Variability of chest pain in suspected acute myocardial infarction according to subjective assessment and requirement of narcotic analgesics

Clinical Factors Associated with Pain in Acute Myocardial Infarction

“…was a great variability in the estimated severi ty and duration of pain which has been shown also in previous studies [1][2][3][4][5]. Thus, whereas 7% of the patients had no pain at all, 39% had pain later than 24 h after admission, and 15% required more than 25 mg of morphine.…”

“…Our results raise the question whether the lower requirement of morphine in females reflects less severe pain, a higher tolerability to pain, or a reluctance of the staff to treat pain in females adequately. According to our own experience, the initial subjective assess ment of pain is similar in males and females [ 2].…”

“…The electrocardiogram was referred to one of the following groups: (1) normal (no pathologic signs): (2) pathologic, but no signs of acute ischemia (e.g., old infarction, bundle branch block, nonspecific ST-T changes, and pacemaker rhythm), and (3) signs of acute ischemia in at least two leads (ST elevation > 1 mm in leads aVL. aVF, I-III.…”

Chest Pain in Acute Myocardial Infarction

“…Some ear lier studies have used the numerical rating scale (NRS) producing unidimensional data [3], In such studies, the patients scored their pain from 0-10, where 0 meant no pain and 10 meant the most severe pain the patient had ever experienced. Considering the fact that pain indeed is a multidimensional phe nomenon, there are ongoing evaluation stud ies in which the patients describe their pain verbally by choosing between various words which will cover the affective as well as the emotional component of pain [5], In the present study, pain was evaluated by analy ses of morphine consumption and the esti mated duration of pain.…”

“…Pain in AMI varies considerably but has generally been described by clinicians as a crushing pain and later on changing to a dull ache located anywhere from the nose to the navel [ 1 ]. Dur ing the first few hours of AMI the pain can be more severe than any pain the patient has ever experienced [2,3). During the initial phase, the pain associated with AMI is often difficult to discriminate from other conditions [4], In an interesting article in this issue of Cardiolo gy, Nielsen et al describe the course of pain in AMI based on morphine consumption and estimated duration of pain.…”