Poor prognosis of patients presenting with symptomatic myocardial infarction but without chest pain

Related Experiment Video

Updated: Oct 4, 2026

Myocardial Infarction and Functional Outcome Assessment in Pigs
12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

M F Dorsch1, R A Lawrance, R J Sapsford

  • 1BHF Heart Research Centre, Jubilee Wing, Leeds General Infirmary, Leeds LS2 9JT, UK.

Heart (British Cardiac Society)
|October 17, 2001
PubMed

Insights

Atypical presentations of myocardial infarction (MI) without chest pain are common and linked to higher mortality. Patients with these symptoms may not receive timely, life-saving treatments, highlighting a critical gap in care.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Acute myocardial infarction (AMI) diagnosis typically relies on classic chest pain symptoms.
  • Atypical presentations of AMI, lacking chest pain, pose diagnostic and therapeutic challenges.
  • Understanding these atypical cases is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the clinical characteristics of patients with atypical acute myocardial infarction.
  • To evaluate the prognosis and treatment patterns in patients presenting without chest pain.
  • To identify factors contributing to the increased mortality in atypical AMI cases.

Main Methods:

  • Retrospective review of consecutive cases of possible acute myocardial infarction across 20 hospitals.
  • Data abstraction included epidemiological and clinical variables from patient records.
  • Statistical analysis, including Cox regression, was used to assess mortality risk.

Main Results:

  • 20.2% of AMI patients presented with symptoms other than chest pain.
  • These patients were older, more frequently women, and had more heart failure history.
  • Atypical presentation was associated with significantly higher 30-day (49.2%) and 365-day (61.0%) mortality and reduced beneficial treatment uptake.

Conclusions:

  • Atypical myocardial infarction presentation without chest pain is prevalent and carries a higher mortality risk.
  • Delayed or missed diagnosis may contribute to poorer outcomes.
  • There is a need to optimize treatment strategies for patients with atypical AMI symptoms.
Abstract

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...