Karlson B W, Herlitz J, Pettersson P, Ekvall H E, Hjalmarson A
Department of Medicine I, Sahlgrenska Hospital, Göteborg, Sweden.
J Intern Med. 1991 Sep;230(3):251-8. doi: 10.1111/j.1365-2796.1991.tb00439.x.
All 7157 patients (55% men) admitted to the emergency room with chest pain or other symptoms indicative of acute myocardial infarction during a period of 21 months were registered consecutively. Chest pain was reported by 93% of the patients. On the basis of history, clinical examination, and electrocardiogram in the emergency room, all patients were prospectively classified in one of four categories: (i) obvious infarction (4% of all patients); (ii) strongly suspected infarction (20%); (iii) vague suspicion of infarction (35%); and (iv) no suspected infarction (41%). In patients with no suspected infarction (n = 2910), musculoskeletal (26%), obscure (21%) and psychogenic origins (16%) of the symptoms occurred most frequently. We conclude that few of the patients had an obvious infarction on admission, and that a musculoskeletal origin of the symptoms occurred most frequently in patients with no suspected infarction.
在21个月的时间里，所有7157名因胸痛或其他提示急性心肌梗死的症状而入住急诊室的患者（55%为男性）均被连续登记。93%的患者报告有胸痛症状。根据病史、临床检查和急诊室心电图，所有患者被前瞻性地分为四类之一：（i）明确梗死（占所有患者的4%）；（ii）高度怀疑梗死（20%）；（iii）疑似梗死（35%）；（iv）无梗死疑似（41%）。在无梗死疑似的患者（n = 2910）中，症状的肌肉骨骼源性（26%）、不明原因（21%）和心因性起源（16%）最为常见。我们得出结论，入院时很少有患者有明确梗死，且症状的肌肉骨骼源性在无梗死疑似的患者中最为常见。
