Are There Symptom Differences in Patients with Coronary Artery Disease Presenting to the ED Ultimately Diagnosed with or Without ACS?

Details

• Personal Author:
  Baker H ; Davidson P ; Doering LV ; Dracup K ; McKinley S ; Meischke H ; Moser DK ; Pelter MM ; Riegel B ; Yang W
• Description:
  Objectives: Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. Methods: A secondary analysis from the PROMOTION (Patient Response tO Myocardial Infarction fOllowing a Teaching Intervention Offered by Nurses) trial, an multicenter randomized controlled trial, was conducted. Results: Of 3522 patients with CAD, at 2 years, 565 (16%) presented to the emergency department, 234 (41%) with non-ACS and 331 (59%) with ACS. Shortness of breath (33% vs 25%, P = .028) or dizziness (11% vs 3%, P = .001) were more common in non-ACS. Chest pain (65% vs 77%, P = .002) or arm pain (9% vs 21%, P = .001) were more common in ACS. In men without ACS, dizziness was more common (11% vs 2%; P = .001). Men with ACS were more likely to have chest pain (78% vs 64%; P = .003); both men and women with ACS more often had arm pain (men, 19% vs 10% [P = .019]; women, 26% vs 13% [P = .023]). In multivariate analysis, patients with shortness of breath (odds ratio [OR], 0.617 [confidence interval [CI], 0.410-0.929]; P = .021) or dizziness (OR, .0311 [CI, 0.136-0.708]; P = .005) were more likely to have non-ACS. Patients with prior percutaneous coronary intervention (OR, 1.592 [CI, 1.087-2.332]; P = .017), chest pain (OR, 1.579 [CI, 1.051-2.375]; P = .028), or arm pain (OR, 1.751 [CI, 1.013-3.025]; P <.042) were more likely to have ACS. Conclusions: In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage. [Description provided by NIOSH]
• Subjects:
  Age Factors Cardiovascular Diseases Cardiovascular System Emergency Responders Occupational Health Safety Sex Characteristics
• Keywords:
  Age Factors Cardiovascular Disease Clinical Symptoms Emergency Treatment Heart Disease Medical Treatment Sex Factors
• ISSN:
  0735-6757
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Kentucky ; Nevada ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 9 ; Pennsylvania ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  30
• Issue:
  9
• NIOSHTIC Number:
  nn:20057100
• Citation:
  Am J Emerg Med 2012 Nov; 30(9):1822-1828
• Contact Point Address:
  Michele M. Pelter PhD, RN, Orvis School of Nursing, University of Nevada, Reno, Mail Stop 134, Reno, NV 89557, USA
• Email:
  mpelter@unr.edu
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The American Journal of Emergency Medicine
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ae98ad31b3c0271ac82b18dabf359c8c6a3599e4ac86ce83cfbd5271926ca0b6c8eccb8840dcdd00cfb767ea16bf5d91152724ecb50bd1a145225de935c6c223
• Download URL:
  https://stacks.cdc.gov/view/cdc/214557/cdc_214557_DS1.pdf
• File Type:
  [PDF - 105.00 KB ]