Modes of presentation of acute myocardial infarction

Aim: To study the various modes of presentation of acute myocardial infarction (AMI). Methods: A total number of 60 patients of AMI admitted in various teaching hospitals of Kasturba Medical College, Mangalore, were studied. The following factors were evaluated: onset of symptoms, mode of presentation, site of infarction, and hospital outcome. Results: Out of 60 patients, 12 (20%) presented with atypical symptoms. The maximum incidence AMI with atypical symptoms was in the age group of 65-74 yr (30.7 %), followed by the age group of 55-64 yr (25%). No patient presented with atypical symptoms below 30 yr. Patients experiencing MI without chest pain tended to be older (mean age 61 vs 58 yr) and were women (35% vs 12.5%); 80% of patients presented with chest pain followed by dyspnea (28.3%) and vomiting (13.3%). The in-hospital mortality of MI patients who presented with typical and atypical symptoms were 16.6% and 33.3%, respectively. In this study, anteroseptal infarction was most common (31.6%). Fifty percent of inferior-wall MI patients presented with atypical symptoms. Conclusion: In this study, there was no significant association between onset of MI and circadian pattern.