Effect of sex and age on acute myocardial infarction presentation and location: low-income country insight

Abstract Introduction: Age and sex-based differences have been recognized as contributing factors to myocardial infarction presentation. Recognition of these differences is important for timely clinical diagnosis. Aim This article aims to examine symptom presentation differences, by sex and age, in patients with acute myocardial infarction. Methods We reviewed 181 medical records of patients with acute myocardial infarction who were admitted to the emergency department of the two biggest central hospitals in Damascus. Results The average age was 61.94 years, 20% were women, 85.5% had STEMI, and the most common presentation was heavy chest pain. Patients were categorized into 6 age groups: >40 years (4.5%), 40–49 years (14.7%), 50–59 years (30.6%), 60–69 years (28.9%), 70–80 years (15.9%) and < 80 years (5.1%). No statistically significant difference was found in the presentation of men and women with acute myocardial infarction. Patients younger than 40 commonly presented with referred pain (p = 0.002) especially to either arm (p = 0.009), while older age groups presented with heavy chest pain (p = 0.058).Young patients had right coronary artery occlusion much less often (p = 0.050), including extensive anterior (p = 0.010) and lateral infarctions (p = 0.019). Anteroapical infarctions were associated with patients older than 80 (p = 0.015). Conclusion The results of this study indicate that myocardial infarction presentation in men and women have no significant difference. However, Younger patients' presentation is much more complex and less likely to be noticed, compared to the typical presentation of old patients. More awareness of symptom clusters that younger patients present by could help reach a faster diagnosis and better prognosis.