{"id":23931,"date":"2012-02-23T20:06:39","date_gmt":"2012-02-24T01:06:39","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&#038;p=23931"},"modified":"2012-02-23T20:06:39","modified_gmt":"2012-02-24T01:06:39","slug":"reality-check-do-42-of-women-with-ami-present-without-chest-pain","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/02\/23\/reality-check-do-42-of-women-with-ami-present-without-chest-pain\/","title":{"rendered":"Reality Check: Do 42% of Women with AMI Present Without Chest Pain?"},"content":{"rendered":"<p>I am reading <a href=\"http:\/\/jama.ama-assn.org\/content\/307\/8\/813.short\">the new paper from NRMI<\/a> in <em>JAMA<\/em> on the association of age and sex with AMI symptom presentation and am struck by the finding that 35% of the patients did not present with chest pain. This percentage is higher than I have seen elsewhere.<\/p>\n<p>In our <a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S1550857909000990\">recent studies<\/a>, spanning many sites, we have found that almost 90% of the patients present with typical or atypical chest pain. In <a href=\"http:\/\/heart.bmj.com\/content\/early\/2008\/05\/07\/hrt.2007.138537\">the GRACE registry<\/a>, \u201cchest pain was the most common symptom for both men (94%) and women (92%).\u201d The NRMI study reported that 42% of women presented without chest pain. They do not report why the patients did present or what other symptoms they experienced.<\/p>\n<p>I wonder how this result compares with the clinical experience of our readers. Have you noted that more than 2 in 5 women in your practice who are admitted with an AMI do not have chest pain? The number seems at odds with my experience and my reading of the recent literature. What are your thoughts?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I am reading the new paper from NRMI in JAMA on the association of age and sex with AMI symptom presentation and am struck by the finding that 35% of the patients did not present with chest pain. This percentage is higher than I have seen elsewhere. In our recent studies, spanning many sites, we [&hellip;]<\/p>\n","protected":false},"author":211,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,9],"tags":[754,245,698],"class_list":["post-23931","post","type-post","status-publish","format-standard","hentry","category-general","category-interventional-cardiology","tag-chest-pain","tag-mi","tag-women"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/23931","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/211"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=23931"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/23931\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=23931"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=23931"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=23931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}