Learning Objective #1: Identify gender difference in self-reporting of chest pain

Learning Objective #2: Discuss implications for health care providers to improve cardiac care to women

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Problem: Patients who have had a myocardial infarction are at risk of sustaining advanced cardiac damage from subsequent episodes of myocardial ischemia. Myocardial ischemia is often manifested as chest pain or other symptom such as arm tingling or numbness, or chest pressure. If a patient reports such episodes, interventions can be initiated to prevent an advancement of cardiac damage. Preliminary research suggests that post MI patientts do not consistently report symptoms of ischemia, and that there are reporting frequency differences between men and women.

Purpose: This study investigated whether patients with documented myocardial infarctions report post MI episodes of ischemia to health care workers, factors influencing their reporting and if their reporting was related to the patient's gender.

Methodology: The sample consisted of 80 patients. Interviews were conducted by the researcher within 48 hours of the paient's transfer from the I.C.U.. Data was analyzed descriptively and groups were compared by gender. 91.3% of men and 96.7% of women did not report episodes of chest pain. Only 18.4% of the sample reported all episodes of pain. Of those who reported pain, all reported it to the nurse while 1/3 reported it to the physician.

Implications: Since not all episodes of pain are reported, all health care providers need to be keyed into this fact. In addition, nurses must remember to question about all forms of ischemia, not just chest pain.