Patients with angina often describe their symptoms in complex ways that do not align with classic diagnostic frameworks, highlighting the need for broad clinical awareness in primary care.
May warrant eliciting nuanced symptom narratives in primary care angina assessment; leaves open impact on diagnostic accuracy.
BACKGROUND: Initial diagnosis of angina in primary care is based on the history of symptoms as described by the patient in consultation with their GP. Deciphering and categorising often complex symptom narratives, therefore, represents an ongoing challenge in the early diagnosis of angina in primary care. AIM: To explore how patients with a preexisting angina diagnosis describe their symptoms. METHOD: Semi-structured interviews were conducted with 64 males and females, identified from general practice records as having received a diagnosis of angina within the previous 5 years. RESULTS: While some patients described their angina symptoms in narratives consistent with typical anginal symptoms, others offered more complex descriptions of their angina experiences, which were less easy to classify. The latter was particularly the case for severe coronary artery disease, where some patients tended to downplay chest pain or attribute their experience to other causes. CONCLUSION: Patients with a known diagnosis of angina do not always describe their symptoms in a way that is consistent with Diamond and Forrester's diagnostic framework for typicality of angina. Early diagnosis of angina in primary care requires that GPs operate with a broad level of awareness of the various ways in which their patients describe their symptoms.
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Jones et al. (2010) studied this question.
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