Understanding Symptom Experiences of Older Individuals with Acute Coronary Syndrome

Abstract

This qualitative descriptive study described the prodromal symptoms of older individuals, age 65 and above, experiencing acute coronary syndrome (ACS). Review of the literature establishes that older adults experiencing precursor symptoms of ACS are a high-risk group, one that experiences disparities in hospital emergency departments (EDs) and decreased ACS survival. Identification of early symptoms predictive of ACS may influence a patient's willingness to seek medical treatment and necessitate early, accurate diagnosis and treatment. The purpose of this study was to describe older individual's prodromal symptoms patterns and symptom experiences including perceptions, interpretations, and treatment seeking decisions. This study compared and contrasted symptom patterns of ACS among groups of older adult participants, age 65+ based upon age, gender, and other demographic characteristics (previous myocardial infarction, race, ethnicity, regular exercise, insurance, and comorbidity). Three specific aims were addressed in this study. Specific Aim 1 Explore the prodromal symptom patterns as perceived by the older individual encountering ACS. Specific Aim 2 Explore the older individual's interpretation of the prodromal symptom patterns encountering ACS. Specific Aim 3 Explore the treatment decision making processes used by older individuals when experiencing and interpreting prodromal symptom patterns in ACS. Participants included patients newly diagnosed with ACS and ≥ 65 years of age. For the qualitative description, participants (n=20) were recruited and a chart audit was conducted. Demographic information and data were obtained from the admitting ED history and physical, and discharge summary. Additionally, face-to-face semi-structured interviews were conducted with each participant. Content and matrix analyses were used to address the study aims. Research findings from this study elucidated early symptom indicators of myocardial ischemia/infarction (MI), which may be used for screening or developing ACS assessment guidelines specific to geriatric patients.