends on rapid assessment, triage, and risk stratification. 11 Emergency nurses are charged with identifying and recognizing quickly individuals who present with symptoms suggestive of ACS. Symptom recognition and timely reperfusion minimize ischemic time, salvage the myocardium, preserve left ventricular function, and improve survival. [12][13][14][15][16] We rely on assessment and triage for rapid clinical decision making, such as the acquisition of an electrocardiogram (ECG) within 10 minutes of presentation to the emergency department. 13,17 I suspect it is the combination of the excitement and challenge of these encounters that draws many of us to the field of emergency nursing.Technology offers us new opportunities to refine the assessment and triage of cardiac patients in the emergency department. In this issue of JEN, we learn about the innovative ways in which clinicians are integrating rapidly evolving technology to advance patient care and improve outcomes. Pon et al 18 report on their quality improvement project to evaluate the causes of high dilTIAZem dosing for individuals presenting to the emergency department with atrial fibrillation (AF). AF is the most frequent arrhythmia seen in the eme...

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The Quality of Symptoms in Women and Men Presenting to the Emergency Department With Suspected Acute Coronary Syndrome

Cited by 12 publications

References 33 publications

Characteristic Differences of Chest Pain in Male and Female Patients with Acute Coronary Syndrome: A Pilot Study

Characteristic Differences of Chest Pain in Male and Female Patients with Acute Coronary Syndrome: A Pilot Study

Symptom recognition and treatment-seeking behaviors in women experiencing acute coronary syndrome for the first time: a qualitative study

Optimizing Patient Outcomes in Emergency Cardiac Care Through Advances in Technology: Nurse Scientists in Action

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