Open Access

Sophia Wolfermann, Timo Schmitz, Philip Raake, Bernhard Kuch, Jakob Linseisen, Christa Meisinger

• To investigate the frequencies of typical and atypical acute myocardial infarction (AMI) symptoms over the past 35 years as well as age- and sex-differences. Methods This study used data from the population-based Augsburg Myocardial Infarction Registry. All cases of hospitalized AMIs occurring between 1985 and 2019 and aged 25 to 74 years were included (n=23,905 patients) in the analysis. During hospital stay patients were interviewed about their symptoms at the acute event and information from patient records was utilized. Multivariable adjusted logistic regression analyses were conducted to investigate the trends of AMI symptoms over time. Results Comparing the time-intervals 1985-1995 with 2006-2019, there was a decrease in frequencies (all p-values <0.001) for the symptoms typical chest pain (83.5% vs. 80.0%), pain left shoulder/arm/hand (52.1% vs. 44.9%), pain between shoulder blades (23.8% vs. 19.5%), nausea/vomiting (36.0% vs. 30.1%), and fear of death/feeling ofTo investigate the frequencies of typical and atypical acute myocardial infarction (AMI) symptoms over the past 35 years as well as age- and sex-differences. Methods This study used data from the population-based Augsburg Myocardial Infarction Registry. All cases of hospitalized AMIs occurring between 1985 and 2019 and aged 25 to 74 years were included (n=23,905 patients) in the analysis. During hospital stay patients were interviewed about their symptoms at the acute event and information from patient records was utilized. Multivariable adjusted logistic regression analyses were conducted to investigate the trends of AMI symptoms over time. Results Comparing the time-intervals 1985-1995 with 2006-2019, there was a decrease in frequencies (all p-values <0.001) for the symptoms typical chest pain (83.5% vs. 80.0%), pain left shoulder/arm/hand (52.1% vs. 44.9%), pain between shoulder blades (23.8% vs. 19.5%), nausea/vomiting (36.0% vs. 30.1%), and fear of death/feeling of annihilation (30.7% vs. 14.7%), while shortness of breath increased significantly over time (43.8% vs. 48.4%; p-value <0.001). Multivariable logistic regression analysis confirmed the decrease of frequencies AMI symptoms over the last decades. The only exception was the occurrence of shortness of breath, where a significantly independent increase was observed comparing 1985-1995 and 2006-2019 (OR 1.22; 95% CI 1.13-1.32). Atypical symptoms occurred more frequently in older patients and women. Conclusions Although there has been a decrease in the frequency of most AMI symptoms over almost four decades, AMIs are still commonly accompanied by typical chest pain. In particular, AMI must be considered if shortness of breath is present.…