AIMS We examined associations between symptom presentation and chance of receiving an emergency dispatch and 30-day mortality among patients with acute myocardial infarction (MI). METHODS AND RESULTS Copenhagen, Denmark has a 24-h non-emergency medical helpline and an emergency number 1-1-2 (equivalent to 9-1-1). Both services register symptoms/purpose of calls. Among patients with MI as either hospital diagnosis or cause of death within 72 h after a call, the primary symptom was categorized as chest pain, atypical symptoms (breathing problems, unclear problem, central nervous system symptoms, abdominal/back/urinary, other cardiac symptoms, and other atypical symptoms), unconsciousness, non-informative symptoms, and no recorded symptoms. We identified 4880 emergency and 3456 non-emergency calls from patients with MI. The most common symptom was chest pain (N = 5219) followed by breathing problems (N = 556). Among patients with chest pain, 95% (3337/3508) of emergency calls and 76% (1306/1711) of non-emergency calls received emergency dispatch. Mortality was 5% (163/3508) and 3% (49/1711) for emergency/non-emergency calls, respectively. For atypical symptoms 62% (554/900) and 17% (137/813) of emergency/non-emergency calls received emergency dispatch and mortality was 23% (206/900) and 15% (125/813). Among unconscious, patients 99%/100% received emergency dispatch and mortality was 71%/75% for emergency/non-emergency calls. Standardized 30-day mortality was 4.3% for chest pain and 15.6% for atypical symptoms, and associations between symptoms and emergency dispatch remained in subgroups of age and sex. CONCLUSION Myocardial infarction patients presenting with atypical symptoms when calling for help have a reduced chance of receiving an emergency dispatch and increased 30-day mortality compared to MI patients with chest pain.

中文翻译：

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心肌梗塞症状表现对应急反应和生存的影响。

目的我们研究了急性心肌梗死（MI）患者的症状表现和接受紧急派遣机会与30天死亡率之间的关联。方法和结果丹麦哥本哈根设有24小时非紧急医疗求助热线，紧急电话为1-1-2（相当于9-1-1）。两种服务都记录呼叫的症状/目的。在致电后72小时内因心肌梗死而被诊断为医院诊断或死因的患者中，主要症状分类为胸痛，非典型症状（呼吸问题，不清楚的问题，中枢神经系统症状，腹部/背部/泌尿系统，其他心脏疾病）症状和其他非典型症状），神志不清，非信息性症状，也没有记录的症状。我们确定了来自MI患者的4880紧急呼叫和3456非紧急呼叫。最常见的症状是胸痛（N = 5219），然后是呼吸困难（N = 556）。在胸痛患者中，有95％（3337/3508）的紧急呼叫和76％（1306/1711）的非紧急呼叫得到了紧急呼叫。紧急/非紧急呼叫的死亡率分别为5％（163/3508）和3％（49/1711）。对于非典型症状，紧急/非紧急呼叫中有62％（554/900）和17％（137/813）收到了紧急派遣，死亡率分别为23％（206/900）和15％（125/813）。在失去知觉的患者中，有99％/ 100％的患者接受了紧急派遣，因紧急情况/非紧急情况而导致的死亡率为71％/ 75％。胸痛的标准30天死亡率是30％，非典型症状是15.6％，并且症状和紧急事件分配之间的关联仍然存在于年龄和性别的亚组中。