Analysing the Presentation of Women with Chest Pain and Other Symptoms Associated with Coronary Heart Disease and Myocardial Infarction

Background: The quantity and intensity of physical activity required for the primary prevention of coronary heart disease remain unclear. Therefore, we examined the association between physical activity and coronary risk. Methods: We studied 100 patients with chest pain, 78 men and 22 women, not older than 65 years, admitted to a coronary care unit. Patients were subdivided in 3 groups: the first group included patients with acute myocardial infarction, the second group included patients with chronic heart disease, the third included patients with non-ischemic chest-pain. A questionnaire on daily physical activity was filled by each patient. Results: A significantly higher percentage of patients with myocardial infarction and coronary heart disease had a sedentary life style compared to patients of the third group. Compared with subjects without heart disease, a significantly higher percentage of patients of the first and second group covered a daily average distance shorter than 500 meters, while a significantly inferior percentage covered a distance longer than 1 Km every day. A significantly lower percentage of patients with coronary heart disease practised sport compared with the third group. At the time of hospitalization a very small percentage of coronary heart disease patients still practised sport. Conclusions: The association between physical activity and reduced coronary risk is clear; in order to obtain benefits it is sufficient just walking every day. Regarding physical activity, continuity is important: patients, who practised sport only in juvenile age, breaking off when older, may lose the obtained advantages.

Download Full-text

Google Trends Insights Into Reduced Acute Coronary Syndrome Admissions During the COVID-19 Pandemic: Infodemiology Study (Preprint)

10.2196/preprints.20426 ◽

2020 ◽

Author(s):

Conor Senecal ◽

Rajiv Gulati ◽

Amir Lerman

Keyword(s):

Myocardial Infarction ◽

Coronary Heart Disease ◽

Acute Coronary Syndrome ◽

Heart Disease ◽

Chest Pain ◽

Emergency Room ◽

Google Trends ◽

Coronary Syndrome ◽

Search Terms ◽

Pain Symptoms

BACKGROUND During the coronavirus disease (COVID-19) pandemic, a reduction in the presentation of acute coronary syndrome (ACS) has been noted in several countries. However, whether these trends reflect a reduction in ACS incidence or a decrease in emergency room visits is unknown. Using Google Trends, queries for chest pain that have previously been shown to closely correlate with coronary heart disease were compared with searches for myocardial infarction and COVID-19 symptoms. OBJECTIVE The current study evaluates if search terms (or topics) pertaining to chest pain symptoms correlate with the reported decrease in presentations of ACS. METHODS Google Trends data for search terms “chest pain,” “myocardial infarction,” “cough,” and “fever” were obtained from June 1, 2019, to May 31, 2020. Related queries were evaluated for a relationship to coronary heart disease. RESULTS Following the onset of the COVID-19 pandemic, chest pain searches increased in all countries studied by at least 34% (USA P=.003, Spain P=.007, UK P=.001, Italy P=.002), while searches for myocardial infarction dropped or remained unchanged. Rising searches for chest pain included “coronavirus chest pain,” “home remedies for chest pain,” and “natural remedies for chest pain.” Searches on COVID-19 symptoms (eg, cough, fever) rose initially but returned to baseline while chest pain–related searches remained elevated throughout May. CONCLUSIONS Search engine queries for chest pain have risen during the pandemic as have related searches with alternative attribution for chest pain or home care for chest pain, suggesting that recent drops in ACS presentations may be due to patients avoiding the emergency room and potential treatment in the midst of the COVID-19 pandemic.

Download Full-text

Google Trends Insights Into Reduced Acute Coronary Syndrome Admissions During the COVID-19 Pandemic: Infodemiology Study

JMIR Cardio ◽

10.2196/20426 ◽

2020 ◽

Vol 4 (1) ◽

pp. e20426

Author(s):

Conor Senecal ◽

Rajiv Gulati ◽

Amir Lerman

Keyword(s):

Myocardial Infarction ◽

Coronary Heart Disease ◽

Acute Coronary Syndrome ◽

Heart Disease ◽

Chest Pain ◽

Emergency Room ◽

Google Trends ◽

Coronary Syndrome ◽

Search Terms ◽

Pain Symptoms

Background During the coronavirus disease (COVID-19) pandemic, a reduction in the presentation of acute coronary syndrome (ACS) has been noted in several countries. However, whether these trends reflect a reduction in ACS incidence or a decrease in emergency room visits is unknown. Using Google Trends, queries for chest pain that have previously been shown to closely correlate with coronary heart disease were compared with searches for myocardial infarction and COVID-19 symptoms. Objective The current study evaluates if search terms (or topics) pertaining to chest pain symptoms correlate with the reported decrease in presentations of ACS. Methods Google Trends data for search terms “chest pain,” “myocardial infarction,” “cough,” and “fever” were obtained from June 1, 2019, to May 31, 2020. Related queries were evaluated for a relationship to coronary heart disease. Results Following the onset of the COVID-19 pandemic, chest pain searches increased in all countries studied by at least 34% (USA P=.003, Spain P=.007, UK P=.001, Italy P=.002), while searches for myocardial infarction dropped or remained unchanged. Rising searches for chest pain included “coronavirus chest pain,” “home remedies for chest pain,” and “natural remedies for chest pain.” Searches on COVID-19 symptoms (eg, cough, fever) rose initially but returned to baseline while chest pain–related searches remained elevated throughout May. Conclusions Search engine queries for chest pain have risen during the pandemic as have related searches with alternative attribution for chest pain or home care for chest pain, suggesting that recent drops in ACS presentations may be due to patients avoiding the emergency room and potential treatment in the midst of the COVID-19 pandemic.

Download Full-text

Women and coronary disease: relationship between descriptors of signs and symptoms and diagnostic and treatment course

American Journal of Critical Care ◽

10.4037/ajcc1998.7.3.175 ◽

1998 ◽

Vol 7 (3) ◽

pp. 175-182 ◽

Cited By ~ 79

Author(s):

S Penque ◽

M Halm ◽

M Smith ◽

J Deutsch ◽

M Van Roekel ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Chest Pain ◽

Signs And Symptoms ◽

The United States ◽

Therapeutic Interventions ◽

Initial Symptom ◽

Men And Women ◽

To Receive

BACKGROUND: Heart disease is the No. 1 killer among women in the United States. Differences in the clinical features of coronary heart disease among men and women have been reported, along with various approaches to the diagnostic workup and therapeutic interventions. PURPOSE: To explore the relationship between descriptors of signs and symptoms of coronary heart disease and follow-up care and to investigate any differences between male and female patients. METHODS: Structured interviews with patients and chart audits were used to assess initial signs and symptoms, associated cardiac-related signs and symptoms, and the diagnostic tests and interventions used for treatment. The sample consisted of 98 patients (51 women and 47 men) who were admitted with a medical diagnosis of myocardial infarction. RESULTS: Chest pain was the most common sign or symptom reported by both men and women. The 4 most common associated signs and symptoms were identical in men and women: fatigue, rest pain, shortness of breath, and weakness. However, significantly more women than men reported loss of appetite, paroxysmal nocturnal dyspnea, and back pain. Women were also less likely than men to have angiography and to receive i.v. nitroglycerin, heparin, and thrombolytic agents as part of acute management of myocardial infarction. CONCLUSION: Chest pain remains the initial symptom of acute myocardial infarction in both men and women. However, women may experience some different associated signs and symptoms than do men. Despite these similarities, men still are more likely than women to have angiography and to receive a number of therapies.

Download Full-text

Purpose in life and reduced risk of secondary myocardial infarction among U.S. Adults with coronary heart disease

PsycEXTRA Dataset ◽

10.1037/e537902012-055 ◽

2011 ◽

Author(s):

E. S. Kim ◽

J. K. Sun ◽

N. Park ◽

C. Peterson

Keyword(s):

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Purpose In Life ◽

Reduced Risk

Download Full-text

Optical coherent tomography for the diagnostic of non-obstructive coronary artery myocardial infarction

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.060 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

I Leonova ◽

S Boldueva ◽

V Feoktistova ◽

D Evdokimov

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Atherosclerotic Plaque ◽

St Elevation ◽

Spontaneous Dissection

Abstract Funding Acknowledgements Type of funding sources: None. The widespread use of coronary angiography (CAG) in patients with acute coronary syndrome led to the understanding that in some patients myocardial infarction (MI) occurs against angiographically unchanged or slightly modified coronary arteries (CA). In such cases, the so-called "type 2 IM" is diagnosed in some patients, however, to determine the true cause of MI, a modern method of investigation such as optical coherence tomography (OCT) is needed to visualize the intima of the CA and detect a minimal atherosclerotic process. The purpose of the study was to establish the etiology of MI without obstructive coronary artery disease (MINOCA) using OCT. Materials and methods 160 conclusions of the OCT were analyzed. In 9 (6%) cases, the study was conducted in patients who underwent proven MI (mean age 43,1 ± 13,2, 8 males, 1 female) who had no hemodynamically significant CA stenosis according to CAG data. Results in 2 cases (22%) patients had ST-elevation MI, thrombotic occlusion of the CA (in one case, thrombaspiration was performed). In both patients, spontaneous dissection of the intima of the unmodified CA was detected in the OCT. The remaining 7 patients had non-ST-elevation MI, and in 2 cases, a diagnosis of type 2 MI was established: in both patients, the atherosclerotic plaque was visualized, narrowing the lumen of the CA less than 50%, in one case MI developed against a background of the hypertensive crisis, in another - against a background of spasm of CA. In the remaining 5 patients, OCT revealed subintimal atheromatous, with elements of local dissection of the intima. Thus, in 78% of patients atherosclerosis of CA of different severity (from the subintimal deposition of lipids to the development of atherosclerotic plaque, narrowing the clearance of the SC by less than 50%) was diagnosed. In the analysis of risk factors for coronary heart disease (CHD), 57% of patients with atheromatous CA had more than 2 risk factors for CHD: 3 (42%) smoked, 5 (71%) - obesity, 4 (57% ) - had arterial hypertension, 3 (42%) had dyslipidemia, 1 (14%) had type 2 diabetes. In the group of patients with spontaneous intima dissection of the CA, 1 patient (woman) did not have CHD risk factors, the 2-nd suffered from obesity and hypertension. For all patients a lifestyle correction was recommended; statins, antiplatelets were prescribed, patients with spontaneous dissection of CA had the recommendation of examination in the medical-genetic center. Conclusion Based on the results of the study, in most cases, the cause of IMBOC development was an atherosclerotic lesion of the coronary arteries, which is not always visualized with standard coronary angiography. Basically, the patients were young and middle-aged. Most patients had different risk factors for coronary heart disease.

Download Full-text

Dietary Soy Consumption and Cardiovascular Mortality among Chinese People with Type 2 Diabetes

Nutrients ◽

10.3390/nu13082513 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2513

Author(s):

Xiaowen Wang ◽

Jun Lv ◽

Canqing Yu ◽

Liming Li ◽

Yonghua Hu ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

International Classification Of Diseases ◽

Cardiovascular Death ◽

Soy Foods ◽

Cox Proportional Hazard Regression

Randomized controlled trials showed that soy intervention significantly improved blood lipids in people with diabetes. We sought to prospectively examine the association of soy consumption with the risk of cardiovascular death among individuals with diabetes. A total of 26,139 participants with a history of diabetes were selected from the Chinese Kadoorie Biobank study. Soy food consumption was assessed by a food frequency questionnaire. Causes of death were coded by the 10th International Classification of Diseases. The Cox proportional hazard regression was used to compute the hazard ratios. During a median follow-up of 7.8 years, a total of 1626 deaths from cardiovascular disease (CVD) were recorded. Compared with individuals who never consumed soy foods, the multivariable-adjusted risks (95% confidence intervals) of CVD mortality were 0.92 (0.78, 1.09), 0.89 (0.75, 1.05), and 0.77 (0.62, 0.96) for those who consumed soy foods monthly, 1–3 days/week, and ≥4 days/week, respectively. For cause-specific cardiovascular mortality, significant inverse associations were observed for coronary heart disease and acute myocardial infarction. Higher soy food consumption was associated with a lower risk of cardiovascular death, especially death from coronary heart disease and acute myocardial infarction, in Chinese adults with diabetes.

Download Full-text

No causal effects of plasma homocysteine levels on the risk of coronary heart disease or acute myocardial infarction: A Mendelian randomization study

European Journal of Preventive Cardiology ◽

10.1177/2047487319894679 ◽

2019 ◽

pp. 204748731989467 ◽

Cited By ~ 3

Author(s):

Liu Miao ◽

Guo-Xiong Deng ◽

Rui-Xing Yin ◽

Rong-Jun Nie ◽

Shuo Yang ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Mendelian Randomization ◽

Plasma Homocysteine ◽

Sensitivity Analyses ◽

Nucleotide Polymorphisms ◽

Genome Wide ◽

Artery Disease

Background Although many observational studies have shown an association between plasma homocysteine levels and cardiovascular diseases, controversy remains. In this study, we estimated the role of increased plasma homocysteine levels on the etiology of coronary heart disease and acute myocardial infarction. Methods A two-sample Mendelian randomization study on disease was conducted, i.e. “coronary heart disease” ( n = 184,305) and “acute myocardial infarction” ( n = 181,875). Nine single nucleotide polymorphisms, which were genome-wide significantly associated with plasma homocysteine levels in 57,644 subjects from the Coronary ARtery DIsease Genome wide Replication and Meta-analysis (CARDIoGRAM) plus The Coronary Artery Disease (C4D) Genetics (CARDIoGRAMplusC4D) consortium genome-wide association study and were known to be associated at p < 5×10–8, were used as an instrumental variable. Results None of the nine single nucleotide polymorphisms were associated with coronary heart disease or acute myocardial infarction ( p > 0.05 for all). Mendelian randomization analysis revealed no causal effects of plasma homocysteine levels, either on coronary heart disease (inverse variance weighted; odds ratio = 1.015, 95% confidence interval = 0.923–1.106, p = 0.752) or on acute myocardial infarction (inverse variance weighted; odds ratio = 1.037, 95% confidence interval = 0.932–1.142, p = 0.499). The results were consistent in sensitivity analyses using the weighted median and Mendelian randomization-Egger methods, and no directional pleiotropy ( p = 0.213 for coronary heart disease and p = 0.343 for acute myocardial infarction) was observed. Sensitivity analyses confirmed that plasma homocysteine levels were not significantly associated with coronary heart disease or acute myocardial infarction. Conclusions The findings from this Mendelian randomization study indicate no causal relationship between plasma homocysteine levels and coronary heart disease or acute myocardial infarction. Conflicting findings from observational studies might have resulted from residual confounding or reverse causation.

Download Full-text