Factors associated with the presentation of Acute Coronary Syndrome

Background The clinical manifestation of acute coronary syndrome (ACS) varies and patients present frequently with symptoms other than chest pain. Early treatment of patients with acute coronary syndromes (ACS) is crucial to reduce morbidity and mortality. Method A descriptive cross sectional study was carried out among 130 patients admitted to 3 randomly selected medical wards in the National Hospital of Sri Lanka, and having a diagnosis of Acute Coronary Syndrome. An interviewer administered questionnaire was used to collect data. The population was then divided in to atypical presentation and typical presentation on the basis of the presenting symptoms. Results Unstable angina was the most common diagnosis out of the 3 categories of ACS. Females were older and more likely to be hypertensive (P<0.05). Smoking was associated with a higher incidence of NSTEMI (P<0.05). Atypical presentation was observed in 38.5% of the population (females 32%). The dominant presenting symptoms were shortness of breath (44%), and dizziness (16%),. Epigastric pain proved to be a presentation common to both males and females (11%). Atypical presentation was found to be more common in patients with a family history and those with a diagnosis of STEMI (P<0.05). Conclusion Atypical presentation among the Sri Lankan population is relatively common. Patients with a family history of ischaemic heart disease and those with STEMI are more likely to have an atypical presentation.