title: An evaluation of facial expression displayed by patients with chest pain.
abstract: OBJECTIVE
  To determine whether patterns of facial expressions of patients complaining of chest pain can aid in the diagnosis of myocardial infarctions.
  
  
  METHODS
  Exploratory.
  
  
  METHODS
  Southeastern university medical center emergency department (ED).
  
  
  METHODS
  Twenty-eight patients in the ED who presented with chest pain. Age range was 40 to 84 years, with a mean of 65.4 years.
  
  
  METHODS
  Common patterns of facial expressions among patients diagnosed with myocardial infarction.
  
  
  METHODS
  On admission to the ED, patients were videotaped during physical examination. Videotapes were reviewed to code the facial action units exhibited by the patients. The presence or absence of creatine kinase (CK) enzymes was determined; these results were blinded to the coders until after all facial actions were coded.
  
  
  RESULTS
  With use of the Facial Action Coding System, 4 facial expressions were found to be associated with true myocardial infarction: lowering the brow, pressing the lips, parting the lips, and turning the head left.
  
  
  CONCLUSIONS
  Additional research with a larger sample of patients presenting with chest pain is needed to validate the findings of this study. However, if these findings are supported, instruction regarding assessment of specific facial expressions in clinical settings may be warranted.
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods*; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014743:Videotape Recording