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- Title
Acute and Neuropathic Pain Characteristics Observed in Men and Women with Acute Coronary Syndromes.
- Authors
O'Keefe-McCarthy, S.; McGillion, M.; Clarke, S.; Victor, J. C.; Rizza, S.; McFetridge-Durdle, J.
- Abstract
Background: Cardiac pain arising from an acute coronary syndrome (ACS) has been described as a complex phenomenon. Lacking are cardiac pain assessments that describe acute ACS pain using a multi-factoral pain assessment tool during the first eight hours of an emergent ACS-related pain episode. Aim: To examine the sensory-discriminative, motivational-affective and cognitive-evaluative dimensions of an emergent ACS-related pain episode. Methods: A descriptive, correlational, cross-sectional design was used to collect data on cardiac pain intensity scores (numeric rating scale-NRS; McGill Pain Questionnaire MPQ-SF) and state anxiety (Speilberger State-Anxiety Inventory-SAI) on 121 ACS patients. Results: The mean age was 67.6 ± 13,50% were female, 40% had Non-ST-Elevation myocardial infarction and 60% had unstable angina. Patients' cardiac pain intensity scores (NRS) remained in the mild range from 1.1 ± 2.2 to 2.4 ±2.7. MPQ-66% of the sample described their global pain as distressing (moderate pain), and 26% reported ACS pain as excruciating (severe pain). ACS pain was described as a mixture of acute injury (nociceptive) and nerve damage (neuropathic) pain. State anxiety was persistent at a high level and ranged from 44.0 ± 7.2 to 46.2 ± 6.6. Conclusions: ACS patients reported both nociceptive and neuropathic types of cardiac pain. It is unclear if individual pain perceptions are due to: i) the pathophysiology of clot formation, ii) co-morbidities, iii) occurrence of a first or repeat ACS episode, or iv) the equivocal relationship of angina pain and myocardial ischemia. Significance: Management of ACS-related pain requires an understanding of the interplay of ischemic, metabolic and neuropathophysiological mechanisms that contribute to individuals' cardiac pain experiences. Use of a multi-dimensional pain assessment tool is necessary to screen those at risk for development of persistent cardiac pain.
- Subjects
ANGINA pectoris; RESEARCH methodology; MYOCARDIAL infarction; PERIPHERAL neuropathy; PAIN; QUESTIONNAIRES; MCGILL Pain Questionnaire; PAIN measurement; CROSS-sectional method; ACUTE coronary syndrome; DESCRIPTIVE statistics
- Publication
Canadian Journal of Cardiovascular Nursing, 2016, Vol 26, Issue 3, p4
- ISSN
0843-6096
- Publication type
Article