Thoughts and behaviors of women with symptoms of acute coronary syndrome

Heart Lung. Nov-Dec 2013;42(6):428-35. doi: 10.1016/j.hrtlng.2013.08.001. Epub 2013 Sep 5.


Objective: Women delay seeking care for symptoms of acute coronary syndrome (ACS) because of atypical symptoms, perceptions of invulnerability, or keeping symptoms to themselves. The purpose of this study was to explore how women recognized and interpreted their symptoms and subsequently decided whether to seek treatment within the context of their lives.

Method: Grounded theory was used to provide the methodological basis for data generation and analysis. Data were collected using in-depth interviews with 9 women with ACS.

Results: All participants went through a basic social process of searching for the meaning of their symptoms which informed their decisions about seeking care. Stages in the process included noticing symptoms, forming a symptom pattern, using a frame of reference, finding relief, and assigning causality. The evolving MI group (n = 5) experienced uncertainty about bodily cues, continued life as usual, until others moved them toward care. The immediately recognizable MI group (n = 4) labeled their condition quickly, yet delayed, as they prepared themselves and others for their departure.

Conclusions: All women delayed, regardless of their ability to correctly label their symptoms. Education aimed at symptom recognition/interpretation addresses only part of the problem. Women should also be educated about the potential danger of overestimating the time they have to seek medical attention.

Keywords: Acute coronary syndrome; Help seeking behavior; Myocardial infarction; Treatment delay; Women.

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / psychology*
  • Adult
  • Decision Making
  • Diagnostic Self Evaluation*
  • Female
  • Hospitalization
  • Humans
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Patient Acceptance of Health Care*