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Is the radiation of chest pain a useful indicator of myocardial infarction? A prospective study of 541 patients

Albarran, John; Durham, B.; Gowers, J.; Dwight, J.; Chappell, G.


John Albarran

B. Durham

J. Gowers

J. Dwight

G. Chappell


In recent years it has been claimed that in those presenting with chest pain, the extent of pain radiation may be predictive of MI and that women's and men's pattern of pain radiation differs. This prospective study therefore investigated whether there were differences in pain radiation between those with and without MI and according to gender. Patients (n = 541) presenting to a CCU with an episode of chest pain were asked to indicate on a body map the region of pain radiation they experienced at the time of symptom onset. As expected, radiation to the left and/or to right shoulder/arm was significantly higher in the MI group. Women with MI experienced more chest pain radiating to the right arm/shoulder (P = 0.0005), upper right region (P = 0.0006) and arm/shoulder than those without MI. Additionally, women with MI also described more pain radiation in the front neck (P = 0.015) area, and the right shoulder/arm (P = 0.02) than their male counterparts. A third of these women also experienced more pain radiating to the back (P = 0.005). The premise of greater chest pain distribution amongst those with an MI could not be confirmed. Nevertheless, the study identified significant differences amongst women with MI, the discussion analyses the implications for practice. © 2002 Elsevier Science Ltd.


Albarran, J., Durham, B., Gowers, J., Dwight, J., & Chappell, G. (2002). Is the radiation of chest pain a useful indicator of myocardial infarction? A prospective study of 541 patients. Accident and Emergency Nursing, 10(1), 2-9.

Journal Article Type Article
Publication Date Jan 1, 2002
Journal Accident and Emergency Nursing
Print ISSN 0965-2302
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 10
Issue 1
Pages 2-9
Keywords chest pain, myocardial infarction
Public URL
Publisher URL
Additional Information Additional Information : This paper has been cited in the International Liaison Committee on Resuscitation guidelines (ILCOR, Acute Coronary Syndromes 2005) to caution clinicians over diagnosing patients solely on the basis of signs and symptoms, particularly in women. Inclusion in the ILCOR guidelines followed rigorous peer scrutiny.