If you are sweating profusely, lightheaded, short of breath and queasy, better grab your chest, too, and groan when you head into the emergency room, even if you're not feeling chest pains.
The charade could save your life.
An international team of researchers looked at data from more than 20,000 patients admitted for acute coronary syndromes. They concluded that patients who presented with what researchers defined as a "typical" ACS symptom -- chest pain -- had a much greater chance of obtaining a correct diagnosis, receiving appropriate treatment and, not surprisingly, enjoying a better outcome, including walking out alive, than similar patients who presented with one or more other "atypical" symptoms, such as diaphoresis, presyncope/syncope, dyspnea, nausea and vomiting.
The report notes that those patients "with acute coronary ischemia in the absence of chest pain are older and sicker than those with chest pain" are often diagnosed "belatedly" and receive initial care that is "suboptimal."
"The current gap in treatment and hospital outcomes for patients with atypical symptoms is a problem that needs to be rectified," said Richard Irwin, M.D., president of the American College of Chest Physicians in a news release today. "More emphasis needs to be given to identifying and properly treating heart attacks in patients who do not exhibit typical symptoms."
The report on the researchers' findings appeared in the August issue of the ACCP journal, CHEST.
The sample was drawn from the Global Registry of Acute Coronary Events, a multinational registry of patients with ACS compiled by 95 hospitals in the U.S. and 13 foreign countries.
Of the 20,881 ACS patients in the study group, 1,763 (8.4%) presented without chest pain.
Those patients without chest pain were given incorrect diagnoses on presentation 23.8% of the time, compared with 2.4% of those with chest pain.
Patients without chest pain also were less likely to receive aspirin and beta-blockers while they were hospitalized and receiving treatment and were less likely to receive statins at discharge.
And ACS patients who presented without chest pain were three times more likely to die in the hospital than those who presented with chest pain. Mortality rates were 13% for those patients without chest pain compared with 4.3% for those with chest pain.
The report authors conclude: "Emergency department and coronary care personnel need to have an increased awareness of this patient cohort, who should be provided with improved early diagnosis and better treatment options to reduce their significant morbidity and mortality."