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American Journal of Critical Care. 2008;17: 26-35
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Response to Signs and Symptoms of Acute Coronary Syndrome: Differences Between Lebanese Men and Women

By Samar Noureddine, RN, PhD, Mary Arevian, RN, MPH, Marina Adra, RN, MSc and Houry Puzantian, RN, MSc. Samar Noureddine is an associate professor, Mary Arevian is a clinical associate professor, Marina Adra is a clinical assistant professor, and Houry Puzantian is a clinical research coordinator at the American University of Beirut, Beirut, Lebanon.

Corresponding author: Samar Noureddine, RN, PhD, School of Nursing, American University of Beirut, PO Box 11-0236, Beirut 1107 2020, Lebanon (e-mail: sn00{at}aub.edu.lb).

Background Signs and symptoms of acute coronary syndromes differ between men and women, but whether men and women respond differently to these indications is not well understood. Such responses influence health outcomes because success of treatment depends on how quickly healthcare is sought.

Objective To explore differences between Lebanese men and women in cognitive, emotional, and behavioral responses to signs and symptoms of acute coronary syndromes.

Methods A convenience sample of 149 men and 63 women with unstable angina or acute myocardial infarction were interviewed within 72 hours of admission to coronary care in a tertiary center by using the Response to Symptoms Questionnaire. Demographic and clinical data were obtained from medical records.

Results Women were older, less educated, and more often widowed than men. More women had hypertension but more men were current smokers. Women had shoulder pain, dyspnea, nausea and vomiting, and palpitations more often than men did. Women’s signs and symptoms were rated more severe by the women than men’s were by the men. Women were less likely to know signs and symptoms of myocardial infarction than were men and delayed coming to the hospital longer than men did. Delay correlated with the characteristics of the signs and symptoms and not realizing their importance in men and with dyspnea and taking the "wait and see" approach in women.

Conclusion Factors related to promptness in seeking care for acute coronary syndromes differ between Lebanese men and women.


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