. Information from the National Institute of
. A study of women's symptoms prior to heart attack indicates
that about 95% said they knew their symptoms were new or
different a month or more before experiencing their Acute Myocardial
Infarction (AMI). . This was true even when the symptoms were common
ones and varied in severity. . The most frequently reported symptoms
were unusual fatigue (70.7%), sleep disturbance
(47.8%), and shortness of breath (42.1%). .
Notably, fewer than 30% of the women reported chest pain
and discomfort prior to AMI, and 43% did not experience
chest pain during AMI. . Most clinicians continue to consider chest
pain as the most important AMI symptom for both women and men.
. This study is one of the initial
investigations of women's experience with heart attacks, and how
this experience differs from men's. . Recognition of symptoms that
provide an early indication of heart attack, either imminently or in
the near future, is critical to forestalling or preventing the
. The article describing the study, entitled "Women's Early
Warning Symptoms of AMI," appears in today's rapid access issue of
. Circulation: Journal of the American Heart Association . .
. The study was funded by the National Institute of Nursing Research
(NINR), part of the National Institutes of Health, Department of
Health and Human Services.
. Jean McSweeney, PhD, RN, Principal Investigator of the study at
the University of Arkansas for Medical Sciences in Little Rock,
said, "Symptoms such as indigestion, sleep disturbances, or weakness
in the arms, which many of us experience on a daily basis, were
recognized by many women in the study as warning signals for AMI. .
Because there was considerable variability in the frequency and
severity of symptoms," she added, "we need to know at what point
these symptoms help us predict a cardiac event."
. There were 515 women participating in the study from 5 sites in
Arkansas, North Carolina and Ohio. . The women were mostly
Caucasian, high school educated and older, and all had all been
diagnosed with AMI within the previous 4 to 6 months. . Their
memories of their prodromal and acute symptoms were assessed using
the McSweeney Acute and Prodromal Myocardial Infarction Symptom
Survey (MAPMISS). . This survey lists 33 prodromal and 37 acute
symptoms previously identified in an earlier study. . The women
responded to the survey by telephone, rating the prodromal symptoms
according to intensity, frequency, and duration. . They rated acute
symptoms by intensity. . They also described whether the symptoms
were new or changed in intensity or frequency prior to the AMI, and
whether they disappeared or returned to usual patterns following the
. According to Patricia A.Grady, PhD, RN, Director of the NINR,
"Increasingly, it is evident that women's symptoms are not as
predictable as men's. . This study offers hope that both women and
clinicians will realize the wide range of symptoms that can indicate
heart attack. . It is important not to miss the earliest possible
opportunity to prevent or ease AMI, which is the number one cause of
death in both women and men."
. Major prodromal symptoms in order of reported frequency
- . Unusual fatigue - 70%
- . Sleep disturbance - 48%
- . Shortness of breath - 42%
- . Indigestion - 39%
- . Anxiety - 35%
. Major acute symptoms during AMI in order of reported frequency
- . Shortness of breath - 58%
- . Weakness - 55%
- . Unusual fatigue - 43%
- . Cold sweat - 39%
- . Dizziness - 39%
Dr. . McSweeney continues to explore women's symptoms of AMI,
including possible ethnic and racial differences.