Symptoms across the continuum of acute coronary syndromes: differences between women and men
Holli A DeVon1, Catherine J Ryan, Amy L Ochs
1Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois 60153, USA. hdevon@luc.edu
Insights
Women with acute coronary syndromes report more indigestion, palpitations, nausea, fatigue, and hand numbness than men. Chest pain intensity did not differ between sexes, but other symptoms varied by diagnosis.
Area of Science:
- Cardiology
- Medical Research
- Symptomology
Background:
- Acute coronary syndromes (ACS) require prompt assessment, with symptom presentation influencing urgency and care.
- Understanding sex-based differences in ACS symptoms is crucial for accurate diagnosis and timely intervention.
Purpose of the Study:
- To compare symptom presentation between women and men across acute coronary syndrome diagnostic categories.
- To control for age, comorbidities, and psychological factors in the analysis of sex-based symptom differences.
Main Methods:
- A sample of 256 patients (112 women, 144 men) hospitalized for ACS were interviewed.
- Data collected included 48 symptom descriptors, demographics, medical history, functional status, anxiety, and depression.
- Statistical analysis identified differences in symptom reporting between sexes, adjusted for covariates.
Main Results:
- Women reported significantly higher levels of indigestion, palpitations, nausea, unusual fatigue, and hand numbness compared to men.
- Chest pain intensity was similar between sexes.
- Differences in dizziness, weakness, and new-onset cough varied by ACS diagnostic category.
Conclusions:
- Women with ACS experience a distinct symptom profile, reporting higher intensity of several non-chest pain symptoms.
- The clinical significance of these sex-based differences in less typical ACS symptoms requires further investigation.
Background:
The urgency and level of care provided for acute coronary syndromes partially depends on the symptoms manifested.
Objectives:
To detect differences between women and men in the type, severity, location, and quality of symptoms across the 3 clinical diagnostic categories of acute coronary syndromes (unstable angina, myocardial infarction without ST-segment elevation, and myocardial infarction with ST-segment elevation) while controlling for age, diabetes, functional status, anxiety, and depression.
Methods:
A convenience sample of 112 women and 144 men admitted through the emergency department and hospitalized for acute coronary syndromes participated. Recruitment took place at 2 urban teaching hospitals in the Midwest. Data were collected during structured interviews in each patient's hospital room. Forty-eight symptom descriptors were assessed. Demographic characteristics, health history, functional status, anxiety, and depression levels also were measured.
Results:
Regardless of clinical diagnostic category, women reported significantly more indigestion (beta = 0.25; confidence interval [CI] = 0.01-0.49), palpitations (beta = 0.31; CI = 0.06-0.56), nausea (beta = 0.37; CI = 0.10-0.65), numbness in the hands (beta = 0.29; CI = 0.02-0.57), and unusual fatigue (beta = 0.60; CI = 0.27-0.93) than men reported. Differences between men and women in dizziness, weakness, and new-onset cough did differ by diagnosis. Reports of chest pain did not differ between men and women.
Conclusions:
Women with acute coronary syndromes reported a higher intensity of 5 symptoms (but not chest pain) than men reported. Whether differences between the sexes in less typical symptoms are clinically significant remains unclear.
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