title: The association of diabetes and older age with the absence of chest pain during acute coronary syndromes.
abstract: Cardiac autonomic neuropathy associated with diabetes can cause silent myocardial ischemia and may influence the way that patients perceive symptoms of acute coronary syndromes (ACS). The purpose of this study was to examine symptoms of ACS in patients with and without diabetes while controlling for length of time with diabetes. A convenience sample of 256 patients from two large medical centers in the Midwest participated. Patients with diabetes comprised 33.2% of the sample and reported significantly less chest pain and more unusual fatigue. Patients with diabetes of longer duration (10 or more years) reported more difficulty breathing than did patients with diabetes of shorter duration (fewer than 10 years). Older patients with the same diabetes status also reported less chest pain. For older patients and for patients with diabetes, lack of chest pain during ACS could delay treatment and is thus a concern.
authors.affiliation: Loyola University Chicago, USA. hdevon@luc.edu
authors.forename: Holli A
authors.initials: HA
authors.lastname: DeVon
authors.forename: Sue
authors.initials: S
authors.lastname: Penckofer
authors.forename: Karen
authors.initials: K
authors.lastname: Larimer
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016022:Case-Control Studies; D002637:Chest Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D010147:Pain Measurement; D010353:Patient Education as Topic; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors