NEW YORK, June 28 (Praxis Press) Although chest pain is widely considered a key symptom of myocardial infarction (MI), not all patients with MI present with chest pain. To determine the frequency with which patients with MI present without chest pain and to examine their subsequent management and outcome, Canto and colleagues performed an observational study of patients with MI (see paper). They examined a total of 434,877 patients and evaluated mortality among MI patients without chest pain and compared them with those with chest pain. Myocardial infarction patients without chest pain had a 23.3% in-hospital mortality rate compared with 9.3% among patients with chest pain. Patients without chest pain represent a large segment of the MI population and are at increased risk for delays in seeking medical attention, less aggressive treatments, and in-hospital mortality.

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