Prodromal Symptoms of Acute Myocardial Infarction in Women: A Systematic Review of Current Evidence.
Vincenza Giordano, Rita Nocerino, Caterina Mercuri and 2 others
PMID 40259795WHAT IT FOUND
Women later diagnosed with acute coronary syndrome often reported prodromal fatigue, anxiety, sleep disturbance, chest discomfort and other symptoms before the event.
Nurses can ask about these when triaging or assessing women with nonspecific symptoms.
Key findings
01Several included studies reported fatigue, sleep disturbance, anxiety and chest symptoms as common prodromal symptoms in women before acute coronary syndrome.
02The review could not pool the studies because designs, populations and symptom measures were too heterogeneous.
03Most included studies were rated at serious risk of bias, mainly from self-reported outcome measurement and participant selection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only women who had already been diagnosed with acute coronary syndrome, so it cannot say how common these symptoms are in women whose symptoms are not cardiac. Symptoms were recalled after diagnosis, so memory and interpretation may be biased. The included studies used different symptom lists and time windows, so results could not be combined. Quality appraisal found serious risk in many studies. The review did not test whether asking about symptoms improves recognition or outcomes.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that these prodromal symptoms diagnose acute coronary syndrome or that asking about them has been shown to improve outcomes. The review reports what women later diagnosed with acute coronary syndrome recalled, not a tested screening strategy.