Ambulance visits patients with myocardial infarction with atypical symptoms less often

Patients with myocardial infarction (MI) who complain of atypical symptoms when calling emergency services have a 30-day mortality rate nearly five times higher than those with typical symptoms.

Danish scientists analyzed registries of emergency medical services, selecting patients who were diagnosed with MI after presentation. The study results were published in the European Heart Journal: Acute Cardiovascular Care.

Denmark has two systems that provide 24-hour medical care: Medical Helpline 1813 and Emergency Medical Service 112. The study analyzed 8,336 calls to these services from patients with myocardial infarction for the period from January 1, 2014 to December 31, 2018. The most common symptoms during visits were identified: chest pain (5219 cases) and breathing problems (556).

Among patients with chest pain, 95% and 76% of calls to each of the two ambulance services resulted in a medical team being dispatched. The mortality rate was 5 and 3% for Medical Helpline 1813 and Emergency Medical Service 112 calls, respectively.

For atypical symptoms, 62% and 17% of patients received medical care from a medical team, and mortality rates were 23% and 15%. Atypical symptoms were more common in older people, especially women.

In 99 and 100% of cases, a medical team went to patients in an unconscious state, and the mortality rate was 71 and 75% of such calls for the first and second services.

Standardized 30-day mortality was 4.3% for chest pain and 15.6% for atypical symptoms.

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