The clinical features of acute myocardial infarction include: (1,2)
Chest pain:
- central, crushing pain
- may radiate to the jaw, neck, and one or both arms
- is a similar pain to that found in angina pectoris but patients with previous angina will often complain that the pain is more severe and lasts longer than angina
- nausea, vomiting, sweating
- the patient is often distressed and may be tachycardic, cold and clammy
- blood pressure is variable
- the patient may be cyanosed
- mild pyrexia is variable feature
Presentation may be with features of the complications, such as left ventricular failure e.g. with dyspnoea
Myocardial infarction is silent in 30% - particularly in diabetics and elderly patients.
References
- Byrne RA, Rossello X, Coughlan JJ, et al; ESC Scientific Document Group. 2023 ESC guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-826.
- National Institute for Health and Care Excellence. Recent-onset chest pain of suspected cardiac origin: assessment and diagnosis. November 2016 [internet publication].