A review of the types of presentation among positive angiographic acute coronary syndrome patients in Hospital Universiti Sains Malaysia

Atypical presentation of myocardial infarction is recognized as an important manifestation of coronary heart disease associated with unfavorable prognosis. Understanding the spectrum of clinical symptoms and presentations are essential to diagnose and deliver appropriate rapid treatment to patients in the emergency department. Hence, this study was carried out to identify the type of presentation of acute coronary syndrome (ACS) and its association with the risk factors related to the atypical presentation in population of study. Out of 260 patients, 25.8% had atypical presentation of ACS with the presentation of right sided chest pain (1.8%), burning chest pain (20.9%) and pricking chest pain (15%). The significant associated diseases were diabetes mellitus and past medical history of ischaemic heart disease (p<0.01) respectively. Other significant associated symptoms were epigastric pain (p<0.001), cough (p<0.01) and giddiness (p<0.01). As a conclusion, ACS with atypical presentations remains an important presentation in the Emergency Department. Despite the availability of advanced medical technology, a thorough history taking remains an important component of diagnosis for a better management and outcome of ACS.