Symptoms Across the Continuum of Acute Coronary Syndromes: Differences Between Women and Men

By: Holli A. DeVon, Catherine J. Ryan, Amy L. Ochs and Moshe Shapiro

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 (â = 0.25; confidence interval [CI] = 0.01-0.49), palpitations (â = 0.31; CI = 0.06-0.56), nausea (â = 0.37; CI = 0.10-0.65), numbness in the hands (â = 0.29; CI = 0.02-0.57), and unusual fatigue (â = 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.

Selengkapnya: (American Journal of Critical Care. 2008;17:14-25