• The Acute Myocardial Infarction Symptom Experience of Mexican-American Women with Coronary Heart Disease in the U.S.-Mexico Border Region

      McEwen, Marylyn M.; Bowles, John Ray; Rosenfeld, Anne G.; Loescher, Lois J.; McEwen, Marylyn M. (The University of Arizona., 2013)
      Background: Mexican-American women are a burgeoning population and are at increased risk for heart disease. However, there are no studies published yet describing acute myocardial infarction (AMI) symptoms unique to this Hispanic subgroup. Aims: Guided by vulnerability theory, the aims were to describe Mexican-American women's perceptions of the AMI symptom experience and to measure their self-reported acute and prodromal MI symptoms. Methods: A convenience sample of eight Mexican-American women mean age 63 years (range 41-78 years) with recent AMI from the U.S.-Mexico border region participated in a semi-structured interview and completed the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS). Qualitative description was used to analyze codes from interview data and descriptive statistics to analyze the MAPMISS responses. Results: Mexican-American women's symptom experience was incongruent with what they knew to be symptoms of a heart attack. They attributed AMI symptoms to non-cardiac causes and did not think they were having an MI. Women self-managed symptoms and delayed seeking health care until symptoms became severe. "Asphyxiatia" (asphyxiating) and "menos fuerza" (less strength) were the most commonly described symptoms in the interviews. On the MAPMISS, Mexican-American women reported a mean of 11.25 (range 5-22) acute and 8.75 (range 0-17) prodromal symptoms. Sleep disturbance and weakness and nausea were the most frequently reported prodromal and acute symptoms, respectively, as measured by MAPMISS. Prodromal leg pain was reported with more frequency than prodromal general chest pain. Conclusions: Delays in seeking health services by Mexican-American women in the U.S.-Mexico border region reflect (1) the difference in their actual MI symptoms compared to preconceived ideas of a heart attack, (2) different terms used to describe their MI symptoms, and (3) not initiating healthcare services themselves. These findings can be used to inform Mexican-American women and healthcare providers in the U.S.-Mexico border region about the unique experiences of Mexican-American women. The findings that participants were not able to recognize or attribute their AMI symptoms suggest that heart health education should be tailored to Mexican-American women and targeted to Mexican-American families and communities.