" (Isaac, 2000) Issac (2005) additionally states that women with "an intermediate-probability profile, who are able to exercise and how have a normal resting ECG, should undergo ECG testing with Duke Treadmill Score (DTS)." (Isaac, 2005)
Isaac stress imaging studies should be performed "in the case of non-diagnostic ECG stress testing or in the presence of baseline ECG abnormalities." (2000) In addition it is reported that "pharmacologic stress using nuclear or echocardiographic techniques can be performed where the patient cannot exercise adequately." (Isaac, 2000) Finally, Isaac (2000) reports that women with a high probability of CAD should "undergo stress testing with DTS or coronary angiography, depending on the severity and stability of symptoms." (Isaac, 2000)
Features of Atypical Chest Pain include those as follows:
(1) Left chest, abdomen, back, arm, without mid-chest pain.
(2) Sharp or fleeting.
(3) Repeated or very prolonged.
(4) Unrelated to exercise.
(5) Not relieved by rest or exercise.
(6) Relieved by antacids.
(7) Characterized by palpitations without chest pain. (Isaac, 2000)
Reported as determinants of the likelihood of CAD in women are the following:
(1) Post-menopausal status'
(2) (without HRT)/age > 65 years
(4) Peripheral Vascular Disease.
(3) Lipid abnormalities.
(2) Sedentary lifestyle.
(3) Family history of CAD. (Isaac, 2000)
Stated as practice points n the work of Isaac (2000) are the following:
(1) patients should be classified as having a high, intermediate, or low probability of CAD and appropriate investigations initiated accordingly by taking into consideration:
(A) chest pain characteristics;
(B) age/menopausal status;
(C) Diabetes; and (D) presence of other factors.
(2) The presence of post-menopausal status or diabetes increases the likelihood of CAD independent of chest pain characteristics. (Isaac, 2000)
Demographic Perception Survey of Patients with Atypical CP Who Present to Cardiac Care Doctors and Patient Outcomes
The methodology utilized in this study will be one of a qualitative nature and one, which involves examination of the literature on women presenting with atypical chest pain to cardiac doctors.
Individuals who present and are diagnosed with atypical chest pain should get a complete physical examination, ECG and undergo exercise stress testing as well as other testing. The research questions addressed in this study include those as follows: (1) "What factors deter African-American women from seeking breast cancer screening? (2) What can doctors and staff in medical and health care facilities do to encourage African-American women to seek out breast cancer scanning?
The proposed research study is one that is qualitative in nature and that seeks to understand the diagnosis of chest pain in women presenting to cardiac doctors. According to Kleen (1995) "Case studies using qualitative methods are most valuable when the question being posed requires an investigation of a real life intervention in detail, where the focus is on how and why the intervention succeeds or fails, where the general context will influence the outcome and where researchers asking the questions will have no control over events. As a result, the number of relevant variables will be far greater than can be controlled for, so that experimental approaches are simply not appropriate."
The sample in this study is a group of women presenting with atypical chest pain to cardiac doctors.
The instrument utilized in this study is that of a survey which will be distributed to the individuals/participants in this study to be answered and returned to the researcher for analysis.
Upon receipt of approval for the research study, there will be a sampling of approximately 80 subjects who have presented to their doctor with atypical chest pain. Sampling will be accomplished through random selection patients and specifically women presenting to cardiac doctors with atypical chest pain.
Data analysis will take place through qualitative analysis of the answers provided by participants in this research study. Qualitative research is interpretive and descriptive in nature. Qualitative research is such "generally involves an iterative, spiraling, or cyclical process that proceeds from more general to more specific observations. Data analysis may begin informally during interviews or observations and continue during transcription, when recurring themes, patterns, and categories become evident. Once written records are available, analysis involves the coding of data and the identification of salient points or structures. Data reduction may include quantification or other means of data aggregation and reduction, including the use of data matrices, tables, and figures." (Miles & Huberman, 1994 in TESOL, 2011)
Cayley, WE (2005) Diagnosing the Case of Chest Pain. American Family Physician. 15 Nob 2005. Retrieved from: http://www.aafp.org/afp/2005/1115/p2012.html
Gotzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. (1):CD001877, 2011.
Issac, DL (2000) Women with Ischemic Heart Disease. Presented at the Canadian Cardiovascular Congress, Vancouver, British Columbia, October 2000. Retrieved from: http://www.stacommunications.com/journals/cme/images/cmepdf/oct01/womencv.pdf
Khan, JJ, Albarran, JW, Lopez, V, and Chair, SY (2010) Gender Differences on Chest Pain Perception associated with Acute Myocardial infarction in Chinese patients: A Questionnaire Survey. J Clin Nurs. 2010 Oct, 19 (19-20)2720-0. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/20846222
Kleen, Justin (1995) Qualitative Research: Case Study Evaluation. British Medical Journal. 12 Aug 1995. Retrieved from: http://www.bmj.com/content/311/7002/444.full
Qualitative Research: Case Study Guidelines (2011): TESOL Quarterly. Retrieved from: http://www.tesol.org/s_tesol/sec_document.asp?cid=476&did=2153
Part One -- Survey/Question on Patient with Atypical CP and their Perception of their Cardiac Doctor and Patient Outcomes
Demographic for Perception Study: Part One
For items 1-7 please check only one answer.
1. Gender: Male ____ Female
2. Age: 22-38____ 39-55____ 56+
3. Level of Education 0-11 ____ 12-23 ____ 24+
4. Occupation: Laborer: ____ Clerical ____ Professional ____ Executive ____ Beginner in field
5. I would describe the area that I live in as
6. My family income is:
7. I am:
8. I have regular mammography scanning conducted.
Demographic for Perception Study: Part Two
Answer questions scoring them according to the following scores:
1 -- Strongly agree
2 -- Agree…