2009 Katharine A. Lembright Award and Lecture—The Evolving Picture of Women With CHD

Abstract

Although coronary heart disease is the No. 1 killer of women, an evidence-based picture of prodromal and acute myocardial infarction symptoms in ethnically diverse women is underdeveloped. This contributes to disparate outcomes, especially in minority women. Lack of recognition of early presenting symptoms associated with coronary heart disease and acute myocardial infarction on the part of women and their healthcare providers contributes to these poor outcomes because delayed recognition of symptoms limits options for efficacious treatment. This presentation will focus on the development of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) that has been used with more than 2800 racially diverse women. This instrument, based on qualitative findings, includes 33 symptoms of prodromal coronary heart disease and 37 symptoms of acute myocardial infarction and questions related to frequency and severity of the symptoms. Women’s symptom experiences and difficulty receiving a diagnosis of coronary heart disease will be discussed. Comparison of both prodromal and acute myocardial infarction symptoms in black, Hispanic, and white women will be presented. The presentation will conclude with a cluster analysis, based on prodromal and acute myocardial infarction symptom scores calculated from symptom reports from more than 1500 women, that examines the association between racially diverse women’s characteristics and symptom clusters. These data make a significant contribution to the evolving picture of women’s prodromal and acute myocardial infarction symptoms.