Which of the following is the most common symptom of myocardial infarction (MI)?
A. Chest pain
B. Dyspnea
C. Edema
D. Palpitations
Correct Answer: A. Chest pain
The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Myocardial ischemia can present as chest pain, upper extremity pain, mandibular, or epigastric discomfort that occurs during exertion or at rest. The chest pain is usually retrosternal and is sometimes described as the sensation of pressure or heaviness. The pain often radiates to the left shoulder, neck, or arms with no obvious precipitating factors, and it may be intermittent or persistent. The pain usually lasts for more than 20 minutes. It is usually not affected by positional changes or active movement of the region.
Option B: Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Myocardial ischemia can also present as dyspnea or fatigue, which are known to be ischemic equivalents.
Option C: Edema is a later sign of heart failure, often seen after an MI. Myocardial edema is a consequence of ischemia and infarction and has functional importance because edema impairs myocyte contractility. The extent of myocardial edema revealed by T2?weighted cardiac magnetic resonance (CMR) imaging correlates with the transmural extent of infarction.
Option D: Palpitations may result from reduced cardiac output, producing arrhythmias. The MI can also present atypically with subtle findings such as palpitations, or more dramatic manifestations, such as cardiac arrest. The MI can sometimes present with no symptoms.
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