Patient-reported symptoms in acute myocardial infarction: differences related to ST-segment elevation: the
I Kirchberger1, C Meisinger, M Heier
1MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany. inge.kirchberger@helmholtzmuenchen.de
Insights
Early recognition of myocardial infarction (MI) symptoms is vital. This study found significant differences in presenting symptoms between ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI) patients, highlighting a need for improved public awareness.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Early symptom recognition is critical for myocardial infarction (MI) outcomes.
- Limited research exists on symptom variations between ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI).
Purpose of the Study:
- To investigate and compare the presenting symptoms of STEMI versus NSTEMI patients.
- To identify key differences in symptom profiles to aid in early diagnosis.
Main Methods:
- A population-based registry study included 889 STEMI and 1268 NSTEMI first-time MI patients (aged 25-74).
- Data on 13 specific symptoms were collected via standardized patient interviews.
- Logistic regression analysis was used to compare symptom prevalence between STEMI and NSTEMI groups.
Main Results:
- STEMI patients were younger, more likely smokers, and less likely to have prior hypertension or sleep disturbances.
- Vomiting, dizziness, and diaphoresis were more frequent in STEMI patients.
- Dyspnea and throat/jaw pain were less common in STEMI patients compared to NSTEMI.
Conclusions:
- Only 50% of patients attributed their symptoms to cardiac causes.
- Distinct symptom patterns exist for STEMI and NSTEMI, necessitating further research.
- Public awareness campaigns for acute MI symptoms require enhancement.
Objectives:
The early recognition of symptoms of myocardial infarction (MI) is crucial for patients with both ST-segment elevation (STEMI) and non-STEMI (NSTEMI). However, to date, only a few studies have examined the differences between patients with STEMI and NSTEMI with regard to the range of presenting MI symptoms.
Design:
The study population comprised 889 individuals with STEMI and 1268 with NSTEMI, aged 25-74, hospitalized with a first-time MI between January 2001 and December 2006 recruited from a population-based MI registry. The occurrence of 13 symptoms was recorded during a standardized patient interview.
Results:
Patients with STEMI were significantly younger, more likely to be smokers and less likely to have a history of hypertension or sleep disturbances prior to the acute MI (AMI) event than those with NSTEMI. A total of 50% of the patients attributed their experienced symptoms to the heart. Logistic regression modelling revealed that patients with STEMI were significantly more likely than patients with NSTEMI to complain of vomiting [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.76-3.05], dizziness (OR 1.63, 95% CI 1.30-2.03) and diaphoresis (OR 1.49, 95% CI 1.23-1.81). Furthermore, patients with STEMI were less likely to experience dyspnoea (OR 0.81, 95% CI 0.68-0.98) or pain in the throat/jaw (OR 0.80, 95% CI 0.66-0.98).
Conclusions:
Only half of all patients correctly attributed their symptoms to the heart. Patients with STEMI and NSTEMI showed differences regarding several presenting symptoms. Further research is needed to replicate our results, and public awareness of AMI symptoms needs to be improved.
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