• acute myocardial infarction
• cTnI
• iron oxide superparamagnetic nanoparticles
• lateral flow immunoassay
• nanozyme

• Antiplatelet therapy
• Bleeding risk
• Myocardial infarction
• Non-cardiac chest pain
• Thrombolysis

• Humans
• Aspirin/administration & dosage
• Chest Pain/mortality
• Chest Pain/drug therapy
• Treatment Outcome
• Self Administration
• Survival Rate
• Acute Coronary Syndrome/mortality
• Acute Coronary Syndrome/drug therapy
• Platelet Aggregation Inhibitors/administration & dosage
• Cardiovascular Diseases/mortality
• Cardiovascular Diseases/prevention & control

• Karl Landsteiner Privatuniversität für Gesundheitswissenschaften

• grounded theory
• inefficient
• myocardial infarction
• qualitative study
• self‐management

• Education
• Health awareness
• STEMI
• Time of presentation to the ER

• Acute coronary syndrome
• Cardiovascular diseases
• Chest pain
• Gender
• Signs and symptoms
• Social media

• Humans
• Social Media
• Cross-Sectional Studies
• Acute Coronary Syndrome/diagnosis
• Female
• Male

• acute coronary syndrome
• education
• emergency ambulance systems
• interpretation
• prehospital

• Humans
• Acute Coronary Syndrome/therapy
• Acute Coronary Syndrome/psychology
• Acute Coronary Syndrome/epidemiology
• Male
• Retrospective Studies
• Female
• Cross-Sectional Studies
• Middle Aged
• Emergency Medical Services/statistics & numerical data
• Intention
• Aged
• Sex Factors
• Australia
• Adult
• Surveys and Questionnaires

• Humans
• Acute Coronary Syndrome/psychology
• Male
• Female
• Middle Aged
• Aged
• Spain/epidemiology
• Decision Making
• Patient Acceptance of Health Care/statistics & numerical data
• Patient Acceptance of Health Care/psychology
• Time Factors
• Chest Pain/psychology
• Chest Pain/etiology
• Surveys and Questionnaires
• Emergency Medical Services/statistics & numerical data
• Retrospective Studies

• decision making
• myocardial infarction
• process assessments (health care)
• recognition

• Humans
• Stroke Rehabilitation
• Male
• Female
• Walking/physiology
• Middle Aged
• Stroke/physiopathology
• Aged
• Risk Factors
• Recovery of Function/physiology
• Adult

• acute myocardial infarction
• cross-section studies
• latent class analysis
• symptom cluster
• unplanned hospital readmission

• AMI (acute myocardial infarction)
• PCI (percutaneous coronary intervention)
• predictive model
• ventricular arrhythmia

• Humans
• Percutaneous Coronary Intervention/adverse effects
• Nomograms
• Male
• Female
• Middle Aged
• Myocardial Infarction/complications
• Myocardial Infarction/therapy
• Aged
• Risk Factors
• Risk Assessment
• Arrhythmias, Cardiac/etiology

• Humans
• Coronary Artery Disease/prevention & control
• Primary Prevention/standards
• Primary Prevention/methods
• Japan

• Awareness
• Healthy lifestyle behaviour
• Heart attack
• Knowledge
• Myocardial infarction
• Outpatients
• Public
• Risk factors
• Symptoms

• Female
• Humans
• Adult
• Middle Aged
• Male
• Cross-Sectional Studies
• Botswana/epidemiology
• Resource-Limited Settings
• Outpatients
• Life Style
• Myocardial Infarction/diagnosis
• Myocardial Infarction/epidemiology
• Risk Factors
• Healthy Lifestyle
• Chest Pain

• UiT The Arctic University of Norway (incl University Hospital of North Norway)

• France
• Heart attack
• Lay diagnosis
• Prevention
• Symptom recognition

• Awareness
• Iran
• Myocardial Infarction
• Questionnaire development
• Symptoms

• alginate
• cardiac tissue engineering
• chitosan
• nanoparticles
• scaffolds

Ischemic heart disease affects 126 million individuals globally which illustrates the importance of finding ways to decrease mortality and morbidity in case of an acute myocardial infarction (AMI). Since knowledge of symptoms, correct reaction to symptoms, and ability to perform cardiopulmonary resuscitation (CPR) decreases the time from symptoms-onset to reperfusion, which leads to lower AMI mortality, we aimed to examine those factors and identify predicting variables in regions with low and high AMI mortality rates.

We conducted a cross-sectional online survey including 633 respondents from the general population in four federal states in Germany with low and high AMI mortality and morbidity rates. We used uni- and multivariable regressions to find health-related and sociodemographic factors associated with knowledge, reaction to symptoms, and skills in CPR.

Out of 11 symptoms, the mean of correctly attributed AMI symptoms was 7.3 (standard deviation 1.96). About 93% of respondents chose to call an ambulance when witnessing an AMI. However, when confronted with the description of a real-life situation, only 35 and 65% of the participants would call an ambulance in case of abdominal and chest pain, respectively. The predicting variables for higher knowledge were being female, knowing someone with heart disease, and being an ex-smoker compared to people who never smoked. Higher knowledge was associated with adequate reaction in the description of a real-life situation and ability to perform CPR. Prevalence ratio for being able to perform CPR was lower in females, older participants, and participants with low educational level. About 38% of participants state to know how to perform CPR. Our results indicate rather no difference regarding knowledge, reaction to AMI symptoms, and ability to perform CPR among different regions in Germany.

Knowledge of symptoms and first responder reaction including skills in CPR is inadequate when confronted with the description of a real-life situation. Educational health campaigns should focus on conveying information close to real-life situations. Interventions for enhancing ability to perform CPR should be compulsory in regular intervals. Interestingly, we found no difference regarding the factors in regions with high and low AMI mortality rates in Germany.

• Ministerium für Wissenschaft und Wirtschaft, Land Sachsen-Anhalt

(1) Context: The management of acute coronary syndrome (ACS) is based on a rapid diagnosis. The aim of this study was to focus on the ACS symptoms differences according to gender, in order to contribute to the improvement of knowledge regarding the clinical presentation in women. (2) Methods: We searched for relevant literature in two electronic databases, and analyzed the symptom presentation for patients with suspected ACS. Fifteen prospective studies were included, with a total sample size of 10,730. (3) Results: During a suspected ACS, women present more dyspnea, arm pain, nausea and vomiting, fatigue, palpitations and pain at the shoulder than men, with RR (95%CI) of 1.13 [1.10; 1.17], 1.30 [1.05; 1.59], 1,40 [1.26; 1.56], 1.08 [1.01; 1.16], 1.67 [1.49; 1.86], 1.78 [1.02; 3.13], respectively. They are older by (95%CI) 4.15 [2.28; 6.03] years compared to men. The results are consistent in the analysis of the ACS confirmed subgroup. (4) Conclusions: We have shown that there is a gender-based symptomatic difference and a female presentation for ACS. The “typical” or “atypical” semiology of ACS symptoms should no longer be used.

Coronary artery disease (CAD) is the single leading cause of death in Europe and the most common form of cardiovascular disease. Little is known about awareness in the European population. A cross-sectional telephone survey of 2609 individuals from six European countries was conducted to gather information on perceptions of CAD, risk factors, preventive measures, knowledge of heart attack symptoms and ability to seek emergency medical care. Level of awareness was compared according to gender, age, socioeconomic status (SES) and educational level. Women were approximately five times less likely than men to consider heart disease as a main health issue or leading cause of death (OR = 0.224, 95% CI: 0.178–0.280, OR = 0.196, 95% CI: 0.171–0.226). Additionally, women were significantly less likely to have ever had a cardiovascular screening test (OR = 0.515, 95% CI: 0.459–0.578). Only 16.3% of men and 15.3% of women were able to spontaneously identify the main symptoms of a heart attack. Almost half of the sample failed to state that they would call emergency services in case of a cardiac event. Significant differences according to age, SES and education were found for many indicators amongst both men and women. Development of a European strategy targeting improved awareness of CAD and reduced gender and social inequalities within the European population is warranted.

• Europe
• awareness
• coronary artery disease
• gender bias
• inequalities
• sex differences

Ankylosing spondylitis (AS) is a chronic progressive inflammatory disease that mainly affects the spine and sacroiliac joints. To the best of our knowledge, AS with acute myocardial infarction (AMI) has rarely been reported. Here, we report an unusual case of AS with AMI in a young patient.

A 37-year-old man was admitted to the Department of Rheumatology and Immunology of our hospital on March 14, 2020, for low back pain. Further evaluation with clinical examinations, laboratory tests, and imaging resulted in a diagnosis of AS. Treatment with a non-steroidal anti-inflammatory drug and a tumor necrosis factor inhibitor partially improved his symptoms. However, his back pain persisted. After 6 wk of treatment, he was admitted to the emergency room of another hospital in this city for sudden-onset severe chest pain consistent with a diagnosis of AMI. Angiography revealed severe narrowing of the coronary arteries. Surgical placement of two coronary stents completely relieved his back pain.

AS can cause cardiovascular diseases, including AMI. It is important to consider the cardiovascular risks in the management of AS.

• Ankylosing spondylitis
• Acute myocardial infarction
• Coronary stent placement
• Non-steroidal anti-inflammatory drugs
• Tumor necrosis factor inhibitors

Background: Health literacy (HL) is a risk factor for adverse outcomes in patients with cardiovascular disease, and shorter pre-hospital delay time is crucial for successful treatment of acute myocardial infraction (AMI) patients. Most previous studies focused on the influencing factors of pre-hospital delay but ignore the essential contribution of decision delay.

Aims: Therefore, the purpose of this study was to explore the effect of HL on decision delay.

Methods: Continuously included AMI patients admitted to a grade A class three hospital in Chongqing. HL level was assessed using Brief Health Literacy Screen and categorized as adequate or inadequate. Mann-Whitney U-test and Chi-square test were used to compare the differences between groups, and binary logistic regression was used to analyze the association between HL and decision delay.

Results: A total of 217 AMI patients were enrolled in this study, including 166 males (76.5%) and 51 females (23.5%), with the median age was 68 years old; 135 (62.2%) patients had delayed decision-making while 82 (37.8%) did not; 157 (72.7%) patients had inadequate HL and 59 (27.3%) had adequate HL. The total HL score of non-delayed group was higher than that in delayed group (9.22 vs. 7.02, P < 0.000).

Conclusion: After adjusting for covariates, HL was significantly negatively associated with decision time. AMI patients with inadequate HL were more likely to delay seeking timely medical care.

• acute myocardial infarction
• decision delay
• health literacy
• patient decision making
• pre-hospital delay

During the SARS-COV-2 (COVID-19) pandemic efforts to reduce virus transmission resulted in non-emergency patients being deterred from seeking help. The number of patients presenting with acute cardiac conditions reduced, significantly

To explore the decision-making process, and influential factors in that process, of patients and their family during an acute cardiac event.

A qualitative research design was employed using purposive sampling of patients who experienced an acute cardiac event during the social containment mandates. Semi-structured interviews were conducted, with thematic analysis of interview transcripts.

Twenty-five participants were recruited from three UK hospitals. Themes identified were reliance on informal support network, lack of awareness of cardiac symptoms leading to delayed help-seeking, and an indirect COVID-19 effect (e.g. avoiding treatment).

These results highlight the need for informed public health messages, targeting patients and their support networks, that allow those in need of treatment to access care.

• COVID 19
• Cardiac surgery
• Decision making
• Heart failure
• Myocardial infarction
• Public health

Seventy percent people are able to recognize chest pain as myocardial infarction (MI) symptoms. There is no difference in awareness of MI symptoms between male and female. There is wide variation in awareness of MI symptoms. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and in Asian countries such as Nepal to as high as 90% in Germany.

Knowledge about myocardial Infarction (MI) symptoms is crucial because inadequate awareness ensures direct association with patient delay and adverse health events subsequently.

PRISMA guidelines were followed while conducting the systematic review with PROSPERO number CRD42020219802. An electronic search was conducted comprehensively through 5 databases to find those relevant articles systematically. Prevalence was calculated for each typical symptom of MI separately and subgroup analysis according to continent, country, gender and ethnicity was done. Meta-Analysis was conducted by using statistical software R version 3.4.3. A random-effects model was used.

Studies from 35 different countries with 120,988,548 individuals were included in the final analysis. The prevalence of chest pain awareness was highest, while it was lowest for jaw, back, and neck pain. There was no difference in terms of awareness in males and females. Prevalence of awareness of typical MI symptoms was higher in the Caucasian white, white, and non-Hispanic white groups than in other groups. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and Asian countries such as Nepal to as high as 90% in Germany.

People are well aware of chest pain as a symptom of MI. However, there is limited knowledge regarding other typical symptoms of MI.

• Awareness
• Meta-analysis
• Myocardial infarction
• Prevalence

A rare case of a 62-year-old woman with an atypical cardiac symptom of sensation of laryngeal obstruction as a manifestation of acute coronary syndrome is described. Initially, the patient showed unremarkable test results and was diagnosed with laryngopharyngitis and discharged from hospital. However, 24 hours later she returned to the hospital with an abnormal electrocardiogram (ECG) and elevated blood troponin levels and was diagnosed with ST-segment elevation myocardial infarction (STEMI). She developed heart failure, cardiogenic shock and died. Clinicians should be aware that patients with an unexplained sensation of laryngeal obstruction should be considered for the presence of MI within their differential diagnosis since this may be the only symptom in some patients with life-threatening cardiac ischemia.

• acute coronary syndrome
• laryngeal obstructed sensation
• myocardial infarction

• acute coronary syndrome
• coronary heart disease
• one-on-one nursing
• protocol

• Acute Coronary Syndrome/psychology
• Coronary Disease/nursing
• Counseling
• Health Knowledge, Attitudes, Practice
• Humans
• Patient Education as Topic/methods
• Randomized Controlled Trials as Topic
• Time-to-Treatment