The patient population consisted of a maximum of 18,570 subjects who completed the NHANES III questionnaire and examination from 1988 - 1994. The physical examination included such things as body mass index and serum samples, social and medical history. The periodontal examination recorded probing depth, attachment loss and gingival bleeding. Serum samples were analyzed for CRP levels, cholesterol levels etc. Demographic, cardiovascular and oral health variables were compared in subjects with a history of heart attack. Result showed that history of heart attack is associated with increased odds ratio for elevated CRP, diabetes, hypertension, cholesterol, male gender, non-white race and smoking. Of the periodontal indicators of disease, only gingival bleeding had an increased odds ratio for association with heart attack history. The unadjusted odds ratio was 1.25 with 95% CI[0.84-1.87]. The adjusted odds ratio increase to 1.93 with 95% CI [1.02-3.71]. These findings are consistent with previous research indicating that elevated CRP is associated with increased risk of heart attack. The interesting finding of this study is that only gingival bleeding, not probing depth or attachment loss, had an increased odds ratio for an associated with self-reported history of heart attack.

Sjukdomar i hjärtats kranskärl och dess komplikationer förorsakar 23% av alla dödsfall hos kvinnor i Sverige där akut hjärtinfarkt ensam står för 6% av fallen. Atypiska och diffusa symtom är en av orsakerna till att kvinnor med hjärtinfarkt inte alltid kommer till sjukhus i tid. Syftet med denna litteraturstudie är att belysa kvinnors upplevelser av hjärtinfarkt i det akuta skedet. Vi vill även få klarhet i varför kvinnor ofta väntar med att söka vård och dessutom riskerar att inte bli tagna på allvar. Vi har valt metod i form av en litteraturstudie där vi analyserar kvalitativ forskning som bygger på nio vårdvetenskapliga artiklar. I vårt resultat kom vi fram till följande teman och subteman: Kvinnor söker inte vård i tid, Tar inte signalerna på allvar, Relaterar symtomen till andra orsaker, Vill inte var till besvär för andra och hjärtinfarkt drabbar inte mig, Något är fel i min kropp, Sökande av råd och stöd och Upplevelser av symtomen i det akuta skedet, samt Kvinnor blir inte alltid tagna på allvar, Risk för felaktig diagnos – felaktig behandling och Blir inte tagna på allvar. Vi ser det som ett stort problem att många kvinnor underskattar risken att drabbas av akut hjärtkärlsjukdom. Likaså att de vid det akuta insjuknandet relaterar sina hjärtinfarktsymtom till något annat och därför väntar med att söka medicinsk hjälp. Vår förhoppning är att kvinnor blir mer uppmärksamma på kroppens signaler och inte tvekar att söka vård om de känner sig osäkra eller oroliga. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

Thesis (MPH) --University of Limpopo, 2007. / Aim of the study: To determine knowledge of CPR and heart attack or cardiac arrest signs and symptoms among university students. Study Design: A questionnaire based descriptive, cross – sectional study. Setting: University of Limpopo – Turfloop Campus in Limpopo Province of South Africa. Subjects: A total sample of 400 students participated in the study. The sample was selected randomly using simple random sampling techniques. Outcome measures: The faculty, age, gender and level of study were determined as well as the knowledge each student has on signs and symptoms of impending heart attack and CPR.Results: Of the 400 students only 26% (n=104) knew the signs and symptoms of an impending heart attack as well as out of hospital management of heart attack by performing CPR. There were differences between and within faculties, age groups, gender and level of study. Based on the Bonferroni test the student from faculty of Sciences, Health and Agriculture are more likely (p-value 0017) to know when to perform CPR compared to students from other faculties. Level of study is not associated (p-value 0128) with how much the students know about the timing and indications of CPR. Overall female students performed worse with 79% (n=123) responding incorrectly to the questions compared to 69% (n=169) males. Conclusion: Based on the results of this study it safely can be concluded that the students’ knowledge of signs and symptoms of an impending heart attack and CPR procedure is poor. It is therefore important for the university as a center of teaching and learning to consider including as part of university curriculum, basic life support and first aid courses which include CPR. The inclusion of basic life support and first aid in university curriculum will prepare students to be able to effectively manage out of hospital heart attack and reduce mortality resulting from the latter. The findings of this study might to a certain extent be reflecting what the public’s knowledge on the subject is, hence the need for the policy makers to take serious note of the findings when public health promotion programmes are developed.

The adoption of health behaviours is essential if coronary heart disease patients are to optimise their chance of survival and reduce the likelihood of recurrent coronary events. However, this behavioural change may not ensue following an acute myocardial infarction(AMI). This study on first AMI subjects sought firstly to examine the psychometric properties of five scaled instruments used for assessing health behaviours. Secondly, the study assessed the prevalence of health-enhancing behaviours at the time of the first AMI and 6 months after this event.Thirdly, the magnitude of health behavioural change was then examined. Fourthly, sociodemographic, clinical and psychosocial predictors of health-enhancing behaviours were explored.These health-enhancing behaviours included non-smoking behaviours, normal body mass index (BMI), adequate physical activity, medication adherence and low dietary fat intake. Finally, the study examined relationships between sociodemographic , psychosocial and modifiable lifestyle factors, based on Antonovsky's hypothesis on sense of coherence(SOC), stress and adaptive coping. The study highlights that some modifiable risk factors, for example, being overweight or obese and physical inactivity were more resistant to change following an AMI.This finding, and the relationship between stress and increased dietary fat suggest a need for individualised programs to support the specific needs of AMI patients to change their modifiable cardiac risk factors. / Doctor of Philosophy (PhD)(Health)

Varje dag drabbas cirka 100 personer av hjärtinfarkt i Sverige, vilket visar att hjärtinfarkt är ett stort samhällsproblem. Det är viktigt att skapa en samlad bild av dessa patienters upplevelser av hälsa och välbefinnande i vardagen för att vårdpersonal ska kunna genomföra en god omvårdnad. Syftet med studien är därför att med hjälp av Katie Erikssons hälsokors belysa patienters upplevelser av hälsa och välbefinnande i vardagen efter en hjärtinfarkt. Metoden som har använts är en kvalitativ litteraturstudie som baserats på självbiografier. I resultatet togs sju kategorier fram som speglar patienternas upplevelser i vardagen. Kategorierna är Känsla av osäkerhet, En stressad livssituation, En livslång sjukdom, Längtan efter en normal vardagstillvaro, Behov av stöd och information, Livsstilsförändringar samt En andra chans. Varje kategori har kopplats till Katie Erikssons hälsokors för att få en bild av patienternas upplevelse av hälsa och välbefinnande. Resultatet visar att alla fyra hälsopositionerna i hälsokorset finns representerade i vardagstillvaron hos patienter som genomgått hjärtinfrakt. Upplevelsen av hälsa och välbefinnande är skiftande beroende på situation, omgivning, vårdpersonalens engagemang samt hjärtinfarktens svårighetsgrad. Resultatet visar att patienter har lättare att uppleva hälsa och välbefinnande ju längre tiden går efter insjuknandet. / Approximately 100 people suffer from heart attacks in Sweden every day, showing that myocardial infarction is a major problem in society. In implementing good health care it is important for health professionals to create an overall picture of these patients' experiences of health and wellbeing in their daily life. The purpose of this study is therefore to emphasize patients' experiences of health and wellbeing in daily life after a heart attack, with Katie Eriksson's health positions as theoretical base. A qualitative study based on seven autobiographies was conducted. Analysis of the data revealed seven major categories, showing the patients' experiences  the daily life after a heart attack: Feeling of insecurity, A stressful life situation, A lifelong disease, Striving for a normal daily life, The need for support and information, Lifestyle changes and A second chance. To get a picture of the experiences of health and wellbeing in these different situations, each category was added to Katie Eriksson's health positions. The findings show that all four health positions are represented in the daily life of patients' suffering from a heart attack. Patients are more likely to experience health and wellbeing as time passes after the heart attack.

Includes vita. / Title from PDF of title page. / Document formatted into pages; contains 103 pages. / Thesis (Ph.D.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The goal of this study was to examine differences in the psychological characteristics of patients admitted to the hospital for acute or chronic Myocardial Infarction (MI) or Unstable Angina (UA). Depression, anger, anxiety, curiosity, defensiveness, social support, and coping were evaluated for 165 patients (86 MI and 79 UA), who were tested on the Cardiology Stepdown Ward of Tampa General Hospital. The following psychological measures were administered to these patients: the Beck Depression Inventory (BDI), the State-Trait Anger Expression Inventory (STAXI-2), the Rationality/Emotional Defensiveness (R/ED) Scale, the Adult Form of the Coping Responses Inventory (CRI-Adult), the Interpersonal Support Evaluation List (ISEL), the Illness Perception Questionnaire (IPQ), the State-Trait Personality Inventory (STPI), and the Structured Clinical Interview (SCID-I) for the DSM - IV. Significantly more chronic patients than acute patients met criteria for depression as measured by the SCID following admission to the hospital, and more UA than MI patients also met these criteria. However, no differences were found between the acute and chronic MI and UA patients two weeks prior to admission. Results of this study also indicated that chronic patients and UA patients reported a greater frequency of illness symptoms and tended to cope with their heart disease through avoidant strategies. Chronic patients endorsed higher levels of state and trait anger compared with acute patients, and UA patients were less likely to believe that their illness could be cured or controlled (Control of Cure) than MI patients. Based on the results of this study, it appears that avoidance coping may be an insufficient strategy for addressing negative emotions of chronic patients and UA patients. In addition, perceived lack of control over the success of treatment may be related to depression for UA patients. These findings have important implications for the development and implementation of interventions designed to address perceived control over treatment effectiveness and coping skills for negative emotions in the treatment and rehabilitation of cardiac patients. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Hjärtinfarkt är en av de vanligaste orsakerna till dödsfall i Sverige. Det är vanligt att de som drabbats har svårt att hantera sin förändrade livssituation eftersom sjukdomen påverkar vardagen fysiskt, psykiskt, socialt och ekonomiskt. Kvinnor har oftare svårare att anpassa sig till livet efter hjärtinfarkten än män. Syftet med studien var att beskriva hur kvinnor upplever det dagliga livet efter en hjärtinfarkt. Metoden för studien var en litteraturöversikt av 10 kvalitativa artiklar. I resultatet framkom fem olika kategorier; En förändrad livssituation som innebär förändrad social roll och hur kvinnan hanterade livet efter hjärtinfarkten. Förändrade relationer beskriver hur relationerna till vänner, familj och arbetskamrater påverkas. Behov av stöd omfattar stödet som kvinnan behöver för att kunna hantera sin nya livssituation. Den förändrade kroppen tar upp vilka kroppsliga symtom som kan komma efter en hjärtinfarkt och Känslomässiga reaktioner beskriver det psykiska måendet som kom med den nya situationen. Slutsatsen är att kvinnorna ofta förlorar kontroll över det dagliga livet och är i behov av stöd både från vårdpersonal och närstående. / Myocardial infarction is one of the most common causes of death in Sweden. It is common for the affected person to have difficulties managing the changes in his or her life situation caused by the disease both physically, mentally, socially and economically. Women have more often difficulties adapting to her life after a myocardial infarction than men do. The aim of this study was to describe how women experience daily life after a myocardial infarction. The methodology for this study was a literature review of ten qualitative studies. The result showed five different categories; A changed life situation, which describes changed social roles and how woman managed life after a myocardial infarction. Changes in relationships, which describes how relationships with friends, family and co-workers are affected. The category Need of support process the assistance that women need in order to manage their new life situation. The changed body, which involves the physical symptoms that can occur after a myocardial infarction and Emotional reactions, which describes the mental condition that accompanies the new situation. The conclusion is that women often lose control over their daily lives and are in need of support from both health care professionals and relatives.

The goal of this study was to examine differences in the psychological characteristics of patients admitted to the hospital for acute or chronic Myocardial Infarction (MI) or Unstable Angina (UA). Depression, anger, anxiety, curiosity, defensiveness, social support, and coping were evaluated for 165 patients (86 MI and 79 UA), who were tested on the Cardiology Stepdown Ward of Tampa General Hospital. The following psychological measures were administered to these patients: the Beck Depression Inventory (BDI), the State-Trait Anger Expression Inventory (STAXI-2), the Rationality/Emotional Defensiveness (R/ED) Scale, the Adult Form of the Coping Responses Inventory (CRI-Adult), the Interpersonal Support Evaluation List (ISEL), the Illness Perception Questionnaire (IPQ), the State-Trait Personality Inventory (STPI), and the Structured Clinical Interview (SCID-I) for the DSM - IV. Significantly more chronic patients than acute patients met criteria for depression as measured by the SCID following admission to the hospital, and more UA than MI patients also met these criteria. However, no differences were found between the acute and chronic MI and UA patients two weeks prior to admission. Results of this study also indicated that chronic patients and UA patients reported a greater frequency of illness symptoms and tended to cope with their heart disease through avoidant strategies. Chronic patients endorsed higher levels of state and trait anger compared with acute patients, and UA patients were less likely to believe that their illness could be cured or controlled (Control of Cure) than MI patients. Based on the results of this study, it appears that avoidance coping may be an insufficient strategy for addressing negative emotions of chronic patients and UA patients. In addition, perceived lack of control over the success of treatment may be related to depression for UA patients. These findings have important implications for the development and implementation of interventions designed to address perceived control over treatment effectiveness and coping skills for negative emotions in the treatment and rehabilitation of cardiac patients.

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.

Coronary heart disease, including acute myocardial infarction (AMI), is the nation's leading cause of death. This study examined the characteristics and outcomes of 397 African American (AA) patients within one year of hospitalization due to AMI at Grady Memorial Hospital (GMH) in Atlanta. The PREMIER study, a nationwide registry, maintained by John Spertus MD, included data from patient interviews, medical records, and clinical characteristics like diabetes, hypertension, smoking, angina frequency and quality of life was used. Patient characteristics, associated with a major adverse event (MAE) within one-year post AMI were evaluated using SAS. Results showed a trend of higher odds of younger age, hypertension, and diabetes in women than men at the time of hospitalization. Although this study did not show any gender differences in the outcomes of AA patients following AMI, a trend of effect modification by gender on various variables was seen. Further research is recommended to examine factors contributing to gender differences in outcomes after an AMI.