Presenting characteristics and management of chest pain among culturally and linguistically diverse populations: a comprehensive review

Background:Delays in seeking medical care for chest pain in general population have been well documented. However,responding to, and managing chest pain symptoms among culturally and linguistically diverse (CALD) populations is a little known and poorly explained area. This literature review compares differences in delay time and management of seeking care for chest pain between CALD patients worldwide.Methods:A comprehensive literature review of English language publications was performed using the Medline, CINALH and other relevant databases. The reference lists of all identified reports and articles were searched for additional studies.Results:The search yielded 5696 articles and 306 full-text articles were assessed for eligibility. Thirteen articles have been included in this study. CALD groups with chest pain were more likely to be younger than Caucasians and presented with atypical symptoms. Seven studies reported differences in seeking care behaviour. Delay times across studies ranging from 1 hour to 8.8 hours with mean and median of 3.09 and 2.25 hours respectively. Eleven studies concluded ethnicity was a significantly associated with longer delay time (p<0.05). The median delay times were 2.05, 2.95,2.58, 2.3 hours for Caucasians, blacks, Asian and Hispanic respectively. Ambulance utilisation ranged from 34.4% to81.4%, with the mean of 49.08%. CALD were less likely to use ambulance than whites.Conclusion:CALD patients have differences in responses to, symptoms of and presentations of cardiac events. They were more likely to delay longer than general population. Further research is recommended to explore this phenomenon and improve in practices