{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:46:51Z","timestamp":1788565611934,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009963","name":"Forskning och Utveckling, Halland","doi-asserted-by":"publisher","award":["209901"],"award-info":[{"award-number":["209901"]}],"id":[{"id":"10.13039\/501100009963","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Department of Ambulance and Prehospital Care, Region","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,25]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess symptom presentation related to age, sex and previous medical history in patients with chest pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two-centre study in a Swedish county emergency medical service (EMS) organisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Unselected inclusion of 2917 patients with chest pain cared for by the EMS during 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data analysis<\/jats:title>\n                    <jats:p>Multivariate analysis on the association between symptom characteristics, patients\u2019 sex, age, previous acute coronary syndrome (ACS) or diabetes and the final outcome of acute myocardial infarction (AMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Symptomology in patients assessed by the EMS due to acute chest pain varied with sex and age and also with previous ACS or diabetes. Women suffered more often from nausea (OR 1.6) and pain in throat (OR 2.1) or back (OR 2.1). Their pain was more often affected by palpation (1.7) or movement (OR 1.4). Older patients more often described pain onset while sleeping (OR 1.5) and that the onset of symptoms was slow, over hours rather than minutes (OR 1.4). They were less likely to report pain in other parts of their body than their chest (OR 1.4). They were to a lesser extent clammy (OR 0.6) or nauseous (OR 0.6). These differences were present regardless of whether the symptoms were caused by AMI or not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A number of aspects of the symptom of chest pain appear to differ in unselected prehospital patients with chest pain in relation to age, sex and medical history, regardless of whether the chest pain was caused by a myocardial infarction or not. This complicates the possibility in prehospital care of using symptoms to predict the underlying aetiology of acute chest pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054622","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T12:45:14Z","timestamp":1659962714000},"page":"e054622","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical presentation in EMS patients with acute chest pain in relation to sex, age and medical history: prospective cohort study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-230X","authenticated-orcid":false,"given":"Kristoffer","family":"Wibring","sequence":"first","affiliation":[{"name":"Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden"},{"name":"Department of Ambulance and Prehospital Care, Halland County, Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Lingman","sequence":"additional","affiliation":[{"name":"Department of Molecular, University of Gothenburg, Goteborg, Sweden"},{"name":"Halland hospital group, Halland County, Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Herlitz","sequence":"additional","affiliation":[{"name":"Research centre PreHospen, University of Bor\u00e5s, Boras, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Ambulance and Prehospital Care, Halland County, Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Lerjebo","sequence":"additional","affiliation":[{"name":"Department of Ambulance and Prehospital Care, Halland County, Halmstad, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"B\u00e5ng","sequence":"additional","affiliation":[{"name":"Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"2025120520451556000_12.8.e054622.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2008.03.229"},{"key":"2025120520451556000_12.8.e054622.2","doi-asserted-by":"crossref","DOI":"10.1186\/s13049-019-0659-6","article-title":"Chest pain in the ambulance; prevalence, causes and outcome - a retrospective cohort study","volume":"27","author":"Pedersen","year":"2019","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2025120520451556000_12.8.e054622.3","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.ijcard.2014.08.004","article-title":"Characteristics and outcome among patients who dial for the EMS due to chest pain","volume":"176","author":"Rawshani","year":"2014","journal-title":"Int J Cardiol"},{"key":"2025120520451556000_12.8.e054622.4","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"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)","volume":"39","author":"Ibanez","year":"20172018","journal-title":"Eur Heart J"},{"key":"2025120520451556000_12.8.e054622.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa624"},{"key":"2025120520451556000_12.8.e054622.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.08.035"},{"key":"2025120520451556000_12.8.e054622.7","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1177\/1474515118777391","article-title":"The second myocardial infarction: is there any difference in symptoms and prehospital delay compared to the first myocardial infarction?","volume":"17","author":"Str\u00f6mb\u00e4ck","year":"2018","journal-title":"Eur J Cardiovasc Nurs"},{"key":"2025120520451556000_12.8.e054622.8","doi-asserted-by":"crossref","unstructured":"Gulati M , Levy PD , Mukherjee D , et al . 2021 AHA\/ACC\/ASE\/CHEST\/SAEM\/SCCT\/SCMR guideline for the evaluation and diagnosis of chest pain: Executive summary: a report of the American College of Cardiology\/American heart association joint Committee on clinical practice guidelines. 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