What are the Presenting Symptoms and Risk Factors of Women Admitted to Port Huron Hospital with the Diagnosis of Unstable Angina or Myocardial Infarction?

Abstract

Women rarely consider coronary artery disease (CAD) as a health concern despite the fact that it is the leading cause of death in women in the United States. Management challenges often relate to the unusual or atypical disease presentation and course and are frequently mis understood by the practicing clinician. Since CAD is the number one cause of death in women, it is important for women and their healthcare providers to be able to recognize both the risk factors and presenting symptoms in women with CAD. The purpose of this research study was to identify the risk factors and presenting symptoms of women admitted to Port Huron Hospital with the diagnosis of unstable angina (USA) or myocardial infarction (MI). <p>The theoretical approach utilized for this study was Evidence-Based Practice. This theory asserts that making clinical decisions based on the best evidence from the research literature and clinical expertise, improves the quality of care and the patient's quality of life. Combining the strongest evidence obtained from clinician expertise, patients preferences and scientific findings for a specific health problem will improve the care of current and future patients who share the same problem (Wakefield et al., 1998). <p>A retrospective, random selection chart review was performed. A total of 75 randomly selected charts of women admitted to Port Huron Hospital with the diagnosis of Unstable Angina or Myocardial Infarction were chosen. A data collection tool was constructed for use within this study, which was highly structured and included in a fixed set of questions that were answered in sequence with pre-designated options. <p>Data were entered and analyzed using SPSS for Windows version 6.0 and 11.0. Descriptive statistics were used to summarize demographic data. Percentages were used to report risk factors and presenting symptoms, as well as specific presenting symptoms of women with diabetes. Z-tests for the standard error of a proportion were used for the final results of presenting symptomology. <p>Results of the study revealed that the age of participants ranged from 38 to 94, and the mean age was 70 (SD 13.3). Ethnicity revealed that 98% (n=74) of women were Caucasian, 12% (n=9) of the women had a college level or higher education status. Of all the 14 presenting symptoms identified by women, the top 6 were chest pain, dyspnea, arm pain/numbness, diaphoresis, fatigue and nausea. Of all the 8 cardiac risk factors identified by women, the top 3 were post menopausal, hypertension and hyperlipidemia. The cardiac risk factor least identified was the use of estrogen replacement therapy/hormone replacement therapy. A z-test for the standard error of a proportion was used for the final results of answering the presenting symptoms section o f the research question and when computed each showed statistical significance at the .05 level. <p>The goal of healthcare providers to accurately diagnose and treat women with CAD, requires making clinical decisions based on best evidence, either from research literature of clinical expertise. This subsequently will improve the quality of care and the patients’ quality of life. Application of the results from this study as well as the subsequent outcomes will differ based on the patient’s values, preferences, concerns and/or expectation. As clinicians we must begin with knowing what clinical questions to ask, how to find the best practice, and how to critically appraise the evidence obtained to appropriately identify the risk factors and presenting symptomology in women with CAD, and therefore apply the theory of Evidence-Based Practice. Prevention strategies, early risk reduction and counseling should be incorporated into every well- woman exam so that women receive the timely and appropriate care they need and deserve.