Specific prodromal symptoms in patients with acute coronary syndrome.
Mehdi Heidarzadeh, Shahla Elyaszadeh, Behrouz Dadkhah and 1 others
PMID 33570273WHAT IT FOUND
Nurses should assess specific prodromal symptoms like chest discomfort, shortness of breath, and diaphoresis in patients at risk for acute coronary syndrome.
Frequency alone is not predictive; severity and history of ischemic heart disease alter symptom presentation and predictive value.
Key findings
01Twenty-four prodromal symptoms were significantly more frequent in patients without a history of ischemic heart disease compared to healthy controls, while patients with a history of ischemic heart disease reported these 24 plus 15 additional symptoms.
02High frequency of a symptom does not indicate specificity for acute coronary syndrome, as symptoms like anxiety and unusual aches were equally prevalent in healthy controls.
03Symptoms such as vomiting were more predictive in patients without a history of ischemic heart disease, whereas shortness of breath, orthopnea, and jaw pain had higher predictive power in those with a history of ischemic heart disease.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Convenience sampling was used, which limits the generalizability of the results. The healthy group was not screened with angiography, the gold standard for ruling out coronary artery disease. The study relied on retrospective recall for patients, which may introduce bias compared to the prospective monitoring of healthy controls. The study was conducted in a specific community in Iran, which may limit applicability to other populations.
Declared interests
The authors have no funding or conflicts of interest to disclose.
The easy way to misread this
Do not assume that high frequency of a symptom like anxiety or unusual aches indicates an impending cardiac event, as these were equally prevalent in the healthy control group. Specificity, not just prevalence, determines predictive value.