Myocardial Infarction

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There are several differences between the signs and symptoms that men and women experience during an acute myocardial infarction. Men usually experience typical angina. Typical angina consisting of substernal chest pain or pressure radiating to the left arm, and pain or discomfort in the jaw, back, shoulder, or abdomen. This pain usually occurs in the morning, lasts more than 30 minutes, and is not relieved by nitrates. (Ignatavicius & Workman, 2013).

Women, regardless of age, generally experience atypical angina. Atypical angina presents as “indigestion, pain between the shoulders, an aching jaw, or a choking sensation that occurs with exertion” (Ignatavicius & Workman, 2013, p. 834). These symptoms can occur during daily activities or stressful periods. This is why it is important to ask women about any changes in their daily routine, since they may decrease their activity level due to chest pain. One of my previous female clients from clinical experienced chest pressure and a choking sensation prior to her heart attack and did not immediately seek care. She assumed it was an anxiety attack since she had had been under a great deal of stress recently. It is important for women to understand atypical angina and how their symptoms may differentiate from what is typically thought of with an MI. (Ignatavicius & Workman, 2013).

The most common lab tests to diagnoses an MI are troponins T and I, creatine kinase-MB (CK-MB), and myoglobin. These markers are used to determine cardiac damage. Although CK-MB is the lab most specific for diagnosing an MI, the peak is not until 24 hours after the patient initially begins to feel in pain. Troponins I and T and myoglobin rises much more quickly and can be an earlier indicator of an MI. Twelve-lead echocardiograms (ECGs) can be used to identify the occurrence and specific location of ischemia or necrosis of the heart. Sometimes the ECG is ordered for the right side in order to determine if any...
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