Risk factors of acute ST segment elevation myocardial infarction patients without chest pain

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. (Hong Kong j.emerg.med. 2012;19:98-102)