Clinical Manifestation of Acute Myocardial Infarction: Classified by Age and Gender

Abstract

Background: The purpose of the study was to evaluate clinical manifestations of acute myocardial infarction as classified by age and gender. Methods: This cross sectional study was conducted in a coronary care unit of a regional urban medical center in northern Iran (Amol). A total of 366 patients diagnosed with acute myocardial infarction were recruited from January to June 2013. Patient demographic information, past medical history, and current symptom data were collected. Results: Multivariatelogisticanalyseswereperformedtoidentifyriskpredictorsof myocardialinfarctionpatientsclassifiedbyage andgender. Riskpredictorsforolderpatientsweredyspnea,OR=1.76(95% CI1.01,3.06),weaknessoddsratio=2.35(95% CI1.31,4.21), nausea odds ratio = 1.83 (95% CI 1.04, 3.20), vomiting odds ratio = 2.48 (95% CI 1.34, 4.57), fatigue odds ratio=1.87 (95% CI 1.02, 3.39), belching, odds ratio = 2.13 (95% CI 1.08, 4.20), and hiccups odds ratio = 2.81 (95% CI 1.25, 6.30). Sub group analysis in older women patients identified weakness odds ratio = 3.13 (95% CI 1.11, 8.85), and belching odds ratio = 34.70 (95% CI 3.86, 312.2) as risk predictors. Among older men patients, the predominant symptoms were sweating odds ratio = 3.74 (95% CI 1.06, 13.2) and vomiting odds ratio = 2.54 (95% CI 1.10, 5.91). Conclusions: Thisstudyconcludesthatolderacutemyocardialinfractionpatientsweremorelikelytohavenon-specificsymptoms. Initial assessment for acute myocardial infarction should consider the possibility of non-specific clinical manifestations, such as weakness and belching in older women, and sweating and vomiting in older men. with statistical significance set at P < 0.05. Differences between the 2 age-groups on demographical and clinical details were assessed using Chi-square tests with odds ratios (95% Confidence Interval) presented. A logistic regression was performed on the clinical symptoms and pain sites comparing the age groups adjusting for demographics and type of myocardial infraction.