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[Criteria for differential diagnosis in cardial symptoms; left- or right-sided chest pain?]
R Beunderman1, M Sramek, R W Koster
1Afd. Medische Psychologie, Academisch Medisch Centrum, Amsterdam.
Insights
Myocardial infarction pain is often felt on the right side of the chest and right arm, unlike non-cardiac chest pain. This finding helps differentiate heart attack symptoms from other chest pain causes.
Area of Science:
- Cardiology
- Pain Medicine
Context:
- Chest pain is a common symptom with diverse etiologies.
- Differentiating acute myocardial infarction (MI) from non-cardiac chest pain (NCCP) is critical for timely intervention.
Purpose:
- To compare the pain localization patterns of acute myocardial infarction (MI) with non-cardiac chest pain (NCCP).
- To identify specific pain locations that may better differentiate MI from NCCP.
Summary:
- Patients with MI and NCCP showed similar pain localization in the mid-chest, left chest, and left arm.
- MI patients reported pain in the right chest and right arm twice as frequently as NCCP patients.
- These findings remained consistent whether assessed acutely or five days later.
Impact:
- Pain localization in the right chest and right arm can be a more effective differentiator between MI and NCCP than classical symptoms.
- This may improve diagnostic accuracy and expedite treatment for myocardial infarction.
Abstract:
We studied the localization of pain in the acute phase of myocardial infarction in comparison with localization in non-cardiac chest pain. Myocardial infarction patients could not be differentiated from patients with non-cardiac chest pain in localization of pain on mid-chest, left side of the chest and left arm. However, myocardial infarction patients reported pain on the right side of the chest and in the right arm twice as often as non-cardiac chest pain patients. Results are similar when patients indicated the localization of the pain symptoms on attending the Emergency Coronary Care Unit, or when asked five days later. Pain symptoms on the right side of the chest and the right arm differentiate better between myocardial infarction and non-cardiac chest pain than the 'classical' symptom pattern.