Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Aug 2008)
CHARACTRISTICS AND FINAL DIAGNOSIS OF PATIENTS WITH PRIMARY DIAGNOSIS OF ACUTE CORONARY SYNDROME
Abstract
BACKGROUND AND OBJECTIVE: Cardiovascular diseases are the leading cause of mortality in Iran (46% of all deaths). 10-30% of patients referred to emergency ward had acute coronary syndrome (ACS), and 1-4% cases with acute coronary syndrome and 2-3% of patients with myocardial infarction discharged mistakenly. The aim of this study was to delineate final diagnosis and characteristics of patients admitted with primary diagnosis of acute coronary syndrome (ACS). METHODS: This cross sectional study was performed on patients with primary diagnosis of acute coronary syndrome admitted in cardiac ward of Loghman hospital from 2003 to 2004. History and physical examination were done before hospitalization. After hospitalization, the result of echocardiography, angiography and electrocardiography was recorded for final diagnosis and then with considering clinical and paraclinical findings, diagnosis was confirmed. Also their family history, current smoking and history of myocardial infarction were surveyed. Test of X 2 and t-test were used for analyzing qualitative and quantitative variables respectively and p<0.05 was considered significant. FINDINGS: From 1015 patients, 116 had primary diagnosis of acute coronary syndrome that 51.6% of patients were female and their mean age was 58.9±12.9 years. Their final diagnoses were acute myocardial infarction in 196 cases (32%), possible unstable angina in 159 cases (26%), definite/probable unstable angina in 135 cases (22%) and non cardiac chest pain in 121 (19.8%). Mean age of acute coronary syndrome group (490 cases) in comparison with non cardiac chest pain group (121 cases) was more. History of diabetes mellitus, hypertension and myocardial infarction were significantly lower in non cardiac chest pain group. Sex, family history and current smoking were not significantly different. CONCLUSION: Considering about 20% of patients with non cardiac chest pain mistakenly hospitalized in cardiology ward, so it is recommended to provide suitable facilities for primary diagnosis in emergency ward to prevent improper hospitalization and discharge.
