Nausea and vomiting as predictors of presence, location and size of acute myocardial infarction

ABSTRACT

In a trial to assess the value of nausea and/or vomiting in prediction presence, location and/or size of acute myocardial infarction [AMI] in patients presenting with acute chest pain and electrocardiographic [ECG], changes suggestive of coronary heart disease [CHD], 220 patients were included in the present work. They classified into AMI group [G1], [which was further classified into anterior Q-wave infarction [G[1a]], inferior Q-wave infarction [G[1b]] and non-Q-wave infarction [G[1c]] and noninfarction group [G[11]]. Nausea and/or vomiting were good predictors of AMI [85% positive predictive value]. They had no relation to infract site [67% in anterior infarction group VS. 65% in inferior infarction group with insignificant difference between them]. Using peak serum creatine kinase [CK] level, as an index of infect size, nausea and/or vomiting were good predictors of larger infarction [nausea and/or vomiting were present in 54%, 70%, 79% and 86% in patients with peak serum CK level < 1.000 IU/liter, > 1000 IU/liter, > 1.500 IU/liter, and > 2.000 IU/liter, respectively]. Thus, nausea and/or vomiting are important predictors in diagnosing AMI and are associated with larger myocardial infarctions but do not suggest infarctions in a particular location