Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires: A Mixed-Methods Study.
Karin Hellström Ängerud, Maria Ericsson, Margareta Brännström and 3 others
PMID 36156094WHAT IT FOUND
In calls to Swedish tele-nurses, chest pain was the most common MI symptom, but fear and tiredness were described less often than in later questionnaires.
Some callers used vague terms, so open questions may capture symptoms that do not fit the template.
Key findings
01Chest pain or similar chest sensations was the most common MI symptom in both calls and questionnaires, with 25 of 30 calls and 24 of 30 questionnaires reporting it (P = 1.0).
02Fear and tiredness were described significantly less often in calls than in later questionnaires (fear 1 of 30 vs 10 of 30, P = .01; tiredness 2 of 30 vs 10 of 30, P = .02).
03Some symptoms described in calls were not listed in the questionnaire, including palpitations (3 of 30), sore muscles (3 of 30), feeling warm (2 of 30), feeling cold (1 of 30), headache (1 of 30), and diarrhea (1 of 30).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 30 patients were analysed, all from one catchment area in Sweden, so the symptom descriptions may not transfer to other populations. The sample had twice as many men as women, and 24 of 30 had STEMI, which may have shaped the symptom pattern. This was a secondary analysis of existing data that were not originally collected to compare calls with questionnaires. The researchers could not ask probing questions during the recorded calls, so some descriptions may be incomplete. Because all patients called a tele-nurse rather than an ambulance directly, the results may not represent people with suspected MI who seek care differently.
Declared interests
The authors report no funding or conflicts of interest.
The easy way to misread this
Do not conclude that a caller who does not mention chest pain is unlikely to be having an MI. Five of 30 callers did not include chest pain in their symptom description, and some described vague sensations instead.