Relation of nausea and vomiting in acute myocardial infarction to location of the infarct.

To determine whether the incidence of nausea and vomiting in patients with acute myocardial infarction (AMI) varies with infarct location, we studied 180 patients who had been admitted to our hospital for ST-segment elevation AMI or AMI associated with left bundle branch block. The presenting symptoms (chest pain, nausea, and vomiting), initial electrocardiographic findings, and additional demographic, clinical, laboratory, and outcome data were extracted from the medical records and correlated with the infarct location. Of the 180 patients with AMI, 108 (60%) had inferior and 72 (40%) had anterior infarcts. Nausea was reported in almost 2/3 of all patients, and vomiting in nearly 1/3. Both nausea and vomiting showed a trend toward a greater incidence in patients with inferior than with anterior infarcts (69% vs 56% and 33% vs 26%, respectively). However, the differences were not statistically significant. In conclusion, nausea and vomiting are common presenting symptoms in patients with either inferior or anterior wall AMI, but their frequency is unrelated to the infarct location.