Correlation between symptomatology and site of acute myocardial infarction

Objective: We determined the occurrence of presenting symptoms in patients with different sites of acute myocardial infarction after controlling for age and conventional risk factors. Methods: Hospital-based study of patients hospitalized because of first anterior (n = 731), inferior (n = 719) and lateral (n = 96) infarction in Clinical Hospital Split between 1990 and 1994. Data form about presenting symptoms and clinical profile was completed for each patient. Results: Anterior infarctions were more often presented by headache (adjusted odds ratio (OR) = 1.67, 95% CI = 1.06-2.62), weakness (OR = 1.60, 95% CI = 1.31-1.96), dyspnea (OR = 1.40, 95% CI = 1.14-1.72), cough (OR = 2.24, 95% CI = 1.59-3.16), vertigo (OR = 2.04, 95% CI = 1.40-2.99) and tinnitus (OR = 2.09, 95% CI = 1.06-3.14). Inferior infarctions were more often associated with epigastric (OR = 1.71, 95% CI = 1.30-2.24), neck (OR = 1.47, 95% CI = 1.10-1.98) and jaw pain (OR = 2.16, 95% CI = 1.42-3.27), sweating (OR = 1.56, 95% CI = 1.27-1.92), nausea (OR = 2.01, 95% CI = 1.64-2.46), vomiting (OR = 1.55, 95% CI = 1.22-1.97), belching (OR = 1.57, 95% CI = 1.21-2.03) and hiccups (OR = 2.88, 95% CI = 1.53-5.42). Patients with lateral infarctions were more likely to complain of left arm (OR = 1.80, 95% CI = 1.07-3.05). left shoulder (OR = 1.82, 95% CI= 1.19-2.79) and back pain (OR = 2.40, 95% CI = 1.28-4.46). Pain was less frequently reported by hypercholesterolemic (P = 1.4 x 10(-7)), patients over 70 years (P = 0.002), women (P = 0.0007) and those with non-triggered infarction (P = 0.0009), whereas: those over 70 (P = 1.7 x 10(-6)) and men (P = 0.0003) were less likely to report other relevant symptoms. Conclusions: Our study suggests a linkage between different infarction sites and specific groups of symptoms. Furthermore, coronary patients should give their full attention to non-specific symptoms and any kind of discomfort. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.