title: The symptom experience of angina in women.
abstract: Angina is the symptom of myocardial ischemia and the most common presentation of women with coronary artery disease. Women have delayed responses to angina and postpone seeking care more than men. Myocardial ischemia is life threatening and timeliness of treatment is critical. Understanding the symptom experience is important to patients and health care providers alike to reduce morbidity and mortality rates. This article reviews current knowledge of the symptom experience to identify gaps in knowledge and provide a basis for future research and interventions. The symptom experience component of the Symptom Management Model is used as an organizing framework. In terms of chest pain perception, biopsychosocially oriented studies are inconsistent. Data suggest that women use different pain descriptors than men and that diabetes, somatic awareness, and hormonal status probably play a role in attenuating or altering anginal pain. In evaluating symptoms, findings suggest that if anginal symptoms were experienced as expected and/or were evaluated as cardiac in origin, response was more appropriate. Even when it is known that the symptoms are related to cardiac disease, women's responses are still delayed because of a need to self-treat to maintain control. If a patient recognizes symptoms to be cardiac in origin, an appropriate evaluation of the urgency of the situation was made more often, and a rapid response was more likely. Therefore, the larger problem may be the accurate perception of the symptom and the recognition that the symptom is cardiac in origin. This article has implications for future research dealing with improved responses.
authors.affiliation: Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA. macaldw3215@aol.com
authors.forename: M A
authors.initials: MA
authors.lastname: Caldwell
authors.forename: C
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000517:prevention & control*; D010147:Pain Measurement; D016387:Women's Health