Development of a Cardiac Prodromal Symptoms Recognition List for the Assessment of Women in Primary Care

Abstract

ABSTRACT Heart disease is the number one killer of American women regardless of age or race. Women still face disparity in the assessment and recognition of heart disease. One key element that contributes to this delay is a prodromal symptom presentation that may impede quick assessment and streamline treatment for cardiovascular events. The aims of this project, using best evidence and initial testing with data from Arizona Health Sciences Center Clinical Research Data Warehouse, is to construct a women's Cardiac Prodromal Symptoms Recognition Assessment List to increase early recognition of cardiovascular etiology, resulting in earlier diagnostics and treatment. A literature review was completed to determine a list of current cardiac prodromal symptoms in women. Symptom data was mined from the clinical research data warehouse and compared to the symptom list. The project results support that prodromal symptoms are valid as identifiers of women experiencing a cardiac event. The literature review identified ten prodromal symptoms; Chest Pain/Discomfort, Shortness of Breath, Fatigue, Arm/Shoulder Pain, Weakness, Nausea/Indigestion, Back Pain, Jaw Pain, Sleep Disturbance and Dizziness/Syncope that are consistent in the literature. The Clinical Research Data Warehouse (CRDW) clinical elements did match the literature prodromal symptoms list with the additional elements of edema defined as a physical finding and depression defined as a risk factor. Application of the literature review and mined clinical data provide an opportunity to explore a clinical issue such as cardiac prodromal symptoms recognition for women and to assist providers in rapid identification and treatment initiation for women experiencing cardiac events.