Women's experiences of cardiac pain: a review of the literature.

BACKGROUND: Women experience coronary heart disease (CHD) differently than men. Presentations of cardiac pain for women can include vague signs and symptoms such as extreme fatigue, discomfort in the shoulder blades, and shortness of breath. Subsequently, the assessment, identification, treatment, and rehabilitation of women with CHD present challenging and unique opportunities for nurses because women experience a multiplicity of symptoms that are often not reported or recognized as cardiac in nature. Women have higher rates of functional disability and a lower prevalence of obstructive coronary heart disease, as evidenced by coronary angiogram, than men. It is important to understand the complexities of women's presentations of cardiac pain if nurses are to improve the quality of health experienced post diagnosis, treatment, and rehabilitation. PURPOSE: The purpose of this article is to identify current qualitative studies that specifically explore women's experiences of cardiac pain and to describe salient themes across the literature identifying implications for clinical practice and areas of further research related to women's cardiac pain experience. METHOD: Qualitative studies that were published in nursing literature between the years of 1995 and 2007 were analyzed to illustrate the current state of qualitative research on women's cardiac pain experiences. This review includes six articles that met the inclusion criteria. CONCLUSION: Results of this review revealed that women experience cardiac pain differently than men. Different cardiac pain experienced by women leads to misunderstandings of warning signs and symptoms of myocardial infarction and ischemic cardiac pain. Moreover, women do not recognize the threat of CHD, even with significant family history, and delay seeking health care for signs of acute myocardial infarction. Further research and education are warranted. Nurses need to challenge the antiquated assumptions surrounding women's experiences of cardiac pain. Clinicians must be cognizant of the importance of a thorough patient assessment, the ability to identify women at risk, individualizing the person's CHD experience, and providing health promotion strategies that educate women to recognize the signs and symptoms of CHD. Studies that identify the educational needs specific to women and cardiac pain are necessary. Educational intervention studies promoting health-related behaviour change that targets cardiac pain recognition for women are imperative. Future research examining whether the experience of changes in cardiac pain over time and post-intervention(s) need to be conducted.

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