Age-related interpretations of acute myocardial infarction in women: a secondary qualitative analysis utilizing on Leventhal’s self-regulatory model

Background: Women experiencing acute myocardial infarction report a broad range of symptoms and interpret them as anxiety, stress, gastrointestinal problems, or chronic conditions. These interpretations, family responsibilities and social influences may delay timely healthcare seeking. Objectives: To explore and compare how younger and older women interpret myocardial infarction symptoms, represent illness, adopt coping strategies, and retrospectively appraise their decisions, using Leventhal’s SelfRegulation Model. Methods: A secondary qualitative analysis was conducted on face-to-face interviews with 34 women hospitalized with acute myocardial infarction in two facilities in Campania, Italy. Participants included 17 women aged under 65 and 17 women aged ≥65. Interviews explored actions, thoughts, and emotions from symptom onset to hospital arrival. Transcripts were coded through hermeneutic phenomenology and deductively mapped to threat interpretation, illness representation, coping, and appraisal. Recruitment continued until data saturation, and researcher triangulation supported analytical rigor. Results: Both groups minimized symptoms and initially attributed them to noncardiac causes. Younger women linked vague symptoms to anxiety, reflux, or stress and delayed care because of family obligations or fear of hospitals. Older women often normalized pain, adopted fatalistic or spiritual explanations, waited passively, used home remedies, and avoided alarming relatives. Across groups, worsening symptoms and encouragement from relatives or physicians represented decisive turning points toward seeking care.