Template:Clinical features ACS: Difference between revisions
No edit summary |
|||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
===Risk of [[ACS]]=== | ===Risk of [[ACS]]=== | ||
Clinical factors that '''increase''' likelihood of ACS/AMI:<ref>Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation. 2010;81(3):281–286. PMID: 20036454</ref><ref>Panju AA, Hemmelgarn BR, Guyatt GH, et al. The rational clinical examination. Is this patient having a myocardial infarction? JAMA. 1998;280(14):1256–1263. PMID: 9786377</ref> | Clinical factors that '''increase''' likelihood of ACS/AMI:<ref>Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation. 2010;81(3):281–286. PMID: 20036454</ref><ref>Panju AA, Hemmelgarn BR, Guyatt GH, et al. The rational clinical examination. Is this patient having a myocardial infarction? JAMA. 1998;280(14):1256–1263. PMID: 9786377</ref> | ||
*[[Chest pain]] radiating both arms > R arm > L arm | *[[Chest pain]] radiating to both arms > R arm > L arm | ||
*[[Chest pain]] associated with diaphoresis | *[[Chest pain]] associated with diaphoresis | ||
*[[Chest pain]] associated with [[nausea/vomiting]] | *[[Chest pain]] associated with [[nausea/vomiting]] | ||
| Line 17: | Line 17: | ||
**Less likely to undergo cardiac catheterization<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | **Less likely to undergo cardiac catheterization<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | ||
**Less likely to receive timely reperfusion therapy<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | **Less likely to receive timely reperfusion therapy<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | ||
**More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness<ref>Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | **More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness,<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> although some studies have found fewer differences in presentation<ref>Gimenez MR, et al. Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction. JAMA Intern Med. 2014; 174(2):241-249.</ref> | ||
*More likely to delay presentation<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | *More likely to delay presentation<ref name=“Mehta 2016”> Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.</ref> | ||
*Men with ACS: | *Men with ACS: | ||
Latest revision as of 17:20, 27 July 2019
Risk of ACS
Clinical factors that increase likelihood of ACS/AMI:[1][2]
- Chest pain radiating to both arms > R arm > L arm
- Chest pain associated with diaphoresis
- Chest pain associated with nausea/vomiting
- Chest pain with exertion
Clinical factors that decrease likelihood of ACS/AMI:[3]
- Pleuritic chest pain
- Positional chest pain
- Sharp, stabbing chest pain
- Chest pain reproducible with palpation
Gender differences in ACS
- Women with ACS:
- Less likely to be treated with guideline-directed medical therapies[4]
- Less likely to undergo cardiac catheterization[4]
- Less likely to receive timely reperfusion therapy[4]
- More likely to report fatigue, dyspnea, indigestion, nausea or vomiting, palpitations, or weakness,[4] although some studies have found fewer differences in presentation[5]
- More likely to delay presentation[4]
- Men with ACS:
- More likely to report central chest pain
Factors associated with delayed presentation[4]
- Female sex
- Older age
- Black or Hispanic race
- Low educational achievement
- Low socioeconomic status
- ↑ Body R, Carley S, Wibberley C, et al. The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes. Resuscitation. 2010;81(3):281–286. PMID: 20036454
- ↑ Panju AA, Hemmelgarn BR, Guyatt GH, et al. The rational clinical examination. Is this patient having a myocardial infarction? JAMA. 1998;280(14):1256–1263. PMID: 9786377
- ↑ Swap CJ, Nagurney JT. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005;294(20):2623–2629. PMID: 16304077
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Mehta LS, et al. Acute myocardial infarction in women: A scientific statement from the American Heart Association. Circulation. 2016; 133:916-947.
- ↑ Gimenez MR, et al. Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction. JAMA Intern Med. 2014; 174(2):241-249.