title: Patient-reported symptoms in acute myocardial infarction: differences related to ST-segment elevation: the MONICA/KORA Myocardial Infarction Registry.
abstract: OBJECTIVE
  The early recognition of symptoms of myocardial infarction (MI) is crucial for patients with both ST-segment elevation (STEMI) and non-STEMI (NSTEMI). However, to date, only a few studies have examined the differences between patients with STEMI and NSTEMI with regard to the range of presenting MI symptoms.
  
  
  METHODS
  The study population comprised 889 individuals with STEMI and 1268 with NSTEMI, aged 25-74, hospitalized with a first-time MI between January 2001 and December 2006 recruited from a population-based MI registry. The occurrence of 13 symptoms was recorded during a standardized patient interview.
  
  
  RESULTS
  Patients with STEMI were significantly younger, more likely to be smokers and less likely to have a history of hypertension or sleep disturbances prior to the acute MI (AMI) event than those with NSTEMI. A total of 50% of the patients attributed their experienced symptoms to the heart. Logistic regression modelling revealed that patients with STEMI were significantly more likely than patients with NSTEMI to complain of vomiting [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.76-3.05], dizziness (OR 1.63, 95% CI 1.30-2.03) and diaphoresis (OR 1.49, 95% CI 1.23-1.81). Furthermore, patients with STEMI were less likely to experience dyspnoea (OR 0.81, 95% CI 0.68-0.98) or pain in the throat/jaw (OR 0.80, 95% CI 0.66-0.98).
  
  
  CONCLUSIONS
  Only half of all patients correctly attributed their symptoms to the heart. Patients with STEMI and NSTEMI showed differences regarding several presenting symptoms. Further research is needed to replicate our results, and public awareness of AMI symptoms needs to be improved.
authors.affiliation: MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany. inge.kirchberger@helmholtzmuenchen.de
authors.forename: I
authors.initials: I
authors.lastname: Kirchberger
authors.forename: C
authors.initials: C
authors.lastname: Meisinger
authors.forename: M
authors.initials: M
authors.lastname: Heier
authors.forename: B
authors.initials: B
authors.lastname: Kling
authors.forename: R
authors.initials: R
authors.lastname: Wende
authors.forename: C
authors.initials: C
authors.lastname: Greschik
authors.forename: W
authors.initials: W
authors.lastname: von Scheidt
authors.forename: B
authors.initials: B
authors.lastname: Kuch
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012042:Registries; D012650:Self Disclosure; D012907:Smoking / Q000009:adverse effects