Diurnal, weekly and seasonal variations of chest pain in patients transported by emergency medical services

Emergency Medicine Journal : EMJ
Ziad FaramandSalah Al-Zaiti

Abstract

Chest pain is among the leading causes for emergency medical services (EMS) activation. Acute myocardial infarction (MI) is not only one of the most critical aetiologies of chest pain, but also one of few conditions encountered by EMS that has been shown to follow a circadian pattern. Understanding the diurnal relationship between the inflow of chest pain patients and the likelihood of acute MI may inform prehospital and emergency department (ED) healthcare providers regarding the prediction, and hence prevention, of dire outcomes. This was a secondary analysis of previously collected data from an observational prospective study that enrolled consecutive chest pain patients transported by a large metropolitan EMS system in the USA. We used the time of EMS call to determine the time-of-day of the indexed encounter. Two independent reviewers examined available medical data to determine our primary outcome, the presence of MI, and our secondary outcomes, infarct size and 30-day major adverse cardiac events (MACE). We estimated infarct size using peak troponin level. We enrolled 2065 patients (age 56±17, 53% males, 7.5% with MI). Chest pain encounters increased from 9:00 AM to 2:00 PM, with a peak at 1:00 PM and a nadir at 6:00 AM....Continue Reading

References

Oct 11, 1992·Annals of Emergency Medicine·R E FrommP E Pepe
Nov 21, 1985·The New England Journal of Medicine·J E MullerT Robertson
Jan 1, 1987·Circulation·J E MullerP H Stone
Jun 1, 1997·The American Journal of Cardiology·M C CohenM A Mittleman
Jun 11, 1999·Journal of the American College of Cardiology·T ShethS Yusuf
Jul 5, 2002·The American Journal of Emergency Medicine·Roberto ManfrediniMassimo Gallerani
Jan 25, 2005·The American Journal of Emergency Medicine·Roberto ManfrediniRajendra H Mehta
Nov 30, 2006·Emergency Medicine Journal : EMJ·D KerrS Bunker
Feb 8, 2008·The American Heart Hospital Journal·Dean J Kereiakes
Aug 30, 2018·Journal of the American College of Cardiology·Kristian ThygesenUNKNOWN Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American He
Sep 18, 2018·Health Promotion Practice·Sabnam MahmudaRicardo Angeles

❮ Previous
Next ❯

Citations

Nov 3, 2020·Acta Cardiologica·Emmanouil I SakelliadisChara A Spiliopoulou
Apr 14, 2021·JAMA Network Open·Francisco Martín-RodríguezAncor Sanz-García

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.