Author + information
- Robert Solomon,
- Richard Nowak,
- Michael Hudson,
- Michele Moyer and
- James McCord
Background: Patient interviews regarding the duration of symptoms are commonly conducted when evaluating a patient with possible acute myocardial infarction (AMI), and are believed to distinguish between AMI and non-AMI symptoms.
Methods: In a single center, 569 patients that were evaluated in the emergency department (ED) for possible AMI from 5/2013 to 4/2015 were prospectively studied. Patients in the ED were asked by trained research personnel what was the longest duration of their predominant symptom. Diagnosis of AMI was adjudicated by 2 independent physicians in accordance with the universal definition of AMI using all clinical information and required cTnI > 0.04 ng/ml (Siemens Ultra-cTnI). In situations where there was disagreement between the adjudicators, a third adjudicator reviewed the case for final determination of AMI. Patients with ECG findings that led to immediate reperfusion were excluded.
Results: There were 45 (8%) AMIs and 484 (85%) had chest pain as their predominant symptom. In those diagnosed with AMI, the mean duration of symptoms was 14.2 ± 33 hrs as compared to 17.9 ± 54.2 hrs in the 524 non-AMI patients (p=0.307). Looking at duration of symptoms in discrete time intervals also did not show a significant difference between AMI and non-AMI patients.
Conclusions: Duration of symptoms did not help distinguish between AMI and non-AMI patients. Clinicians should focus on other elements of the history when evaluating patients with possible AMI.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-347
- 2017 American College of Cardiology Foundation