1887
Volume 2025, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Acute myocardial infarction (AMI) affects around 3 million people annually worldwide. Typical symptoms prompt timely care, while atypical symptoms may delay diagnosis and treatment, increasing the risks of heart failure and sudden cardiac death.

This study aimed to compare typical and atypical myocardial infarction (MI) presentations to enhance early diagnosis, treatment, and prognosis by examining clinical characteristics, chronic comorbidities, history of coronary artery disease, and smoking status at a tertiary hospital in Amman.

This purposive, descriptive, retrospective study was conducted at the coronary care unit of Al Basheer Hospital in Amman, Jordan, from July 1, 2022, to July 1, 2023. Records of patients diagnosed with MI (ICD-10 code I21) were extracted. Data were analyzed using the IBM SPSS Statistics software (version 25.0). Tests of association were adjusted at the 5% significance level.

The study included 267 MI cases: 60.3% were typical, and 39.7% were atypical. No significant differences were found among age ( = 0.58) and sex ( = 1.27). Atypical MI was linked to a history of coronary artery disease ( < 0.05) and higher diabetes prevalence ( < 0.05). Recurrence rates ( = 0.41) and artery involvement, especially the left anterior descending artery, were similar between groups. Echocardiography showed identical rates of left ventricular hypertrophy in both types, with tricuspid regurgitation more common in atypical MI.

The study found that atypical MI was linked to higher rates of diabetes and coronary artery disease history compared to typical MI. Recurrence rates, artery involvement, and echocardiography results were similar between both types.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2025.41
2025-06-09
2025-07-17
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/2/qmj.2025.41.html?itemId=/content/journals/10.5339/qmj.2025.41&mimeType=html&fmt=ahah

References

  1. Then KL, Rankin JA, Fofonoff DA. Atypical presentation of acute myocardial infarction in 3 age groups. Heart Lung. 2001 Jul-Aug; 30:(4)285–93.
    [Google Scholar]
  2. Mechanic OJ, Gavin M, Grossman SA. Acute myocardial infarction. StatPearls [Internet]. Treasure Island (FL):StatPearls Publishing;2017 Oct 31. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK459269/
    [Google Scholar]
  3. Sarma D, Jentzer JC. Cardiogenic shock. Crit Care Clin. 2024; 40:(1)37–56. https://doi.org/10.1016/j.ccc.2023.01.005
    [Google Scholar]
  4. DeVon HA, Mirzaei S, Zègre-Hemsey J. Typical and atypical symptoms of acute coronary syndrome: time to retire the terms?J Am Heart Assoc. 2020 Apr 7; 9:(7). https://doi.org/10.1161/JAHA.119.015539
    [Google Scholar]
  5. Møller AL, Mills EHA, Gnesin F, Jensen B, Zylyftari N, Christensen HC, et al.. Impact of myocardial infarction symptom presentation on emergency response and survival. Eur Heart J Acute Cardiovasc Care. 2021 Dec; 10:(10)1150–9. https://doi.org/10.1093/ehjacc/zuab023
    [Google Scholar]
  6. Qureshi WT, Zhang ZM, Chang PP, Rosamond WD, Kitzman DW, Wagenknecht LE, et al.. Silent myocardial infarction and long-term risk of heart failure: the ARIC study. J Am Coll Cardiol. 2018 Jan 2; 71:(1)1–8. https://doi.org/10.1016/j.jacc.2017.10.071
    [Google Scholar]
  7. Cheng YJ, Jia YH, Yao FJ, Mei WY, Zhai YS, Zhang M, et al.. Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021 Jan 5; 10:(1). https://doi.org/10.1161/JAHA.120.017044
    [Google Scholar]
  8. Omran S, Al-Hassan M. Gender differences in signs and symptoms presentation and treatment of Jordanian myocardial infarction patients. J Clin Nurs. 2006; 12:(4)198–204. https://doi.org/10.1111/j.1440-172X.2006.00572.x
    [Google Scholar]
  9. Ochiai ME, Lopes NH, Buzo CG, Pierri H. Atypical manifestation of myocardial ischemia in the elderly. Arq Bras Cardiol. 2014; 102:(3)e31–3. https://doi.org/10.5935/abc.20140025
    [Google Scholar]
  10. Ricci B, Cenko E, Varotti E, Puddu PE, Manfrini O. Atypical chest pain in ACS: a trap especially for women. Curr Pharm Des. 2016; 22:(25)3877–84.
    [Google Scholar]
  11. Brush JE Jr, Krumholz HM, Greene EJ, Dreyer RP. Sex differences in symptom phenotypes among patients with acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2020; 13:(2)e005948. https://doi.org/10.1161/CIRCOUTCOMES.119.005948
    [Google Scholar]
  12. Joseph NM, Ramamoorthy L, Satheesh S. Atypical manifestations of women presenting with myocardial infarction at a tertiary health care center: an analytical study. J Mid-life Health. 2021 Jul-Sep; 12:(3)219–24. https://doi.org/10.4103/jmh.JMH_20_20
    [Google Scholar]
  13. Ferry AV, Anand A, Strachan FE, Mooney L, Stewart SD, Marshall L, et al.. Presenting symptoms in men and women diagnosed with myocardial infarction using sex-specific criteria. J Am Heart Assoc. 2019 Aug 20; 8:(17). https://doi.org/10.1161/JAHA.119.012307
    [Google Scholar]
  14. Schulte KJ, Mayrovitz HN. Myocardial infarction signs and symptoms: females vs. males. Cureus. 2023 Apr 13; 15:(4)e37522. https://doi.org/10.7759/cureus.37522
    [Google Scholar]
  15. Shem-Tov T. Clinical characteristics of myocardial infarction in diabetic patients [master’s thesis]. Kaunas:Lietuvos sveikatos mokslų universitetas;2021. Retrieved from: https://lsmu.lt/cris/entities/etd/0bbfd236-b4a2-4e01-a4e2-1efbf0f243f0
    [Google Scholar]
  16. Boliuk M, Halushko O. Acute coronary syndrome in elderly and senile diabetic patients. Ageing Longev. 2024; 5:(2)66–72.
    [Google Scholar]
  17. Stacey RB, Leaverton PE, Schocken DD, Peregoy JA, Bertoni AG. Prediabetes and the association with unrecognized myocardial infarction in the multi-ethnic study of atherosclerosis. Am Heart J. 2015 Nov; 170:(5)923–8. https://doi.org/10.1016/j.ahj.2015.08.003
    [Google Scholar]
  18. Xiao M, Malmi MA Jr, Schocken DD, Zgibor JC, Alman AC. Longitudinal blood glucose level and increased silent myocardial infarction: a pooled analysis of four cohort studies. Diabetol Metab Syndr. 2024 Apr 18; 23:(1)130. https://doi.org/10.1186/s12933-024-02212-3
    [Google Scholar]
  19. Khan IA, Karim HM, Panda CK, Ahmed G, Nayak S. Atypical presentations of myocardial infarction: a systematic review of case reports. Cureus. 2023 Feb 26; 15:(2)e35492. https://doi.org/10.7759/cureus.35492
    [Google Scholar]
  20. Scherer KR. Theory convergence in emotion science is timely and realistic. Cogn Emot. 2022; 36:(2)154–70. https://doi.org/10.1080/02699931.2021.1973378
    [Google Scholar]
/content/journals/10.5339/qmj.2025.41
Loading
/content/journals/10.5339/qmj.2025.41
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Acute myocardial infarction (AMI)atypicaldelayed diagnosisJordan and typical
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error