The predictive role of dyspnea in left main and/or three-vessel coronary artery involvement in patients with myocardial infarction: an analytical cross-sectional study.

backgroundHeart disease is one of the leading causes of death globally. Clinical symptoms are among the first predictors of heart disease. This study was conducted to investigate the predictive role of symptoms in left main coronary artery (LM) and three-vessel disease (3VD) in patients with myocardial infarction.

methodsIn this analytical and Cross-sectional study, 177 cardiac patients with myocardial infarction who referred to the emergency department of Imam Reza and Ghaem hospitals in Mashhad were included in the study using a purposive method and in accordance with the inclusion criteria. At the beginning of the study and after obtaining informed consent, 12-lead ECGs were obtained from the patients and a demographic questionnaire and clinical symptom checklist were completed for all patients. Blood pressure, pulse, and respiration rate were measured by the researcher, while the presence of nausea, pain, shortness of breath, and other subjective symptoms were self-reported by the patient. The Visual Analog Scale (VAS) was used to determine pain intensity. Then, the patients underwent angiography by a cardiologist, and the angiographies were performed by one person. Data analysis was performed using SPSS version 21 software. The normality of quantitative variables was assessed using the Kolmogorov-Smirnov test. The chi-square test was used to compare the frequency of clinical symptoms in the three groups. Logistic regression was used to determine the association of clinical symptoms with pain and QRS duration with 3VD and LM.

resultsAmong the participants, 19 (10.7%) had both LM and 3VD, 69 (39%) had either LM or 3VD, and 89 (50.3%) had neither. A significant difference in pain intensity was also found between the three groups. Patients with either LM or 3VD experienced more intense pain, whereas those with both LM and 3VD reported less severe pain compared to the other two groups. Logistic regression analysis showed that the odds of having 3VD or LM were 5.2 times higher in patients with shortness of breath in addition to pain, compared to those without shortness of breath (CI = 1.60-16.94).

conclusionsIn the present study, Patients who experienced shortness of breath in addition to pain were more likely to have LM and 3VD. Given that both conditions are associated with higher mortality rates and poorer prognoses, Paying attention to these signs is important.