Coronary Artery Disease in Women

Acute Myocardial Infarction Experience Among Mexican American Women

INTRODUCTION

Health disparities in cardiovascular disease risk factors affect a burgeoning segment of the U.S. population-Mexican American (MA) women. MAs experience disparities in the prevalence of heart disease risk factors. However, there are no studies describing acute myocardial infarction (AMI) symptoms unique to this Hispanic subgroup. The aim of the study was to describe MA women's AMI symptom experience.

METHODS

A qualitative descriptive design guided the study. Data were collected in semistructured interviews with eight MA women who reported having an AMI within the past 18 months. Data were analyzed using qualitative content analysis.

RESULTS

The overall theme was "The nature of my AMI experience." This theme, composed of four categories, described their prodromal and AMI symptom experience: my perception of AMI, having a heart attack, AMI symptoms, and actions taken. No participants recognized prodromal or symptoms of AMI. Asphyxiatia (asphyxiating) and menos fuerza (less strength) were commonly described symptoms.

CONCLUSION

Participants attributed both prodromal and AMI symptoms to noncardiac causes, self-managed symptoms, and delay in seeking health care. Findings suggest that community engagement through culturally tailored family-focused heart health education for MA women and their family members may improve recognition of prodromal symptoms.

Gender inequality in acute coronary syndrome patients at Omdurman Teaching Hospital, Sudan

BACKGROUND

Gender differences among patients with the acute coronary syndrome is still being debated, no research has been done on gender inequality among coronary syndrome patients in Sudan.

OBJECTIVES

To study gender differences in presentation, management, and outcomes of acute coronary syndrome in Sudan.

SUBJECTS AND METHODS

This cross-sectional descriptive longitudinal study was conducted in Omdurman Teaching Hospital between July 2014 and August 2015. Patients were invited to sign a written informed consent form, were interviewed and examined by a physician, and then followed during their hospital stay. Information collected includes coronary risk factors, vital signs, echocardiography findings, arrhythmias, heart failure, cardiogenic shock, and death. The Ethical Committee of Omdurman Teaching Hospital approved the research.

RESULTS

A total of 197 consecutive acute coronary syndrome patients were included, 43.1% were females. A significant statistical difference was evident between males and females regarding the type of acute coronary syndrome, its presentation, and time of presentation to the hospital, smoking, and receipt of thrombolysis (P < 0.05). No differences were found with regard to age, hypertension, diabetes, family history of myocardial infarction, percutaneous coronary intervention, and in-hospital acute coronary complications (P > 0.05).

CONCLUSION

Women were less likely to receive thrombolytic therapy, present with chest pain, and diagnosed with ST-segment elevation myocardial infarction. No gender differences were found in acute coronary syndrome risk factors apart from smoking, which was more common in males, and there were no differences between males and females as regards in-hospital complications.

Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: A quasi-experimental study in Iran

BACKGROUND AND AIMS

Coronary artery bypass graft is a major surgery and has complications that require professional and long term follow-up and nursing care that if do not properly handled, could reduce the quality of life and increase post-operative complications. On the other hand Tele-nursing is a cost-effective way to educate and follow-up of patients. This study aimed to assess the impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft.

MATERIALS AND METHODS

A quasi-experimental study was carried out at Ekbatan Therapeutic and Educational Center of Hamadan University of Medical Sciences at Hamadan, Iran, in 2013. In this study, 71 patients who had undergone coronary artery bypass graft surgery and had inclusion criteria were randomly divided into two experimental group (n=36), and control group (n=35). They completed questionnaire before discharging from Therapeutic and Educational Center. In the experimental group on days 2, 4, 7, second week (day 11), third week (day 18) and fourth week (day 25) after discharge, follow-up interventions and nursing education with Tele-nursing was done, but in the in the control groups, patients received only routine interventions. After completion of the intervention period, both groups completed the questionnaire and the results were compared.

RESULTS

Adherence of treatment plan in both groups did not have significant difference before intervention (P=0.696), but had a significant difference with regard to baseline after intervention in aromatherapy group (P< 0.01) and with control group after intervention (P<0.01). Adherence to treatment plan in the aromatherapy group was better in compared to control group (P<0.01).

CONCLUSION

Tele-nursing is a convenient way, cost effective training and follow-up care for patients after coronary artery bypass surgery, which can improve patients' adherence to treatment plan in developing countries such as Iran.

Primary health care resources for rehabilitation and secondary prevention after myocardial infarction - a questionnaire survey

BACKGROUND

During the first year after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes.

AIM

This study describes the primary health care centres' (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region.

METHOD

A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned.

RESULT

Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty-one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long-term secondary prevention programmes, and few (6%) had any routines for offering socio-economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations.

CONCLUSIONS

The PHCCs need to improve the strategies and long-term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long-term care programmes for CHD patients.

Myocardial infarction in women: promoting symptom recognition, early diagnosis, and risk assessment

Even with national campaigns to help increase awareness, most people do not realize that heart disease is now the leading cause of death for women. Women experiencing an acute cardiac event often do not recognize the symptoms or are misdiagnosed by healthcare providers because of atypical symptom presentation. This can lead to a significant delay in treatment and a less desirable recovery outcome. To help promote early identification of cardiac risk and cardiac events, this article highlights the range of symptom presentation in women with myocardial infarction and focuses on how advanced clinical nurses can increase nurses' and the public's understanding of this disease in women.