Chest Pain In Men Research Articles

Clinical symptoms and ECG data in women with acute coronary syndrome

Background. There are many differences in chest pain symptoms between men and women in terms of location, nature, and additional symptoms. The issue of describing the differences in chest pain in men and women with acute coronary syndrome (ACS), as well as their correlation with changes in the electrocardiogram (ECG) and coronary angiography (CAG) remains relevant.Methods. The study included 588 patients of the cardiology department of the Novokuznetsk City Clinical Hospital No. 1 from 2013 to 2017 with a diagnosis of ACS. Depending on the gender, the subjects were divided into two groups: Group I – 330 men; Group II – 258 women.Results. ACS with ST elevation was more common in men (45.8 %) than in women (33.3 %; p = 0.002). There were no pathological ECG changes in women in 58.1 % of cases, in men – in 45.5 % (p < 0.001). ECG type Q/ST elevation was detected more often in men (45.8 %) than in women (33.3 %; p = 0.002). The absence of coronary artery lesions was observed in 27.9 % of men and 44.2 % of women (p < 0.001). Hemodynamically significant coronary artery stenosis was more common in men (57.6 %) than in women (38.7 %; p < 0.001). In a typical angina clinic, hemodynamically significant coronary artery disease in patients with Q/without ST elevation ACS was detected in 40.2 % of men and in 58.5 % of women (p = 0.002). In the atypical angina clinic, hemodynamically significant lesions of coronary artery were more common in men (40.6 %) than in women (34.1 %; p = 0.02).Conclusion. In women atypical chest pains and intact coronary arteries were detected more often than in men, and hemodynamically significant coronary artery stenosis were found less often than in men. In men, a more pronounced pathology of the coronary arteries in ACS was revealed, in women – great difficulties in diagnosing ACS.

Construction of content framework of pain management plan in perianal abscess patients after surgery

Objective To construct the content framework of pain management plan in perianal abscess patients after surgery so as to provide a basis for scientific pain control. Methods From July 2018 to May 2019, the first draft was developed based on the theory of Manchester pain management mode and cross-cultural nursing theory, evidence-based medicine extraction and needs of postoperative perianal abscess patients on pain management condensed by the qualitative interview. Totals of 15 medical and nursing experts engaging in pain management for a long time were selected in Shanghai by purposive sampling to revise the first draft with the Delphi method so as to construct the content framework of pain management plan in perianal abscess patients after surgery. Results Following two rounds of expert consultation, the content framework of pain management plan included 5 first-level indexes, 23 second-level indexes and 67 third-level indexes. The expert authority coefficient was 0.90. There was a statistical difference in the expert coordination coefficient (P<0.01) . Conclusions Construction of the content framework of pain management plan in perianal abscess patients after surgery is scientific and credible. The content combines with the evidence-based medicine as well as patient needs and is practical which plays a guidance role in postoperative pain management for perianal abscess patients. Key words: Pain; Abscess; Anus diseases; Delphi method; Postoperative; Construction

Gender Differences in Somatic Symptoms and Current Suicidal Risk in Outpatients with Major Depressive Disorder.

ObjectiveAlthough somatic symptoms are common complaints of patients with major depressive disorder (MDD), their associations with suicide are still unclear.MethodsA total of 811 MDD outpatients of aged between 18 to 64 years were enrolled nationwide in Korea with the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Depression and Somatic Symptom Scale (DSSS).ResultsOn stepwise regression analysis, current suicidality scores were most strongly associated with chest pain in men, and neck or shoulder pain in women. Severe chest pain was associated with higher current suicidality scores in men than in women, whereas severe neck or shoulder pain showed no significant differences between the genders. In conclusion, MDD patients of both sexes with suicidal ideation showed significantly more frequent and severe somatic symptoms than those without. Current suicidal risk was associated with chest pain in men, and neck or shoulder pain in women.ConclusionWe suggest that clinicians pay attention to patients' somatic symptoms in real world practice.

An Investigation into the Scale and Impact of Self-Reported Foot Problems Associated with Systemic Lupus Erythematosus: A Study Protocol and Survey Questionnaire Development.

Systemic lupus erythematosus (SLE) can manifest with arthralgia and myalgia, and, in severe cases, disorganization of the joints and tendon rupture. Further, Raynaud's phenomenon and other circulatory problems such as vasculitis have been reported, and may be associated with loss of sensation and ulcers. Associated with impaired peripheral neurovascular function there is the potential for changes in tissue viability leading to thinning of the skin or callus formation. In addition, resistance to infections may be reduced, such as fungal infection of the skin and nails, bacterial infection associated with wounds and viral infections such as verruca. There is a dearth of evidence for the effects of SLE in the foot, the prevalence of foot problems in SLE and the impact of these on the individual. In addition, it is not known if people with SLE and foot problems have access to specialist care through foot health services. Hence, there is a need to investigate the scale of foot problems associated with SLE. In order to achieve this, a questionnaire needs to be developed in order to carry out a national survey in England. The items required for the questionnaire were generated using a focus group, which comprised patient advisers with SLE, consultants who specialized in SLE, specialist rheumatology podiatrists and specialist rheumatology nurses. From this consensus approach to the item generation, the draft questionnaire was developed with agreement on themes, question format and overall structure. Additionally, the Manchester Pain and Disability Questionnaire was included in order to capture levels of pain and associated disability. An iterative process followed, with feedback from the focus group reducing the number of other items from 53, until the penultimate version of questionnaire was produced with 50 items. Following on from this, a process of cognitive debriefing was used with two people with SLE who were naïve to the questionnaire. Minor changes to two questions and the layout was required before a final version of the questionnaire was produced. The questionnaire will be used for a study which aims to identify the frequency of patients' self-reported foot problems, the impact of foot problems on their lives and the status of foot care provision. This will be achieved through a survey of people with SLE across six clinical sites and interviews with some people in order to explore their experience of foot problems. The results from the present study will provide the information required to inform further research. In addition, it could potentially inform the design and delivery of foot health information and services to this patient group. Copyright © 2015 John Wiley & Sons, Ltd.

Characteristics of Chest Pain in Women

According to this study: * The characteristics of chest pain in men and women with acute myocardial infarction (AMI) were similar. However, chest pain characteristics alone weren't helpful for early detection of AMI in women.

1621 Heart Rates and Respiratory Rates are Associated with Manchester Pain Scores in Children Presented at the Emergency Department

Background and AimsAcute pain increases vital signs and is measured by the Manchester pain scale during triage. This multicentre observational study aims to determine associations between respiratory rates or heart...

1619 Paediatric Painful Sickle Cell Crises: A Prospective Audit of Analgesic Practise in a Tertiary Paediatric Emergency Department

IntroductionAlthough children with painful sickle cell crises (PSCC) frequently present to the Emergency Department (ED), pain in sickle cell disease is often under-recognised, under-treated and treatment may be delayed. We...

An introduction to the biopsychosocial complexities of managing wound pain

Using the Manchester pain management model (PAIN), this review discusses the care of acute and chronic wounds, focussing on the particular skills required to manage pain associated with different types of wounds, and addressing the important area of dressing change. Acute and chronic wounds can be associated with either acute or chronic pain, making management of wound pain a significant challenge. Pain can be of either nociceptive or neuropathic origin, and the longer it has been present, the more likely that psychological, social or cultural determinants influence the reactions seen in the patient. Understanding the biopsychosocial and cultural elements of pain enables the practitioner to prepare, assess, intervene and normalise effectively, during all aspects of wound care management. Utilising individualised evidence-based practice is essential to ensure that high-quality care is delivered in this key area.

β-Endorphin Modulates Adenosine Provoked Chest Pain in Men, But Not in Women—A Comparison Between Patients With Ischemic Heart Disease and Healthy Volunteers

Increasing evidence suggests the existence of sex differences in pain perception. Adenosine, an early messenger for myocardial ischemia induces angina pectorislike symptoms in healthy volunteers and in patients with ischemic heart disease. To study whether sex influences adenosine-provoked chest pain and the analgesic effect of the opioid receptor agonist beta-endorphin. Twenty patients (10 male and 10 female) with significant coronary artery disease and 20 healthy volunteers (10 male and 10 female) were studied. Both the hand algometer and Borg CR-10 scale were used to estimate chest pain. Chest pain was provoked double-blind by injections of placebo, 1/3, 2/3, 3/3 of maximal tolerable dose of adenosine twice in randomized order. This procedure was repeated after bolus injection of beta-endorphin followed by infusion and repeated a third time after bolus injection of naloxone 0.8 mg. Central chest pain and physiologic responses were quantified using hemodynamic and psychophysical methods. Pain estimate by hand algometer and the Borg CR-10 scale was correlated (r=0.77, P<0.001). Both sexes reported a dose-dependent increase of adenosine-provoked chest pain with no differences for maximum tolerable dose of adenosine per kilogram. beta-Endorphin administration lowered adenosine-provoked pain in both male patients and male healthy volunteers (P=0.02) but not in women. Naloxone tended to increase the pain perception in male patients (P=0.052) and male healthy volunteers (P=0.054), but did not have any significant effect on pain modalities in female. In conclusion, women were resistant to beta-endorphin modulation of adenosine-provoked chest pain. In male patients, beta-endorphin induced analgesia.

The convergent validity of the manchester pain scale

To test the convergent validity of the Manchester pain scale when compared to the current 'gold standard' in children's pain assessment, the Oucher pain scale. One hundred and fifty two children presenting to the emergency department had pain scale assessments using both the Manchester and Oucher pain scales. The order of presentation of the scales was randomised. The degree of convergence between the scales was assessed using Spearman's rank correlation as well as Bland and Altman plots. One hundred and thirteen children used numerical scales; the correlation coefficient for these was 0.802. Thirty nine children used pictorial scales; the correlation coefficient was 0.820. There is strong convergent validity between the scales as demonstrated by a high degree of correlation between the numerical and pictorial scores generated by the Manchester and Oucher pain scales. The Manchester pain scale can be used to assess pain in children presenting to emergency departments.

Sex-specific differences in risks and management of coronary heart disease

Reports from several countries indicate that women are disadvantaged in the treatment of coronary heart disease. The aim of the present review is to examine--on the basis of current population-based data (National Health Survey [NHS], hospital diagnosis registry, mortality rates)--whether in the Federal Republic of Germany more recently a change in favor of women could be established. According to NHS results prevalence rates of hypertension, overweight, and smoking in men exceed those of women, whereas hypercholesterolaemia is equally prevalent in both sexes. From 1984/85 to 1990/91 the NHS revealed a marked decline of smoking in men, and a parallel increase in women. The prevalence of chest pain shows no gender difference, but chest pain in men is more predictive for coronary artery disease. In acute myocardial infarction [AMI] thrombolysis and PTCA are applied with equal frequency; the average length of stay in hospital is greater for women. Coronary bypass surgery and rehabilitation in hospitals are less frequently applied in women. Little is known about gender differences in psychosocial adaptation after AMI. AMI mortality rates in all age groups are lower in women, and their mean age of death is higher. However, the decline of AMI mortality since 1980 was less pronounced in women compared to men.

Characteristics and determinants of sumatriptan-associated chest pain.

Serious cardiac adverse reactions, including myocardial infarction, have been attributed to the antimigraine drug sumatriptan succinate. Chest pain is considered to be a relatively common adverse reaction to sumatriptan. Postmarketing study. The study was a part of a national cohort study on adverse reactions to sumatriptan, which was performed with the assistance of drug-dispensing general practitioners in the Netherlands. After data were collected on observed adverse reactions, the patients received a second questionnaire, with specific questions regarding the adverse event, and questions regarding medical history, other health complaints, and smoking habits. Furthermore, they had a physical examination and a blood cholesterol measurement. A total of 137 patients with chest pain associated with intake of sumatriptan were identified and compared with 229 consumers of sumatriptan without this adverse reaction. After multivariate analysis, young age, hypertension, general complaints of abdominal pain, and a family history of myocardial infarction were associated with an increased risk of chest pain attributed to sumatriptan. Hypertension in particular was a risk factor for sumatriptan-induced chest pain in men (relative risk, 8.0; 95% confidence interval, 1.8-40) compared with hypertension as a risk factor in women (relative risk, 1.63; 95% confidence interval, 0.9-3.1). Young age, hypertension, general complaints of abdominal pain, and a family history of myocardial infarction are associated with an increased risk of chest pain attributed to sumatriptan. Sex is an effective modifier of risk factors of sumatriptan-induced chest pain. In particular, hypertension is a strong risk factor in men.

Association between physical and psychological morbidity in the Whitehall II study

Mechanisms for the association between psychiatric disorder measured by the General Health Questionnaire and subjective and objective indices of physical illness are examined among 6900 male and 3414 female civil servants aged between 35 and 55 yr from the cross-sectional results of the Whitehall II Study. It was hypothesized that the association between physical illness and psychiatric disorder might be because psychiatric disorder was either secondary to the pain and disability of physical illness, or related to the somatic presentation of psychiatric disorder, or to common causes of both physical and psychiatric illness. Overall health status, and self-reported physical symptoms were strongly associated with psychiatric disorder. Angina in men and severe chest pain in men and women were significantly associated with psychiatric disorder, but electrocardiographic abnormalities were not. Established risk factors for physical illness: alcohol intake in women and men and smoking habit in men were related to psychiatric disorder. Fibrinogen was related to self reported physical symptoms but not psychiatric disorder. The association between psychiatric disorder and self-reported physical symptoms is most likely explained by somatisation and plaintive set. However, psychiatric disorder is likely to be secondary to the pain and disability of conditions such as angina.

Work Stress and Chest Pain in Men and Women Under Age 65

ABSTRACT The object of the present study was to examine the work stress profiles of men and women suffering from angina-like chest pain previous to retirement. The study was performed in Sweden, where 48% of the working population are women. Twins were observed so that the contribution of psychosocial variables could be examined after the removal of the variance in angina-like chest pain accounted for by heredity. However, no evidence of heritability was found. Three different measures of occupational strain were employed in order to obtain both subjective and objective measures of career strain. With respect to traditional ischemie heart disease risk factors, both men and women with angina smoked more than those without it, and women with angina had a higher body mass index than those without. Both men and women with angina also had higher Type A scores. However, both subjectively- and objectively-defined occupational Stressors were much more prominent in the profiles of men who had angina. These data su...

Gender Differences in Self-Reported Heart Disease Morbidity: Are Intervention Opportunities Missed for Women?

Women live longer than men but report more illness, possibly because of greater use of preventive health care, which leads to increased diagnosis. This hypothesis was tested in the Alameda County Study cohort consisting of 885 men and 1,058 women who did not report chest pain or heart trouble in 1965 and who were followed for new reports of these conditions during 1973–1974, and mortality through 1988. Contrary to expectations, preventive health care use was not associated with subsequent reports of chest pain or heart trouble for women. However, having a preventive checkup in the past year was associated with more than a 50% reduction in subsequent reports of chest pain (p <.001) and heart trouble (p =.06) for men. Similarly, possession of health insurance (an indicator of access to health care) was associated with a reduction of reported chest pain in men (p =.02) but not women. Gender differences in associations were significant and independent of other predictors of heart disease. Having a regular physician or clinic was not associated with subsequent reports of chest pain or heart trouble for either sex. These findings are not consistent with the hypothesis that high rates of preventive care use cause women to be diagnosed more often, and thus to report more heart disease morbidity. Results suggest gender differences in the content of preventive care and missed intervention opportunities for women.