Age differences in the chief complaint associated with a first acute myocardial infarction and patient's care seeking behavior
American Journal of Medicine Mar 24, 2020
Tisminetzky M, Gurwitz JH, Miozzo R, et al. - Researchers examined how patient's chief complaint related to a first myocardial infarction differ by age. In addition, they examined how the “typicality” of patient's acute symptoms relates to extent of prehospital delay. They reviewed the medical records of 2,586 central Massachusetts residents who were hospitalized at 11 greater Worcester medical centers with a first myocardial infarction on a biennial basis between 2001 and 2011. Categorization of patients into five age strata was done: those less than 55 years old (23%), 55-64 years (20%), 65-74 years (19%), 75-84 years (22%), and those 85 years and older (16%). Patients < 55 years exhibited the lowest proportion (11%) of atypical symptoms of myocardial infarction, increasing to 17%, 28%, 40%, and 51% across the respective age groups. At the time of hospitalization, chest pain was the most prevalent chief complaint but they observed decrease in the proportion of patients reporting this symptom from the youngest (83%) to the oldest patient groups (45%). A slightly increased risk of prehospital delay was noted across the different age groups (higher in the oldest old) among those who presented with atypical rather than typical symptoms of myocardial infarction.
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