Impact of myocardial infarction symptom presentation on emergency response and survival

Amalie Lykkemark Møller*, Elisabeth Helen Anna Mills, Filip Gnesin, Britta Jensen, Nertila Zylyftari, Helle Collatz Christensen, Stig Nikolaj Fasmer Blomberg, Fredrik Folke, Kristian Hay Kragholm, Gunnar Gislason, Emil Fosbøl, Lars Køber, Thomas Alexander Gerds, Christian Torp-Pedersen

*Kontaktforfatter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

5 Citationer (Scopus)

Abstract

AIMS: We examined associations between symptom presentation and chance of receiving an emergency dispatch and 30-day mortality among patients with acute myocardial infarction (MI).

METHODS AND RESULTS: Copenhagen, Denmark has a 24-h non-emergency medical helpline and an emergency number 1-1-2 (equivalent to 9-1-1). Both services register symptoms/purpose of calls. Among patients with MI as either hospital diagnosis or cause of death within 72 h after a call, the primary symptom was categorized as chest pain, atypical symptoms (breathing problems, unclear problem, central nervous system symptoms, abdominal/back/urinary, other cardiac symptoms, and other atypical symptoms), unconsciousness, non-informative symptoms, and no recorded symptoms. We identified 4880 emergency and 3456 non-emergency calls from patients with MI. The most common symptom was chest pain (N = 5219) followed by breathing problems (N = 556). Among patients with chest pain, 95% (3337/3508) of emergency calls and 76% (1306/1711) of non-emergency calls received emergency dispatch. Mortality was 5% (163/3508) and 3% (49/1711) for emergency/non-emergency calls, respectively. For atypical symptoms 62% (554/900) and 17% (137/813) of emergency/non-emergency calls received emergency dispatch and mortality was 23% (206/900) and 15% (125/813). Among unconscious, patients 99%/100% received emergency dispatch and mortality was 71%/75% for emergency/non-emergency calls. Standardized 30-day mortality was 4.3% for chest pain and 15.6% for atypical symptoms, and associations between symptoms and emergency dispatch remained in subgroups of age and sex.

CONCLUSION: Myocardial infarction patients presenting with atypical symptoms when calling for help have a reduced chance of receiving an emergency dispatch and increased 30-day mortality compared to MI patients with chest pain.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal: Acute Cardiovascular Care
Vol/bind10
Udgave nummer10
Sider (fra-til)1150–1159
Antal sider10
ISSN2048-8726
DOI
StatusUdgivet - dec. 2021

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