21 types of chest pain in STEMI : A rare study , that failed to enter mainstream cardiology academia.
April 29, 2025 by dr s venkatesan
It is an unusual study on STEMI ,yet profound, in adding clinical wisdom in this techno era. The study is titled : Symptoms Predictive of Acute Myocardial Infarction in the Troponin Era: Analysis From the TRAPID-AMI Study . Kudos to the Henry ford hospital team, for thinking to produce such a study .
This study looked into the clinical characters of STEMI presentation and correlated with various aspects including Troponin levels with reference tothe clinical factors.
Reproducing just one sample data about the character of chest pain. Please go through the complete paper.
Few observations need a comment
The pull or catchining type of pain has 0% likelyhood of STEMI.The last in the list is mentioned as dyspnea is of great importance.It is the angina equivalnet ,which is reported to be 50 % is quiet high.
One observation, and an unlikely miss I could found, is the incidence of epigastric pain and rare abdominal pain in some of those pateints with inferio posterior MI where it direct intimacy with diaphgram and whcih can radiate downwrds.We have missed some cases as acute abdomen, as pancreatitis , later on proven to be RCA STEMI.
Final message
We keep talking at length, dozens of listless trials fighting between single or two stent strategies in bifurcation lesions in every compulsive interventional workshop. Currently, I don’t think any conference would give a stage space to discuss trials such as TRAP-AMI which can infuse fresh thoughts in youngsters’ minds. It is an unrealistic wish though; any cardiology scientific committee should be mandatorily instructed to allot at least 30% of time to clinical cardiology that can bring back the field of cardiology, on the righteous track again.
Reference
1.McCord J, Aurora L, Lindahl B, Giannitsis E, Calle-Muller C, Nowak R, Body R, Christ M, deFilippi CR, Christenson RH, Jacobsen G, Alquezar A, Panteghini M, Melki D, Plebani M, Verschuren F, French J, Bendig G, Weiser S, Mueller C; TRAPID-AMI Investigators. Symptoms Predictive of Acute Myocardial Infarction in the Troponin Era: Analysis From the TRAPID-AMI Study. Crit Pathw Cardiol. 2019 Mar;18(1):10-15. doi: 10.1097/HPC.0000000000000163. PMID: 30747759.
