Comparison between Chest Discomfort and Type of Acute Myocardial Infarction in Patients with or without Diabetes Mellitus

Abstract

Introduction: Myocardial infarction (MI) is the most prevalent disorder causing a high mortality rate. In patients, chest pain is a common compliant, but sometimes it occurs without pain. Painless infarction may occur in diabetic patients. It is believed that infarction without and with slight pain, is more possible in diabetic patients due to autonomic neuropathy. Consequently, these patients are hospitalized and undergo diagnostic procedures more than non-diabetic patients. But it remains unclear whether diabetic patients with MI have similar symptoms compared to non-diabetic ones. Therefore, this study was conducted to compare the chest pain pattern and type of infarction in diabetic and non-diabetic patients with myocardial infarction. Materials & Methods: This analytic-descriptive study was conducted in the emergency wards of Imam Reza and Ghaem Hospitals. 40 diabetics and 70 non-diabetics with MI were selected by convenience methods. The needed data was collected through using interview, samples, demographic, pain characteristics, and observation forms for selecting the samples, and also recording the electrocardiogram and laboratory results, pain numerical rating scale, Mc-Melzac questionnaire and electrocardiogram device were used, then the data was analyzed. Results: The results of this research revealed that there was no significant difference in age (P = 0.26) and family history (P=0.63). Most of the diabetic patients were significantly female (55% VS 45%; P<0.0001). Intensity of infarction angina in diabetic patients was lower (6.50 ± 4.11 VS 7.73 ± 2.71;P=0/37) and duration of pain was shorter (238/50 ± 97.35 VS 250/89 ± 148/98; P=0.99) than those of non-diabetic patients, but these differences were not statistically significant. There was also no statistically substantial difference between the two groups in location, radiation, associated symptoms, alleviating and aggravating factors of pain and infarction type. Inferior infarction was more common in the two groups. Conclusion : According to the results of this research, clinical characteristics and chest pain pattern possibility are similar in diabetic and non-diabetic patients with MI. Therefore, it seems that these patients do not need more hospitalization and diagnostic tests and other evaluations. Further studies about chest pain pattern in diabetic patients are particularly recommended.