Can Symptom Presentation Predict Unstable Angina/Non-ST-Segment Elevation Myocardial Infarction in a Moderate-Risk Cohort?

Abstract

Clinicians should not rely on classic descriptions of angina when evaluating patients suspected of UA/NSTEMI.

Are there symptom differences in patients with coronary artery disease presenting to the ED ultimately diagnosed with or without ACS?

“…4, 6, 7 These two symptoms were also associated with non-ACS when demographics, clinical history and other symptoms were accounted for. This is counterintuitive because one might expect these symptoms as a result of altered cardiac output during acute ischemia.…”

Unusual Pharyngeal Pain Caused by Acute Coronary Syndrome: A Report of Three Cases

“… 6 It was also reported that patients who never experienced chest pain had a 3 times higher risk of death than patients whose chest pain persisted or recurred in the Emergency Department. 7 Therefore, it is important that the physicians make a correct initial diagnosis. An ECG and a cardiac biomarker test are recommended to exclude ACS with atypical presentation in cases with pharyngolaryngeal findings suggesting pharyngeal pain.…”

Symptomology, Outcomes and Risk Factors of Acute Coronary Syndrome Presentations without Cardiac Chest Pain: A Scoping Review

“…atypical chest pain or atypical symptoms/anginal equivalents). [ 16 ] Articles had to be available in English language and full text and published in peer-reviewed journals, and no limiters regarding methodology were used. Limiters of adults (aged >18 years) and publication from the year 2000 were applied; the date limit was selected to coincide with marked changes within the study of ACS.…”

“…Subsequently, a better understanding of the varying symptomology of ACS has the potential to advise public health campaigns, inform clinical guidelines, encourage early health-seeking behaviour and support clinicians in their approach and decision-making. [ 16 ] As such, research to identify what the constellation of symptoms suggestive of myocardial ischaemia are is vital. Hence, the aims of this scoping review were to systematically investigate and collate: definitions of presentations other than cardiac chest pain in ACS patients; atypical chest pain and anginal equivalent symptoms reported and their proportions; risk factors in presentations without cardiac chest pain; and lastly, outcomes for ACS patients presenting without cardiac chest pain and comparing those with patients experiencing cardiac chest pain.…”