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Multicenter Study
. 2008 Jan;17(1):14-24; quiz 25.

Symptoms across the continuum of acute coronary syndromes: differences between women and men

Holli A DeVon  1 , Catherine J Ryan, Amy L Ochs, Moshe Shapiro
Affiliations
Multicenter Study

Symptoms across the continuum of acute coronary syndromes: differences between women and men

Holli A DeVon et al. Am J Crit Care. 2008 Jan.

Abstract

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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Figures

Figure 1
Figure 1
Framework to explain differences between women and men in perception of symptoms of acute coronary syndromes.
Figure 2
Figure 2
Frequently reported symptoms of acute coronary syndromes in women and men.
See this image and copyright information in PMC

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