JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.
Atypical Symptoms of Acute Coronary Syndrome and
Their Predictors

JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.
Atypical Symptoms of Acute Coronary Syndrome and
Their Predictors

Acute coronary syndrome, Signs and symptoms, Clinical presentation

Introduction: The most important diagnostic indicator of Acute Coronary Syndrome (ACS)
is typical clinical symptoms, like chest pain, but many patients may experience nonspecific
(atypical) symptoms. Understanding these symptoms and their associated factors results in
early diagnosis and more appropriate treatments.
Objective: We aimed to determine atypical clinical symptoms and their predictors in patients
with Acute Coronary Syndrome.
Materials and Methods: This cross-sectional study was conducted on 1167 patients with
ACS hospitalized at a specialized hospital in Rasht City, Iran, between December 2019 and
October 2020. The research samples were selected by a consecutive sampling method.
Data were collected through a researcher-made questionnaire by interview, in which
sociodemographic characteristics, risk factors, disease-related factors, and symptoms of
patients with ACS were collected. Data analysis was done by descriptive statistics and
multiple logistic regression by the backward LR (likelihood ratio) method. The significance
level was set as P<0.05.
Results: In this study, 56.3% of the patients were male. The Mean±SD age of the patients was
60.9±11.1 years. About 28.1% of the patients experienced atypical clinical symptoms. The
most common atypical symptoms were shortness of breath (29.4%), back pain (18.3%), and
left shoulder pain (12.7%). The predictors of atypical symptoms were age (OR=0.98, 95% CI;
0.975 - 0.999, P=0.047), alcohol use (OR=1.86, 95% CI; 1.047 - 3.303, P=0.034), brain diseases
(OR=2.36, 95% CI; 1.463 - 3.811, P=0.001), blood diseases (OR=1.45, 95% CI; 1.059 - 2.002,
P=0.021), and gastroesophageal reflux (OR=1.31, 95% CI; 1.006 - 1.719, P=0.045)
Conclusion: Since more than a quarter of ACS patients have unusual symptoms, detecting
these symptoms and related factors can help in early diagnosis and conduct more appropriate
medical treatment.

Masoumeh Rezvani , Mohammad-Taghi Moghadamnia , Ehsan Kazemnejad Leili , Majid Pourshaikhian , Hojjat Houshyari Khah

April 2023, Volume 33, Number 2

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