CHAPTER 16 ACUTE MI WITHOUT CHEST PAIN

Prevalence, Clinical Characteristics, and Mortality Among Patients with Myocardial Infarction Presenting Without Chest pain

Canto JG1, Shlipak MG, Rogers WJ, et al. JAMA. 2000;283(24):3223–3229

BACKGROUND

AMI is a primary cause of mortality in the United States, however 2% to 3% of the time this diagnosis is missed and patients are sent home. While patients most often present with chest pain, as the Pope et al.¹ study showed (see Chapter 16), presenting with an alternate chief complaint, such as shortness of breath, made it more likely that MI would be missed. This study sought to characterize the population of patients with MI who present without chest pain.

OBJECTIVES

To determine the frequency that patients with MI present without chest pain and to examine their clinical characteristics, subsequent management, and outcome.

METHODS

Prospective observational study using NRMI-2, a national registry designed to collect hospital data on patients admitted with an MI.

Participants

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