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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心肌梗死症状表现对应急反应和生存的影响

目的 我们检查了急性心肌梗死 (MI) 患者的症状表现和接受紧急派遣的机会与 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和紧急电话 1-1-2（相当于 9-1-1）。两种服务都记录呼叫的症状/目的。在接到电话后 72 小时内以医院诊断或死亡原因为 MI 的患者中，主要症状被归类为胸痛、非典型症状（呼吸问题、不明问题、中枢神经系统症状、腹部/背部/泌尿、其他心脏症状和其他非典型症状）、无意识、非信息性症状和没有记录的症状。我们确定了来自 MI 患者的 4880 个紧急呼叫和 3456 个非紧急呼叫。最常见的症状是胸痛（N = 5219），其次是呼吸问题（N = 556）。在胸痛患者中，95%（3337/3508）的紧急呼叫和76%（1306/1711）的非紧急呼叫接到紧急调度。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，62% (554/900) 和 17% (137/813) 的紧急/非紧急呼叫接到紧急调度，死亡率分别为 23% (206/900) 和 15% (125/813)。在昏迷中，99%/100% 的患者接受了紧急调度，紧急/非紧急呼叫的死亡率为 71%/75%。胸痛的标准化 30 天死亡率为 4.3%，非典型症状为 15.6%，症状与紧急调度之间的关联仍然存在于年龄和性别的亚组中。