113 Oral Inconsistency in measuring pre-hospital delay: Recommendations for defining symptom onset

Abstract

Background: Some symptoms commonly associated with myocardial infarction may appear as early symptoms in the absence or presence of chest pain in both women and men. Purpose: To describe the general symptoms in patients with MI and to analyze gender differences. Methods: Descriptive study with prospective data collection on 406 patients admitted to a coronary intensive care unit diagnosed of myocardial infarction by electrocardiogram, serum cardiac enzimes and clinical symptoms. General symptoms collection during the acute crisis was performed by personal interview to the patient. We adapted the "McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey" to a list of 27 symptoms, and to our language cultural context. Symptom checklist developed by D´Antono in 2006 was used to evaluate general symptoms: twenty-three-item checklist designed to assess the more subtle symptoms associated with ischemia. Interviews was performed by a group of cardiology nurses at the first day after the admission or when patient was clinically stable. Informed consent was obtained from all patients enrolled in the study Results: 98% of the patients showed any general symptoms. The average symptom onset was 5.6 symptoms (standard deviation 2.4 symptoms). The most common general symptoms in all participants during the acute crisis were: sweating (71.4%), fatigue / tiredness (71.4%), feeling of weakness (56.4%), dyspnea (50.5%) nausea (44.3%), upset stomach (29.8%), dizziness (29.6%). The differences between women and men were seen in 5 general symptoms: women were more fatigue / tiredness (women: 66.5% vs. men: 52.7%, p <0.005) than men, dizziness (women: 35.5% vs. men: 23, 6%, p <0.009), the sensation of a lump in my throat (women: 14.3% vs. men: 7.4%, p <0.025), heart palpitations (women: 9.4% vs. men: 3%, p < 0.007), and flushing (women: 7.4% vs. men: 3%, p <0.044). Conclusions: Most of the patients in the acute phase of myocardial infarction presented general symptoms. Differences were observed by gender, being more common in women of fatigue, dizziness, throat, palpitations and flushing.