Association between subjective descriptors of coronary pain and disease characteristics: A pilot study in a Hellenic rural population

Summary 

Purpose

We explored whether the way Hellenic patients describe their cardiac chest pain (verbal descriptions of the nature, intensity, temporal quality, location and radiation) associates with the diagnosis [acute myocardial infarction (AMI) versus unstable angina (UA)] as well as with the location of the coronary lesions.

Methods

A cross-sectional correlational design was employed to study 80 consecutive coronary care patients (44 with AMI, 36 with UA) from northwestern Hellas.

Results

Pain intensity did not differ significantly between AMI and UA, in contrast to treatment-seeking behaviour and accompanying symptoms (p≤0.03). Of AMI patients, women used more often the word “pain” (p=0.011), and indicated pain at the left shoulder (p=0.004). AMI patients used fewer words (p=0.03), and experienced pain at the back of the neck (p=0.03) and of the left arm (p=0.02) less often. The descriptions “knob”, “constriction” and “drill” were more prevalent in UA patients (p<0.01). The description “drill” discriminated between diagnostic groups in a multivariate model (p=0.03). Associations between the infarct and pain location (p≤0.03), and the use of some sensory descriptors (p≤0.02) were detected. Pain locations associated with ECG findings (p≤0.005).

Conclusions

Subjective acute coronary pain descriptions and pain characteristics may associate with the pathophysiological processes in coronary syndromes.

Keywords: Myocardial infarction, Angina, Pain, Gender, Atypical symptom description