Patient-reported symptoms improve prediction of acute coronary syndrome in the emergency department

Research in Nursing & Health
Jessica K Zègre-HemseyHolli A DeVon

Abstract

Early diagnosis is critical in the management of patients with acute coronary syndrome (ACS), particularly ST-elevation myocardial infarction (STEMI), because effective therapies are time-dependent. Aims of this secondary analysis were to determine: (i) the prognostic value of symptoms for an ACS diagnosis in conjunction with electrocardiographic (ECG) and troponin results; and (ii) if any of 13 symptoms were associated with prehospital delay in those presenting to the emergency department (ED) with potential ACS. Patients receiving a cardiac evaluation in the ED were eligible for the study. Thirteen patient-reported symptoms were assessed in triage. Prehospital delay time was calculated as the time from symptom onset until registration in the ED. A total of 1,064 patients were enrolled in five EDs. The sample was 62% male, 70% white, and had a mean age of 60.2 years. Of 474 participants diagnosed with ACS, 118 (25%) had STEMI; 251 (53%) had non-ST elevation myocardial infarction (NSTEMI); and 105 (22%) had unstable angina. Sweating (OR = 1.42 CI [1.01, 2.00]) and shoulder pain (OR = 1.64 CI [1.13, 2.38]) added to the predictive value of an ACS diagnosis when combined with ECG and troponin results. Shortness of breath (OR = 0.7...Continue Reading

References

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Citations

Nov 5, 2020·International Journal of Environmental Research and Public Health·Julija Gecaite-StoncieneNijole Kazukauskiene
Mar 8, 2021·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Dileep KumarHitesh Kumar
Sep 19, 2020·Critical Pathways in Cardiology·David SupinskiCatherine Benziger

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