Abstract
Study Objective
This study aims to assess the prevalence of both typical and atypical pain in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding atypical symptoms.
Methods
This cross-sectional study was conducted on patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Damascus, Syria, from 2021 to 2023. Patients were asked to mark the sites of their pain on an anatomic illustration. Typical pain was identified as pain located in the precordial area, with or without radiating to the left shoulder or the left arm. Any other distribution of pain was considered atypical. Patients’ demographics and previous medical history were documented to investigate any potential associations with atypical pain.
Results
Among the 100 patients, 64% (64) had atypical pain, while 36% (36) had typical symptoms. Referred pain to areas like the left shoulder and left arm was reported by 81.9% of patients, with 47% and 41% of the sample mentioning discomfort in these regions, respectively. We found that smoking and previous heart disease were associated with atypical pain, with 73% of patients who experienced atypical pain being smokers.
Conclusion
The study found that atypical pain is common, affecting 64% of individuals primarily in the right shoulder, right arm, and back. This type of pain is associated with smoking and prior heart disease. Misdiagnosing coronary artery disease (CAD) can have serious consequences, as patients with atypical symptoms may miss important pre-hospital procedures like ECG.