ArticleClinical research in cardiology : official journal of the German Cardiac Society2012
The patient's interpretation of myocardial infarction symptoms and its role in the decision process to seek treatment: the MONICA/KORA Myocardial Infarction Registry.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review.BMC cardiovascular disorders · 2020Pooled it
- Trial
- Association Between Symptom Characteristics, Knowledge Sources, and Patient Interpretation of Acute Coronary Syndrome: Insights From the Japanese Circulation Society Chest Pain Registry.Circulation reports · 2026Article
- Public Recognition of Emergencies and Appropriate Ambulance Use in Riyadh: A Cross-Sectional Survey.Healthcare (Basel, Switzerland) · 2025Article
- Development and Systematic Evaluation of a Progressive Web Application for Women With Cardiac Pain: Usability Study.JMIR human factors · 2025Article
- The Role of Chronic Stress in the Pathogenesis of Ischemic Heart Disease in Women.Comprehensive Physiology · 2025Review
- Behavioral delays in seeking care among post-acute myocardial infarction women: a qualitative study following percutaneous coronary intervention.Frontiers in global women's health · 2025Article
- Prediction of Major Adverse Coronary Events Using the Coronary Risk Score in Women.Radiology. Cardiothoracic imaging · 2024Article
- The impact of admission modes on the treatment outcome and in-hospital mortality rate of STEMI patients undergoing PPCI.Scientific reports · 2024Article
- Symptom Presentation of Patients with Coronary Artery Disease.Journal of pharmacy & bioallied sciences · 2024Article
- Community- and Patient-Partner Engagement in Women's Cardiovascular Disease Research: A Rapid Review of the Evidence.CJC open · 2024Review
- Myocardial Infarction Within 30 Days of Discharge From an Emergency Department: A Descriptive Study of Albertan Women.CJC open · 2024Article
- Symptomology, Outcomes and Risk Factors of Acute Coronary Syndrome Presentations without Cardiac Chest Pain: A Scoping Review.European cardiology · 2024Article
- A Survey of Female-Specific Cardiovascular Protocols in Emergency Departments in Canada.CJC open · 2023Article
- Patient symptom exaggeration is associated with communication effectiveness and trust.PEC innovation · 2022Article
- Observational
- Biology, Bias, or Both? The Contribution of Sex and Gender to the Disparity in Cardiovascular Outcomes Between Women and Men.Current atherosclerosis reports · 2022Review
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe patients' misinterpretation of symptoms of an evolving acute myocardial infarction (AMI) is a major cause for prolonged pre-hospital delays. The objective of this study was to identify factors associated with an attribution of the symptoms to the heart and to investigate the association between symptom misinterpretation and time until first medical contact (delay time).
methodsThe study population comprised 1,684 men and 559 women, aged 25-74 years, hospitalized with a first-time AMI recruited from a population-based AMI Registry.
resultsA total of 50.3 % of the patients attributed their experienced symptoms to the heart. Logistic regression modeling revealed that symptoms like chest pain, pain in the left upper extremity, and fear of death facilitated a correct attribution to the heart, whereas symptoms like vomiting or pain in the right upper extremity made a correct labeling difficult. Female sex, low educational status, migration background, and current smoking were associated with a higher risk of misinterpretation of symptoms. A family history of AMI or a history of angina pectoris, hypertension, and hyperlipidemia were shown to facilitate a correct interpretation of symptoms. Variables associated with a misinterpretation of symptoms did not significantly differ between men and women. People with misinterpretation of symptoms had a 1.59-fold risk (95 % confidence interval 1.33-1.90) to have a delay time of at least 2 h, compared with persons who correctly attributed their symptoms.
conclusionsSymptom misinterpretation is common among patients with AMI, significantly related to symptoms, sociodemographic characteristics and individual risk factors, and associated with a prolonged delay time.
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