Abstract
This study was designed to determine the clinical significance of nausea and vomiting (NV) in relation to the onset of chest pain in patients with acute Q-wave myocardial infarction (MI). Two hundred forty patients with acute Q-wave MI admitted≤12 hours from the onset of chest pain were divided into two groups according to the presence or absence of NV in the prehospital phase; 79 patients (33%) had NV (group I) and 161 patients had no NV (group II). Group I was subdivided into 2 subgroups, i. e., group Ia: 36 patients with NV anteceding and/or simultaneously with the onset of chest pain, and group Ib: 43 patients with NV after the onset of chest pain. Group Ia had significantly higher prevalence of young MIs (≤40 years), smokers, proximal coronary artery lesions, pericardial rubs and larger number of left ventricular asynergic segments than those in group Ib and group II. In addition, group Ib had significantly higher incidence of inferior MI compared to group Ia. We concluded that NV anteceding chest pain was associated with larger MI, and was more frequently observed in young and transmural MI.
