{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:59:23Z","timestamp":1785506363265,"version":"3.56.0"},"reference-count":16,"publisher":"FapUNIFESP (SciELO)","issue":"6","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Samaritano Paulista Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  INTRODUCTION: Around 30% of patients with acute myocardial infarction do not report chest pain, but data on symptom patterns according to the type of myocardial infarction and attending physician specialty are scarce.  OBJECTIVE: The aim of this study was to identify common clinical presentations of acute myocardial infarction in a Brazilian registry, stratified by infarction type and physician specialty.  METHODS: Observational analysis of two datasets: (1) retrospective cohort of 2,783 acute myocardial infarction patients from 15 hospitals (2014\u20132018) initially evaluated by emergency physicians; (2) prospective registry of 718 acute myocardial infarction patients (2018\u20132020) assessed in the acute phase by cardiologists via telemedicine. Cases were classified as ST-segment Elevation Myocardial Infarction or Non-ST-segment Elevation Myocardial Infarction. Symptoms were categorized as typical\/atypical chest pain, epigastric pain, or absence of both; additional symptoms were recorded. Categorical variables were compared using chi-square tests (p&lt;0.05).  RESULTS: Typical chest pain occurred in 60.3% of patients, more frequent in ST-segment Elevation Myocardial Infarction than Non-ST-segment Elevation Myocardial Infarction (66.5 vs. 56.5%; p&lt;0.01). Absence of chest\/epigastric pain was more common in Non-ST-segment Elevation Myocardial Infarction (6.1%) than ST-segment Elevation Myocardial Infarction (2.7%) (p&lt;0.01). Cardiologist assessment identified more acute myocardial infarction cases without chest\/epigastric pain than emergency physician assessment (11.0 vs. 3.2%; p&lt;0.01). ST-segment Elevation Myocardial Infarction patients without chest\/epigastric pain had the highest mortality (29.4%) in the emergency physician cohort.  CONCLUSION: In this registry, absence of chest or epigastric pain was less frequent than previously reported but associated with high mortality. Telemedicine evaluation by cardiologists identified a greater proportion of pain-free acute myocardial infarction presentations.  Clinical Trial Registration Number:  ClinicalTrials.gov NCT02753023.<\/jats:p>","DOI":"10.1590\/1806-9282.20251775","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:03:18Z","timestamp":1785502998000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical profile of acute myocardial infarction: the Registry of Acute Medical Emergencies registry"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1940-4470","authenticated-orcid":false,"given":"Pedro Gabriel Melo de Barros e","family":"Silva","sequence":"first","affiliation":[{"name":"Hospital Samaritano Paulista,  Brazil; Brazilian Clinical Research Institute,  Brazil; Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3777-1947","authenticated-orcid":false,"given":"Alexandre Matos","family":"Soeiro","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8836-2060","authenticated-orcid":false,"given":"Rodrigo","family":"Balada","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4463-3291","authenticated-orcid":false,"given":"Lucas","family":"Macedo","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5309-2226","authenticated-orcid":false,"given":"Milena Del Valle de","family":"Lacerda","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2688-7978","authenticated-orcid":false,"given":"Luan Vitor Aguiar","family":"Correia","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9796-6430","authenticated-orcid":false,"given":"Maria Carolina","family":"Ximenes","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6549-8142","authenticated-orcid":false,"given":"Karen Teixeira","family":"Dias","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8295-4957","authenticated-orcid":false,"given":"Sabrina Carvalho","family":"Moura","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1758-7871","authenticated-orcid":false,"given":"Sofia Gabriela Gregolini","family":"Catellani","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio S\u00e3o Camilo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2999-4961","authenticated-orcid":false,"given":"Renato Deslacio","family":"Lopes","sequence":"additional","affiliation":[{"name":"Brazilian Clinical Research Institute,  Brazil; 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