Prodromal myocardial infarction symptoms experienced by women

Most women experience prodromal myocardial infarction (MI) symptoms, but more information is needed about the perception, attribution, and care-seeking behaviors related to these prodromal symptoms. We aimed to describe women's perceptions, attributions, and care-seeking behaviors related to prodromal MI symptoms. We used a qualitative, multiple case study approach, recruiting participants during summer 2019 from a large hospital in the Midwestern United States. Data were collected from interviews with the women who experienced MI and some of their family members, journals, and electronic health records. An inductive, comparative analysis procedure was applied. Ten women, ages 42 to 84, participated in the study. The women experienced a mixture of certainty and uncertainty related to their symptoms and engaged in several cognitive processes to conceptualize and act upon their symptoms. Although all the women retrospectively reported at least 4 prodromal symptoms, they lacked knowledge of prodromal MI symptoms and often responded to prodromal sensations that they experienced using emotion- and avoidance-based strategies. It was difficult for the women to establish a symptom pattern that was attributable to heart disease. The findings of this study may be used as evidence to support interventions that would facilitate women's care seeking for and health care providers' recognition of prodromal MI symptoms. Additional research is necessary to more fully characterize the cognitive processes at play for women of many different sociocultural backgrounds who experience prodromal MI symptoms.

Translation, validation, predictive analysis of the Italian version of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey and symptom cluster characterization in women.

Prodromal symptoms in individuals with risk factors remain challenging, even though myocardial infarction has been noted in research. This study determined the association of risk factors with patients' baseline myocardial infarction related prodromal symptoms. In a cross-sectional study, 154 Iranian men and women, mean age 59.62 ± 12.74 years were assessed in 2016-2017. The frequency besides severity of 33 prodromal symptoms and risk factors was assessed using McSweeney Prodromal Myocardial Infarction Symptom Survey. The main cardiac prodromal symptoms experienced by patients were chest pain/discomfort (n = 99, 64.30%), unusual fatigue (n = 78, 50.60%), and sleep disturbance (n = 33, 20.40%). Women experienced more prodromal symptoms than men (33.26 ± 21.88 vs. 25.48 ± 17.75). Among risk factors, only sex was associated with prodromal symptoms score (P < 0.05). The frequently experienced prodromal symptoms, i.e., before MI were chest pain/discomfort, unusual fatigue, and sleep disturbance. A crucial finding was the significant association between sex and prodromal symptoms. Identifying prodromal symptoms in patients with risk factors can prevent the incidence of myocardial infarction.

To explore why young- and middle-aged adults ignore prodromal myocardial infarction symptoms from a life course and sociocultural perspective. A qualitative descriptive study. We applied purposeful sampling to recruit participants from a tertiary hospital in Guangzhou from July to November 2021. Face-to-face interviews were performed. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis methods. Twenty-four young- and middle-aged adults diagnosed with acute myocardial infarction participated in this study. Analysis revealed three main themes: I'm still young, it will not happen to me; to be somebody and different roles, multiple pressures. Age-related self-confidence led to inappropriate perceptions and responses to prodromal symptoms among young- and middle-aged adults. These individuals strived to align their behaviours and attention with social expectations and self-expectations, underestimating the importance of perceiving the warning signs of acute myocardial infarction and seeking medical treatment. Pressure from social roles also prevented them from paying enough attention to prodromal symptoms. Targeted social support, public education and technologies should be provided to these individuals since they are pillars of the family and society. We also highlight how nurses can function these strategies appropriately. This study contributes to a better understanding of the neglect of prodromal symptoms among young- and middle-aged adults. Its results enhance our understanding of the perception of and coping with prodromal symptoms among this population, which will help avoid the burden caused by acute myocardial infarction. The patients involved in our study shared their experiences and insights to provide new perspectives regarding the neglect of prodromal myocardial infarction symptoms among young- and middle-aged adults.

Data remain sparse on women's prodromal symptoms before acute myocardial infarction (AMI). This study describes prodromal and AMI symptoms in women. Participants were 515 women diagnosed with AMI from 5 sites. Using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, we surveyed them 4 to 6 months after discharge, asking about symptoms, comorbidities, and demographic characteristics. Women were predominantly white (93%), high school educated (54.8%), and older (mean age, 66+/-12), with 95% (n=489) reporting prodromal symptoms. The most frequent prodromal symptoms experienced more than 1 month before AMI were unusual fatigue (70.7%), sleep disturbance (47.8%), and shortness of breath (42.1%). Only 29.7% reported chest discomfort, a hallmark symptom in men. The most frequent acute symptoms were shortness of breath (57.9%), weakness (54.8%), and fatigue (42.9%). Acute chest pain was absent in 43%. Women had more acute (mean, 7.3+/-4.8; range, 0 to 29) than prodromal (mean, 5.71+/-4.36; range, 0 to 25) symptoms. The average prodromal score, symptom weighted by frequency and intensity, was 58.5+/-52.7, whereas the average acute score, symptom weighted by intensity, was 16.5+/-12.1. These 2 scores were correlated (r=0.61, P<0.001). Women with more prodromal symptoms experienced more acute symptoms. After controlling for risk factors, prodromal scores accounted for 33.2% of acute symptomatology. Most women have prodromal symptoms before AMI. It remains unknown whether prodromal symptoms are predictive of future events.

The purpose of this study was to test how teaching format (factual versus storytelling) and restructuring the social norm of caring for others to caring for self affects how women learn to identify and respond to myocardial infarction (MI) symptoms. The study was a randomized pretest posttest full factorial experiment. One hundred and thirteen women participated. Before and after reading the intervention pamphlet, the women wrote all the MI symptoms that they knew and rated their intention to call 911 if symptoms occurred. The women read one of the four MI pamphlets corresponding to the four conditions. No significant effects for learning MI symptoms resulted from teaching format or social norms. Women learned three additional MI symptoms. All responded with high intention to call 911 if MI symptoms occurred. Women can learn additional MI symptoms from reading a brief pamphlet about MI symptoms. Use of a storytelling format and the social norm of caring for self might not impact how many MI symptoms women learn. Studies using audiovisuals and larger samples are needed to clarify whether storytelling format and the social norm of caring for self-impact learning MI symptoms.

Objectives: The purpose of this study is to investigate the awareness level of myocardial infarction (MI) symptoms for the residents in the underserved and deserved emergency medical services areas and verify the effect of the existence of residence in the underserved emergency medical services areas on the awareness of MI symptoms. Methods: This is a cross sectional study by using the data of the 2017 Korea Community Health Survey. The residence in the underserved emergency medical services areas is defined as being targeted to the residents in 101 areas notified in ⸢Emergency Medical Service Act⸥. The awareness of MI symptoms was classified as being aware of all five items of MI symptoms. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are computed by multivariable logistic regression. Results: Of the total 195,246 subjects, 43.6% were aware of MI symptoms (43.7% and 43.6% of underserved and deserved emergency medical services areas, respectively). The residence in the underserved emergency medical services areas was associated with the awareness of MI symptoms (aOR 1.15, 95% CI=1.11-1.18). In addition, this study has found that gender, age, education level, income level, occupation, subjective stress level, drinking frequency, current smoking, and diagnosis of hypertension and diabetes were factors influencing the awareness of MI symptoms. Conclusions: Continuous efforts are needed to increase the awareness of MI symptoms for the residents in the underserved and deserved emergency medical services areas. Education and promotion should be conducted in consideration of gender, age, education level, income level, and occupation to improve the awareness of MI symptoms.

I n t r o d u c t i o n: Mortality from myocardial infarction (MI) is determined by patients' ability to prevent it and, in case of its occurrence, to recognise its symptoms and call an ambulance immediately. There is scarce data on rural populations' knowledge of MI, even though they are disadvantaged in access to medical emergency services. Objective: The aim of the study was to investigate the rural patients' awareness of MI risk factors, symptoms, necessity of calling an ambulance in response to MI symptoms, and its determinants. Materials and Methods: An anonymous and voluntary survey was conducted among 194 patients and their caregivers with median age 68 years at a rural non-public healthcare facility in Poland. R e s u l t s: 60.3% perceive their knowledge of MI as insufficient. Only 26.3% were able to recognise all suggested MI risk factors. 44.8% did not know whether they are at risk of MI. Furthermore, 78% of respondents who had at least three MI risk factors were unaware of being at risk. 45.4% recognised at least three out of four suggested MI symptoms. 76.2% would call an ambulance in response to chest pain suggesting they have MI. Merely 80% were able to provide the emergency phone number. Moreover, among respondents who declared they would not call an ambulance, 38.7% were afraid of in-hospital COVID-19 infection or healthcare system collapse. C o n c l u s i o n s: Rural patients' knowledge of MI risk factors, symptoms, and proper response to them is insufficient. The problem is exacerbated by the COVID-19 pandemic. To improve survival in MI an education campaign is needed.

OBJECTIVESWe aimed to determine the level of awareness of myocardial infarction (MI) symptoms among the general public in Korea and identify factors affecting awareness of MI symptoms using data from the 2017 Korea Community Health Survey (KCHS).METHODSThis is a cross-sectional study using KCHS data. Based on five questions about MI symptoms, participants were divided into an awareness group (replied ‘yes’ to all five questions) and an unawareness group (replied ‘no’ or ‘not sure’ to at least one of five questions) for analysis.RESULTSOf a total of 228,281 participants, 42.4% were aware of MI symptoms. There was a high level of awareness of chest pain and shortness of breath, but a low level of awareness of gastrointestinal symptoms and pain in the arm, shoulder, jaw, neck, and back. While women had a higher level of overall awareness relative to men, they showed a lower level of awareness regarding chest pain and discomfort. The factors affecting awareness of MI symptoms were gender, age, education level, occupation, smoking, drinking, physical inactivity, and cardiovascular disease risk factors. CONCLUSIONSIn order to enhance awareness of MI symptoms among the general population, appropriate education and promotion efforts must be implemented based on gender, age, education level, and occupation. Moreover, active efforts by the government, educational institutions, and medical institutions are necessary to improve awareness of both typical and atypical MI symptoms. Furthermore, health policies to promote reduced smoking and drinking and increased physical activity, as well as continuous monitoring and management of individuals with cardiovascular disease risk factors, are required.

Objectives In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors.Method Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n = 525) and the public (n = 2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities).ResultsThe valid response rate was 97.9% comprising 97.8% for the public (n = 2199) and 98.1% for outpatients (n = 515). Public respondents (35.2 ± 12.3 years) were younger than outpatients (38.5 ± 12.6 years). The public comprised 56.9% females while outpatients 54.6%.In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores ± SD of 3.49 ± 2.84 vs 2.80 ± 2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33 ± 3.22 vs 3.82 ± 3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35–49 years.Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours.ConclusionResults call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior.

BACKGROUNDPatients affected by myocardial infarction (MI) report prodromal symptoms before heart attack. Deep understanding of these symptoms can increase the likelihood of early recognition and treatment of coronary heart disease (CHD). The purpose of this study was to describe the prodromal symptoms of MI experienced by Iranian adults.METHODSIn this qualitative conventional content analysis, data was collected through an in-depth semi-structured interview with 14 men and women (aged 40-82 years). The patients were interviewed at the hospital 2 or 3 days after hospitalization due to MI. MAXQDA software was used for data analysis.RESULTSData analysis led to the emergence of the 4 categories of ‘Misperception of the symptoms’, ‘Reactions to the symptoms’, ‘Heart disease knowledge deficit’, and ‘Ideas and beliefs about heart disease’. The participants had not recognized the prodromal symptoms of MI and they attributed their symptoms to non-cardiac causes. They did not consider themselves at risk of heart disease, so they did not seek health services.CONCLUSIONThe participants were unaware of their prodromal symptoms. Clinicians should be attentive that men and women at risk of MI may experience a range of unfamiliar and vague prodromal symptoms, so they must give greater attention to their narratives. A greater understanding of the prodromal symptoms experienced may lead to a more truthful and timely interpretation of their symptoms and earlier detection by physicians.

Background Cardiovascular disease is the leading global cause of mortality. Recognition of myocardial infarction (MI) symptoms is crucial as it influences clinical outcomes. Furthermore, awareness of MI risk factors assists in obtaining healthier lifestyles, alleviating its burden and mortality rates. This study aims to evaluate the awareness levels of the general population in Saudi Arabia regarding MI symptoms and risk factors and to identify its determinants. Methods A descriptive cross-sectional study was conducted among the general Saudi population, with 1,247 participants, excluding those residing outside Saudi Arabia and healthcare-related individuals. An online self-administered questionnaire encompassed sociodemographic characteristics, awareness of MI symptoms and risk factors, and participants' perceptions concerning appropriate responses during an MI event. Results The majority of participants recognized chest pain and shortness of breath as MI symptoms, with a percentage of 87.1% and 86%, respectively. Risk factors awareness was substantial at 90.3% for smoking and 76.1% for obesity. The mean overall awareness score was 26.6±7.5, and around 36% were aware of both symptoms and risk factors. Higher education levels were positively associated with both risk factors and symptom awareness, while employment status showed negative associations with both. Higher-income correlated with greater risk factors awareness. Gender remained significant, with males exhibiting a lower awareness of risk factors and symptoms. Region and chronic disease status were positively associated with risk factors and symptom awareness. More than 90% of participants perceived going to the emergency room immediately if they recognized an MI attack. Conclusion This study highlights the necessity for inclusive awareness campaigns to enhance the identification of MI symptoms and risk factors in Saudi Arabia. It should focus on groups with limited awareness, such as males, employed and retired individuals, and specific pronounced regional disparities.

Introduction: Stroke and Myocardial Infarction (MI) are the leading causes of death in the United States. Awareness of symptoms is vital for early recognition and prompt treatment, which can significantly improve health outcomes. This study examines MI and stroke symptom awareness among Asian American adults, a group with limited prevalence estimates on this critical health metric. Hypothesis: There is variability in MI and stroke symptom awareness among Asian American subgroups, influenced by sociodemographic factors such as age, nativity, education, and income. Methods: We conducted a secondary analysis using data from the 2014 and 2017 National Health Interview Survey. Our sample included 2,832 Asian adults, categorized into self-identified ethnic groups: Asian Indian, Chinese, Filipino, and "Other Asian" (an aggregate category including Japanese, Korean, Vietnamese, and others due to low sample sizes). We assessed awareness of MI and stroke symptoms and the prevalence of recognizing 9-1-1 as the appropriate subsequent action using the Rao-Scott chi-square test to account for the complex survey design. Results: The study sample consisted of 2,832 adults (46.7 % male, 53.3% female, mean age 44.6 years [SD: 16.5 years]). Ethnic distribution was 22.0% Asian Indian, 22.5% Chinese, 20.8% Filipino, and 34.7% Other Asians. Significant disparities in symptom awareness were found among subgroups. Filipino adults exhibited the highest awareness of all five stroke symptoms (68%, 95% CI: 63%-73%) compared to Chinese (62%, 95% CI: 57%-67%), Asian Indian (53%, 95% CI: 48%-58%), and Other Asian adults (59%, 95% CI: 57%-61%). Similarly, Filipino adults also had the highest awareness of MI symptoms (51%, 95% CI: 45%-56%), compared to Asian Indian (37%, 95% CI: 32%-42%), Chinese (30%, 95% CI: 25%-34%), and Other Asian adults (30%, 95% CI: 27%-34%) (Figure). Conclusion: There is significant heterogeneity in MI and stroke symptom awareness among Asian American adults. Filipino adults demonstrated the highest levels of knowledge regarding subsequent actions. The study underscores the need for targeted public health interventions to enhance MI and stroke symptom awareness, particularly focusing on subgroups with lower awareness.

To explore the extant literature for key features of prodromal and acute myocardial infarction fatigue experienced by women, including estimates of severity, narrative descriptors, impacts on activities of daily living and frequency, and to describe what is known from the current evidence base. Several studies, conducted across the globe, have investigated prodromal and acute myocardial infarction symptoms experienced by women and suggested that fatigue is prevalent, and they have also sporadically described specific characteristics of fatigue, such as narrative descriptors and severity. However, no review specific to this acute and prodromal fatigue could be located in the literature. Integrative review, guided by Whittemore and Knafl's approach and the Theory of Unpleasant Symptoms. We used a comprehensive, systematic approach to searching, screening, selecting, evaluating and analysing the records. Data were collected in February 2017. Twenty-one articles were included in the review, including nine quantitative, six qualitative and six mixed-methods studies, with the majority (14) published in the USA. The average age of participants across the studies was the early 60s. Distress, quality, intensity and timing of prodromal myocardial infarction fatigue were more completely described in the literature than acute myocardial infarction fatigue. Fatigue is the most common prodromal myocardial infarction symptom experienced by women and is also a common acute symptom. Additional research exploring prodromal and acute myocardial infarction fatigue is necessary. As healthcare professionals work with women across the healthcare spectrum, recognising fatigue as an important potential myocardial infarction symptom is essential. Not only can women be educated about this symptom and other possible myocardial infarction symptoms, but clinicians can consider fatigue as an important symptom in a constellation of factors when evaluating women's health and the potential for coronary disease and myocardial infarction.

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.