Atypical Symptoms and Mortality in Patients with Acute Myocardial Infarction at a Hospital in Acapulco, Mexico
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Objective: to identify factors associated with atypical clinical presentation and mortality in patients with acute myocardial infarction (AMI) treated in the emergency department. Methods: an analytical cross-sectional study was conducted including 184 patients diagnosed with AMI who were admitted to the emergency department of Regional General Hospital No. 1 “Vicente Guerrero” in Acapulco, Guerrero, during 2022-2023. Medical records were reviewed to obtain information on medical history, symptoms, electrocardiographic findings, and clinical course. Simple frequencies were calculated, and bivariate and multivariate analyses were performed. Results: atypical symptoms were present in 27.72% (51) of patients. In the multivariate analysis, the following factors were associated with the presence of atypical symptoms: female sex (OR: 2.63, 95% CI: 1.29-5.38, p<0.001) and an electrocardiogram without ST-segment elevation (OR: 2.55, 95% CI: 1.13-5.72, p=0.023). Mortality was 21%. In the multivariate analysis, the following factors were associated with death: atypical symptoms (OR: 4.91, 95% CI: 2.02-11.9, p<0.001) and an electrocardiogram without ST-segment elevation (OR: 12.64, 95% CI: 4.89-32.6, p<0.001). Conclusion: a high proportion of patients with AMI presented atypical symptoms; the associated factors were female sex and an electrocardiogram without ST-segment elevation. Mortality was high, and atypical symptoms and an electrocardiogram without ST-segment elevation were identified as associated factors.
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