Typical and atypical presentations of myocardial infarction: Symptoms and associated risk factors.

Background/introduction: Acute myocardial infarction (AMI) affects around 3 million people annually worldwide. Typical symptoms prompt timely care, while atypical symptoms may delay diagnosis and treatment, increasing the risks of heart failure and sudden cardiac death.

Objective/purpose: This study aimed to compare typical and atypical myocardial infarction (MI) presentations to enhance early diagnosis, treatment, and prognosis by examining clinical characteristics, chronic comorbidities, history of coronary artery disease, and smoking status at a tertiary hospital in Amman.

Methods: This purposive, descriptive, retrospective study was conducted at the coronary care unit of Al Basheer Hospital in Amman, Jordan, from July 1, 2022, to July 1, 2023. Records of patients diagnosed with MI (ICD-10 code I21) were extracted. Data were analyzed using the IBM SPSS Statistics software (version 25.0). Tests of association were adjusted at the 5% significance level.

Results: The study included 267 MI cases: 60.3% were typical, and 39.7% were atypical. No significant differences were found among age (p = 0.58) and sex (p = 1.27). Atypical MI was linked to a history of coronary artery disease (p < 0.05) and higher diabetes prevalence (p < 0.05). Recurrence rates (p = 0.41) and artery involvement, especially the left anterior descending artery, were similar between groups. Echocardiography showed identical rates of left ventricular hypertrophy in both types, with tricuspid regurgitation more common in atypical MI.

Conclusion: The study found that atypical MI was linked to higher rates of diabetes and coronary artery disease history compared to typical MI. Recurrence rates, artery involvement, and echocardiography results were similar between both types.