People with kidney disease have a somewhat different symptom profile when they present with acute myocardial infarction than those without kidney disease, reported Dr. Jonathan Sosnov of Tufts-New England Medical Center, Boston, and his associates.
More patients with kidney disease die from cardiovascular causes than from any other cause. “Accurate and rapid diagnosis of MI in these high-risk patients might decrease their risk for subsequent morbidity and mortality by providing definitive treatment in a more timely manner,” the investigators said.
They reviewed data from a large, ongoing prospective epidemiologic study of MI to examine whether kidney disease might alter the symptom profile of MI, much as diabetes recently has been shown to do. They analyzed the medical records of 4,482 patients hospitalized for MI at 11 medical centers in the Worcester, Mass., area in 1997, 1999, 2001, and 2003.
Patients with kidney disease were significantly less likely to present with chest pain as their chief complaint (44%) than patients without kidney disease (72%), Dr. Sosnov and his associates said (Am. J. Kidney Dis. 2006;47:378–84).
Patients with kidney disease were significantly less likely to complain of arm pain, numbness or tingling in the arm or hand, shoulder pain, jaw pain, or neck pain.