The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?

Strömbäck, Ulrica; Engström, Åsa; Lundqvist, Robert; Lundblad, Dan; Vikman, Irene

doi:10.1177/1474515118777391

Cited by 9 publications

(11 citation statements)

References 36 publications

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“…This is in line with previous results from studies based on questionnaires and medical records. 20,[30][31][32] For most patients in our study, there was good consistency between symptoms reported in calls and symptoms reported in questionnaires, with 2 exceptions: fear and tiredness. These symptoms were more often reported in questionnaires than described in the calls.…”

Section: Discussionsupporting

confidence: 63%

Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires

et al. 2021

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Background: Patient-reported symptoms of acute myocardial infarction (MI) may be affected by recall bias depending on when and where symptoms are assessed. Aim: The aim of this study was to gain an understanding of patients' symptom description in more detail before and within 24 hours after a confirmed MI diagnosis. Methods: A convergent parallel mixed-methods design was used to examine symptoms described in calls between the tele-nurse and the patient compared with symptoms selected by the patient from a questionnaire less than 24 hours after hospital admission. Quantitative and qualitative data were analyzed separately and then merged into a final interpretation. Results: Thirty patients (median age, 67.5 years; 20 men) were included. Chest pain was the most commonly reported symptom in questionnaires (24/30). Likewise, in 19 of 30 calls, chest pain was the first complaint mentioned, usually described together with the symptom onset. Expressions used to describe symptom quality were pain, pressure, discomfort, ache, cramp, tension, and soreness. Associated symptoms commonly described were pain or numbness in the arms, cold sweat, dyspnea, weakness, and nausea. Bodily sensations, such as feeling unwell or weak, were also described. Fear and tiredness were described in calls significantly less often than reported in questionnaires ( P = .01 and P = .02), whereas "other" symptoms were more often mentioned in calls compared with answers given in the questionnaire ( P = .02). Some symptoms expressed in the calls were not listed in the questionnaire, which expands the understanding of acute MI symptoms. The results showed no major inconsistencies between datasets. Conclusion: Patients' MI symptom descriptions in tele-calls and those reported in questionnaires after diagnosis are comparable and convergent.

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Section: Discussionsupporting

confidence: 63%

Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires

et al. 2021

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“…Strömbäck et al showed that the appearance of atypical symptoms in a second AMI was not a predictor of a longer delay time [116]. One reason for this observation might be that a history of AMI seems to increase symptom congruence [111].…”

Section: Knowledge and Its Relationship To Cardiac Attributionmentioning

confidence: 99%

Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review

Birnbach

Höpner

Mikolajczyk

2020

BMC Cardiovasc Disord

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Background Since the knowledge of the symptoms of acute myocardial infarction (AMI) may reduce the decision time for patients to seek help in case of an AMI, we aimed to summarize evidence on the knowledge of the AMI symptoms and the symptom attribution in case of an acute coronary syndrome (ACS). Methods Therefore, we systematically searched the databases PubMed, CINAHL, Embase, and Cochrane Library for relevant studies published between January 1, 2008 and 2019 (last search August 1, 2019). Results A total of 86 studies were included, with a composite sample size of 354,497 participants. The weighted mean of the knowledge scores for the symptoms of AMI of 14,420 participants from the general population, was 42.1% (when maximum score was considered 100%) and 69.5% for 7642 cardiac patients. There was a substantially better level of knowledge for six symptoms (‘chest pain or discomfort’, ‘shortness of breath’, ‘pain or discomfort in arms or shoulders’, ‘feeling weak, lightheaded, or faint’, ‘pain or discomfort in the jaw, neck, or back’, and ‘sweating’) (49.8–88.5%) compared to the four less obvious/atypical symptoms ‘stomach or abdominal discomfort’, ‘nausea or vomiting’, ‘headache’, and ‘feeling of anxiety’ (8.7–36.7%). Only 45.1% of 14,843 patients, who experienced ACS, have correctly attributed their symptoms to a cardiac cause. Conclusion In conclusion, we found a moderate to good knowledge of “classic” and insufficient knowledge of less obvious symptoms of AMI. This might suggest that increasing knowledge about less obvious symptoms of AMI could be beneficial. It appears also important to address cardiac attribution of symptoms.

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“…Интересными, на наш взгляд, были результаты шведского исследования (820 больных), в котором изучались характер симптомов острого ИМ и динамика временного интервала от начала симптомов заболевания до ПМК при первичном и повторном ИМ у одного и того же пациента [46]. Примечательным было то, что небольшое количество пациентов (10% мужчин и 16,2% женщин) сообщали о различном характере симптомов при первичном и повторном ИМ.…”

Section: вмешательства направленные на повышение грамотности населенunclassified

Delayed help-seeking for emergency medical care of patients with acute coronary syndrome/myocardial infarction: review of studies

2019

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The review article provides an analysis of domestic and foreign studies evaluating the dynamics of temporary indicators of prehospital medical care for patients with acute coronary syndrome (ACS)/myocardial infarction (MI). It was noted that the delay in applying for medical care of patients with ACS/MI is currently a significant factor determining the effectiveness of the treatment of these diseases. Over the past decades, modern treatment methods and bright-line health system recommendations have appeared. Significant progress has been made in reducing the time from calling an ambulance to receiving treatment, especially in developed countries. However, in spite of the efforts made, the problem of late appealability of patients is still unresolved. In the world and inRussia, experience aimed to educate patients in terms of ACS/MI symptoms and the importance of timely help-seeking has been gained at the population level. There is no doubt that along with organizational measures aimed to treat cardiovascular patients, increasing public awareness of the ACS symptoms and emergency aid should be considered as one of the priority areas.

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The second myocardial infarction: Is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?

Abstract: Symptoms of second myocardial infarctions are not necessarily the same as those of first myocardial infarctions. A patient's behaviour at the first myocardial infarction could predict how he or she would behave at a second myocardial infarction.

Cited by 9 publications

References 36 publications

Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires

Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires

Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review

Delayed help-seeking for emergency medical care of patients with acute coronary syndrome/myocardial infarction: review of studies

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