Abstract
References
- Parodi G. Editor’s Choice-Chest pain relief in patients with acute myocardial infarction. European Heart Journal: Acute Cardiovascular Care 2016; 5: 277-81.
- Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 7; 39: 119-77.
- Gregoratos G. Clinical manifestations of acute myocardial infarction in older patients. Am J Geriatr Cardiol 2001; 10: 345-7.
- Lu L, Liu M, Sun RR, Zheng Y, Zhang P. Myocardial Infarction: Symptoms and Treatments. Cell Biochem Biophys 2015; 72: 865-7.
- Goch A, Misiewicz P, Rysz J, Banach M. The clinical manifestation of myocardial infarction in elderly patients. Clin Cardiol 2009; 32: E45-E50.
- Herlitz J, Karlson BW, Edvardsson N, Emanuelsson H, Hjalmarson Å. Prognosis in diabetics with chest pain or other symptoms suggestive of acute myocardial infarction. Cardiology 1992; 80: 237-45.
- Glare P, Walsh D, Sheehan D. The adverse effects of morphine: a prospective survey of common symptoms during repeated dosing for chronic cancer pain. Am J Hospice Palliat Med 2006; 23: 229-35.
- Murphy PB, Bechmann S, Barrett MJ. Morphine. In: StatPearls Internet. Treasure Island FL: StatPearls Publishing; 2022 Jan.
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction. J Am Coll Cardiol 2018; 72: 2231-64.
- Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emerg Med 2001; 8: 1153-7.
- Malik MA, Khan SA, Safdar S. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pakistan J Med Sci 2013; 29: 565.
- DeVon H, Penckofer S, Larimer K. The association of diabetes and older age with the absence of chest pain during acute coronary syndromes. West J Nurs Res 2008; 30: 130-44.
- Lee JW, Moon JS, Kang DR, et al. Clinical impact of atypical chest pain and diabetes mellitus in patients with acute myocardial infarction from prospective KAMIR-NIH registry. J Clin Med 2020; 9: 505.
- Yan W, Yang S, Chen L, Yang J. Analgesia in acute ischemic chest pain. Coronary Artery Disease 2020; 31: 556-64.
- Batchelor R, Liu DH, Bloom J, Noaman S, Chan W. Association of periprocedural intravenous morphine use on clinical outcomes in ST‐elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention: Systematic review and meta‐analysis. Catheterization and Cardiovascular Interventions 2020; 96: 76-88.
- Cantor WJ, Tan M, Berwanger O, et al. Morphine and clinical outcomes in patients with ST segment elevation myocardial infarction treated with fibrinolytic and antiplatelet therapy: Insights from the TREAT trial. Am Heart J 2022; 251: 1-12.
- Nielsen JR, Pedersen KE, Dahlstrøm CG, et al. Analgetic Treatment in Acute Myocardial Infarction: A Controlled Clinical Comparison of Morphine, Nicomorphine and Pethidine. Acta Medica Scandinavica 1984; 215: 349-54.
- Weldon ER, Ariano RE, Grierson RA. Comparison of fentanyl and morphine in the prehospital treatment of ischemic type chest pain. Prehospital Emergency Care 2016; 20: 45-51.
- Rahul K, Rajendra PB, Amandeep G, Abhay JK. A survey of opioid analgesics used for treating pain of acute myocardial infarction (AMI): Need for promoting rational use of drugs. Pravara Med Rev 2010; 2: 20-3.
- Soylu K, Coksevim M, Yanık A, Cerik IB, Aksan G. Effect of COVID‐19 pandemic process on STEMI patients timeline. Int J Clin Pract 2021; 75: e14005.
- Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med 2013; 369: 901-9.
Abstract
Aim: ST-segment elevation myocardial infarction (STEMI) is one of the most severe forms of pain. However, the guidelines give quite a few places for pain control in STEMI and, do not offer strong recommendations on this issue. This study aimed to reveal which medications are given to STEMI patients for pain control until they arrive at the catheter laboratory, in which situations they are used, and the frequency of use.
Material and Method: A total of 272 consecutive STEMI patients were prospectively collected. Medications were administered to the patients until they arrived at the angiography laboratory; vital signs, comorbidities, referral status, infarction types, the time between the onset of pain and the admission to the emergency department, and the door-balloon time were also noted. The patients’ pain characteristics and intensity were evaluated.
Results: It was observed that 96.3% of the patients presented with chest pain. The pain of diabetic patients was severe according to the visual analog scale (VAS) score (p=0.023). It was witnessed that 9.92% of the patients were administered drugs for analgesic purposes. The most commonly administered medication was paracetamol. It was noticed that morphine was used frequently after paracetamol. Medication administration for analgesia was more common in referred patients (p=0.040).
Conclusion: Physicians behave timidly in their clinical practice in pain control of STEMI and move away from the guideline. In terms of comfort and hemodynamic stabilization of the patients, it will be beneficial for the applications in the field to give more place to the treatments for pain control in the guidelines.
References
- Parodi G. Editor’s Choice-Chest pain relief in patients with acute myocardial infarction. European Heart Journal: Acute Cardiovascular Care 2016; 5: 277-81.
- Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 7; 39: 119-77.
- Gregoratos G. Clinical manifestations of acute myocardial infarction in older patients. Am J Geriatr Cardiol 2001; 10: 345-7.
- Lu L, Liu M, Sun RR, Zheng Y, Zhang P. Myocardial Infarction: Symptoms and Treatments. Cell Biochem Biophys 2015; 72: 865-7.
- Goch A, Misiewicz P, Rysz J, Banach M. The clinical manifestation of myocardial infarction in elderly patients. Clin Cardiol 2009; 32: E45-E50.
- Herlitz J, Karlson BW, Edvardsson N, Emanuelsson H, Hjalmarson Å. Prognosis in diabetics with chest pain or other symptoms suggestive of acute myocardial infarction. Cardiology 1992; 80: 237-45.
- Glare P, Walsh D, Sheehan D. The adverse effects of morphine: a prospective survey of common symptoms during repeated dosing for chronic cancer pain. Am J Hospice Palliat Med 2006; 23: 229-35.
- Murphy PB, Bechmann S, Barrett MJ. Morphine. In: StatPearls Internet. Treasure Island FL: StatPearls Publishing; 2022 Jan.
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction. J Am Coll Cardiol 2018; 72: 2231-64.
- Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic Emerg Med 2001; 8: 1153-7.
- Malik MA, Khan SA, Safdar S. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pakistan J Med Sci 2013; 29: 565.
- DeVon H, Penckofer S, Larimer K. The association of diabetes and older age with the absence of chest pain during acute coronary syndromes. West J Nurs Res 2008; 30: 130-44.
- Lee JW, Moon JS, Kang DR, et al. Clinical impact of atypical chest pain and diabetes mellitus in patients with acute myocardial infarction from prospective KAMIR-NIH registry. J Clin Med 2020; 9: 505.
- Yan W, Yang S, Chen L, Yang J. Analgesia in acute ischemic chest pain. Coronary Artery Disease 2020; 31: 556-64.
- Batchelor R, Liu DH, Bloom J, Noaman S, Chan W. Association of periprocedural intravenous morphine use on clinical outcomes in ST‐elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention: Systematic review and meta‐analysis. Catheterization and Cardiovascular Interventions 2020; 96: 76-88.
- Cantor WJ, Tan M, Berwanger O, et al. Morphine and clinical outcomes in patients with ST segment elevation myocardial infarction treated with fibrinolytic and antiplatelet therapy: Insights from the TREAT trial. Am Heart J 2022; 251: 1-12.
- Nielsen JR, Pedersen KE, Dahlstrøm CG, et al. Analgetic Treatment in Acute Myocardial Infarction: A Controlled Clinical Comparison of Morphine, Nicomorphine and Pethidine. Acta Medica Scandinavica 1984; 215: 349-54.
- Weldon ER, Ariano RE, Grierson RA. Comparison of fentanyl and morphine in the prehospital treatment of ischemic type chest pain. Prehospital Emergency Care 2016; 20: 45-51.
- Rahul K, Rajendra PB, Amandeep G, Abhay JK. A survey of opioid analgesics used for treating pain of acute myocardial infarction (AMI): Need for promoting rational use of drugs. Pravara Med Rev 2010; 2: 20-3.
- Soylu K, Coksevim M, Yanık A, Cerik IB, Aksan G. Effect of COVID‐19 pandemic process on STEMI patients timeline. Int J Clin Pract 2021; 75: e14005.
- Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med 2013; 369: 901-9.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | October 21, 2022 |
| Publication Date | October 22, 2022 |
| Published in Issue | Year 2022 Volume: 4 Issue: 4 |
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