Faculty of Medicine, Damascus University, Damascus, Syria.
Laboratory of Anatomy, Faculty of Medicine, Damascus University, Damascus, Syria.
BMC Cardiovasc Disord. 2024 Aug 24;24(1):445. doi: 10.1186/s12872-024-04127-z.
This study aims to assess the prevalence of both classic and non-classic pain sites in patients with ischemic heart disease, emphasizing the importance of recognizing and not disregarding non-classic symptoms.
This cross-sectional study included 100 patients diagnosed with coronary artery disease (CAD) who were admitted to two major hospitals in Syria. classic pain was identified as pain located in the precordial area, with or without radiation to the neck, jaw, left shoulder or arm. Patients' demographics and previous medical history were documented to investigate any potential associations with non-classic pain.
62% of the patients experienced non-classic pain, while 12% had no precordial pain. For those without precordial pain, the most common pain site was the left chest (66.7%). Non-classic pain was significantly associated with smoking, with 72.2% of smokers experiencing non-classic pain compared to 35.7% non-smokers (p = 0.001). Additionally, patients with previous heart disease were more likely to have non-classic pain (71.7%), compared with patients with no history of heart disease (51.1%) (p = 0.03). Other factors such as age, sex, and diabetes were not statistically significant.
Non-classic pain is common, affecting 62% of individuals, primarily in the right shoulder, right arm, and back. This type of pain could be associated with smoking and prior heart disease. Misdiagnosing coronary artery disease can have serious consequences, as patients with non-classic symptoms may miss important pre-hospital procedures like ECG.
本研究旨在评估缺血性心脏病患者中经典和非经典疼痛部位的患病率，强调认识和不忽视非经典症状的重要性。
这是一项横断面研究，纳入了 100 名在叙利亚两家大医院就诊的冠心病患者。经典疼痛被定义为位于前胸部的疼痛，伴有或不伴有向颈部、下颌、左肩或左臂的放射痛。记录患者的人口统计学和既往病史，以调查非经典疼痛与任何潜在关联。
62%的患者出现非经典疼痛，而 12%的患者无前胸痛。对于无前胸痛的患者，最常见的疼痛部位是左侧胸部（66.7%）。非经典疼痛与吸烟显著相关，吸烟者中 72.2%出现非经典疼痛，而不吸烟者中这一比例为 35.7%（p=0.001）。此外，有既往心脏病史的患者更可能出现非经典疼痛（71.7%），而无心脏病史的患者这一比例为 51.1%（p=0.03）。其他因素，如年龄、性别和糖尿病，无统计学意义。
非经典疼痛很常见，影响 62%的个体，主要发生在右肩、右臂和背部。这种类型的疼痛可能与吸烟和既往心脏病有关。误诊冠心病可能会产生严重后果，因为有非经典症状的患者可能会错过心电图等重要的院前程序。
