Paper
Thursday, July 14, 2005
Symptom Differences in Myocardial Infarction and Unstable Angina
Holli A. DeVon, PhD, RN, College of Nursing, Marquette University, Milwaukee, WI, USA and Julie Johnson Zerwic, PhD, RN, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
| Learning Objective #1: Discuss the symptoms of acute myocardial infarction and unstable angina as described in the liteature |
| Learning Objective #2: Discuss the implications of accurately describing the symptoms of MI and UA for the general public and for nursing |
The American Heart Association estimated that 650,000 people would experience a new myocardial infarction (MI) or sudden death and 150,000 would experience their first episode of unstable angina (UA) in 2004. Individuals must recognize the possibility that symptoms may be serious in order to seek emergent care. The purpose of this study was to examine whether the symptoms experienced by patients with myocardial infarction (MI) differed from the symptoms experienced by patients with unstable angina (UA). Data were analyzed from two studies; one describing the symptoms of MI (n=238) and one describing the symptoms of UA (n=100). Data were collected at three medical centers in the Midwest. Interviews were conducted in the patient's room after admission through the emergency department. Chi-square statistic and t-tests were used to test the association between diagnosis and baseline characteristics. Chi-square was also used to identify symptom differences across diagnosis. There were no differences between patients with MI or UA in age, sex, or race. The patients experiencing MI reported significantly more nausea (46% v. 32%), vomiting (19% v. 2%), indigestion (42% v. 16%), and fainting (9% v. 2%). The patients experiencing UA reported significantly more chest discomfort (97% v. 87%) lightheadedness (52% v. 39%), numbness in the hands (43% v. 28%), and neck discomfort (31% v. 13%). Patients with MI rated the peak intensity of the chest discomfort higher than patients with UA (M=8.4 vs. M=7.7). Results indicate that the proportion and intensity of symptoms experienced varied slightly between patients with MI and UA. Only one symptom, vomiting, seemed to distinguish MI from UA. Since only a small number of patients reported this symptom, we consider it clinically insignificant. More data is needed to determine if symptoms vary across the clinical diagnoses of acute coronary syndromes.