A Qualitative Exploration of Prodromal Myocardial Infarction Fatigue Experienced by Women

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Publication Date



Acute coronary syndrome, Anergia, Asthenia, Fatigue, Myocardial infarction, Prodromal symptoms, Theory of Unpleasant Symptoms


Aims and objectives

The purpose of this study was to explore adult women's unique and shared experiences of prodromal myocardial infarction fatigue.


Fatigue is the most prevalent symptom experienced by women in the weeks and months before myocardial infarction. However, dimensions of this fatigue, such as timing, distress, intensity, quality, patterns and associated characteristics have not been established through studies of this symptom. A lack of understanding of the characteristics of myocardial infarction fatigue and the context in which it occurs makes clinical decision‐making difficult.


A qualitative, multiple case study guided by the Theory of Unpleasant Symptoms.


Women were purposively enrolled from a large hospital in the Midwestern USA. Semi‐structured, audio‐recorded interviews were conducted during hospitalisation and at 2–3 months postdischarge; women were also provided with a journal. A supplementary interview with family members and electronic health record review also assisted in data triangulation. Analysis was inductive and conducted within and across cases, using coding and categorisation, counting, clustering, visual displays of data and thematic development. The SRQR checklist was used in reporting the study.


Ten women, with a median age of 60, participated. Fatigue was described primarily using the terms tiredness and lack of energy, though some women described generalised weakness and cognitive fog. This fatigue was unusual and a notable change from baseline. Many women described significant difficulties performing activities of daily living due to fatigue.


The findings of this study will advance symptom science and an understanding of prodromal myocardial infarction fatigue. Future instrument development or selection of instruments for quantitative work will be aided by this study.

Relevance to clinical practice

This study provides a clearer picture of prodromal myocardial infarction fatigue experienced by women, aiding healthcare professionals in understanding and identifying this symptom.


This article was originally published in Journal of Clinical Nursing 29, no. 19-20 (October 2020): 3882-3895. https://doi.org/10.1111/jocn.15432