Cardiac pain burdens more women than men. Women have a varied pattern and distribution of chest- and non-chest-related pain symptoms associated with both obstructive and non-obstructive coronary artery disease. Women often describe their cardiac pain as sharp and burning, with additional symptoms of discomfort in the jaw and neck, shortness of breath, sweating and extreme fatigue. This varied pattern and distribution of symptoms make it difficult for women to interpret their pain to be cardiac-specific. Women minimize their symptoms, prefer to consult with family and friends, and as a result, delay seeking appropriate care for their cardiac pain.
Non-obstructive coronary artery disease, or Cardiac Syndrome X (CSX), is angina-like chest discomfort without evidence of coronary artery obstruction. Every year in Ontario, 45,000 people with chest pain undergo coronary angiography; 10 – 30% are postmenopausal women with no evidence of obstruction in their large coronary arteries. Women are also more likely than men to report persistent pain of moderate to severe intensity up to two years after cardiac surgery. They do not want to complain about their pain, and they prefer to be less active and reduce their intake of pain medication. Poorly controlled acute pain leads to persistent pain, a debilitating complication for women following cardiac surgery. Women have difficulty remembering information about pain management and they want more individualized information about the self-management of pain.
Mobile health technologies have been recently developed to help women manage weight, increase physical activity, monitor for perinatal depression, and assist with smoking cessation. Women view mobile health technologies as novel and supportive, and they indicate that these technologies motivate healthy behaviors, reduce symptoms, improve quality of life, and are a crucial source of information for them. The overall goal of this program of research is to develop and systematically evaluate an integrated smartphone (iPhone/Android) and web-based intervention (HEARTPA♀N) to provide real-time support and decision-making for women with cardiac pain.