AMBULANCE DESPATCHERS ESTIMATION OF INTENSITY OF PAIN AND PRESENCE OFASSOCIATED SYMPTOMS IN RELATION TO OUTCOME IN PATIENTS WHO CALL FOR AN AMBULANCE BECAUSE OF ACUTE CHEST PAIN

Background: A large number of patients who call for an ambulance becau se of acute chest pain have an acute ischaemic event, bur some do not. Aim: To relate the ambulance despatcher's estimated severity of pain and presence of associated symptoms, in patients who call for an ambul ance because of acute chest pain, to whether they develop acute myocar dial infarction (AMI) and to the risk of early death. Patients: All th ose with acute chest pain who contacted the despatch centre in Gotebor g over a 2-month period. Results: In all, 503 patients fulfilled the i nclusion criteria. Patients judged as having severe chest pain (68%) d eveloped AMI during the first 3 days in hospital on 26% of occasions a s compared with 13% among patients judged as having only vague chest p ain (P=0.0004). The difference was less mal ked among the elderly and women. The presence of any of the following associated symptoms, dyspn oea, nausea, vertigo, cold sweat oi syncope, tended to be associated w ith a higher infarction rate (24%) than if none of these symptoms was present (17%, P=0.06). Mortality during the pre-hospital and the hospi tal phase was not associated with the estimated severity of pain ol th e presence of associated symptoms. Conclusions: The despatcher's estim ation of the severity of pain and the presence of associated symptoms appears to be associated with the development of AMI but not with earl y mortality.