Risk Factors of Acute ST Segment Elevation Myocardial Infarction Patients without Chest Pain

Abstract

Introduction To identify factors associated with ST-segment myocardial infarction (STEMI) patients who had no chest pain, and to improve recognition of STEMI patients without presentation of chest pain in the emergency department (ED). Method Clinical characteristics and presentations were recorded in patients diagnosed with STEMI in the ED in a retrospective study of patients treated from 2006 to 2009. Patients with and without chest pain were compared according to clinical features. Results Among 260 STEMI patients, 12.7% of patients had no chest pain presentation in the ED. Syncope, epigastric pain, and dyspnea accounted for more than 60% of symptoms in STEMI patients without chest pain. Diabetes mellitus (DM), cerebrovascular accident (CVA), and old age were risk factors for STEMI patients without chest pain. Conclusions DM, CVA, and elderly patients are more likely to be without chest pain when STEMI occurred.