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Perceptions of chest pain differ by race.
Diane Klingler1, Robbya Green-Weir, David Nerenz
1Henry Ford Heart and Vascular Institute, USA. feline369@aol.com
American Heart Journal
|July 3, 2002
Summary
African American patients often misattribute cardiac symptoms to non-cardiac causes, impacting acute myocardial infarction diagnosis. Understanding symptom perception is key to improving care for chest pain in diverse populations.
Area of Science:
- Cardiology
- Health Disparities
- Symptom Perception Research
Background:
- African American patients receive less thrombolytic therapy and coronary revascularization compared to white patients.
- Differences in care may stem from delays and clinical presentation variations.
Purpose of the Study:
- To investigate how race influences symptom recognition and perception in patients presenting with chest pain.
- To characterize symptoms and care-seeking behaviors in African American and white patients.
Main Methods:
- Prospective study conducted in an Emergency Department (ED) Chest Pain Unit from April to September 1999.
- Interviews with 215 patients (admitted or observed) using structured questions within 48 hours of presentation.
Main Results:
- African American patients had lower acute myocardial infarction admission rates (8.9%) than white patients (31%).
- Both groups reported similar typical symptoms, but African Americans were more likely to attribute them to gastrointestinal issues (61% vs. 26%).
- Despite perceiving symptoms as severe, African Americans experienced similar prehospital delays as white patients.
Conclusions:
- Racial disparities in symptom perception for chest pain exist.
- African American patients more frequently attribute symptoms to non-cardiac causes, influencing diagnostic and therapeutic approaches.
- Further research into self-attribution is needed to address care differences.