Document Detail


Prevalence of atypical chest pain descriptions in a population from the southern United States.
MedLine Citation:
PMID:  10487403     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The character of chest pain (CP) is a major factor determining triage and admission for patients presenting to the emergency department (ED). Previous studies have found atypical descriptions in as little as 10-15% of patients with true myocardial ischemic pain. Atypical descriptions may be more prevalent in the Deep South of the United States because of cultural differences in the semantic description of pain. METHODS: A retrospective study of patients presenting to the ED of a southern U.S. urban hospital with enzyme-documented myocardial infarction was conducted to determine the prevalence of atypical CP descriptions. A multivariate analysis of those patients with atypical pain descriptions was conducted to determine the independent demographic factors associated with these descriptions. RESULTS: In a total of 77 subjects (56% black; 44% white) meeting the study criteria, 43% were found to have atypical elements in the character of their CP descriptions. Only the black race demographic was found to be significantly correlated with the atypical descriptions. The use of the descriptive term "sharp" accounted for nearly half of the atypical presentations. CONCLUSION: Regional differences in the description of the character of CP may result in misleading portrayals of ischemic heart disease in southern U.S. populations. These differences are associated with a higher prevalence of atypical CP because of semantic distinctions, such as the use of the term "sharp" as a descriptor of acuity rather than character or quality.
Authors:
R L Summers; G J Cooper; F B Carlton; M E Andrews; J C Kolb
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  318     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-09-24     Completed Date:  1999-09-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  142-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans / statistics & numerical data*
Aged
Chest Pain / ethnology*,  etiology
Communication*
Diagnosis, Differential
European Continental Ancestry Group / statistics & numerical data*
Female
Humans
Language
Male
Medical Records
Middle Aged
Mississippi / epidemiology
Multivariate Analysis
Myocardial Infarction / complications,  diagnosis*,  ethnology*
Prevalence
Retrospective Studies
Rural Population / statistics & numerical data
Sex Distribution
Terminology as Topic
Triage
Urban Population / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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