Acute coronary syndrome in diabetic patients: clinical characteristics and pain diagnosis
Background. Acute coronary syndrome (ACS) remains a common cause of hospitalization in patients with diabetes mellitus. Due to the frequent development of diabetic neuropathy, it is believed that this category of patients is characterized by a high frequency of atypical acute coronary syndrome, but...
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| Format: | Article |
| Language: | English |
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Zaslavsky O.Yu.
2022-10-01
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| Series: | Медицина неотложных состояний |
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| Online Access: | https://emergency.zaslavsky.com.ua/index.php/journal/article/view/1515 |
| Summary: | Background. Acute coronary syndrome (ACS) remains a common cause of hospitalization in patients with diabetes mellitus. Due to the frequent development of diabetic neuropathy, it is believed that this category of patients is characterized by a high frequency of atypical acute coronary syndrome, but data on this are quite contradictory. The objective: to determine the features of pain syndrome and its severity in people with acute coronary syndrome and concomitant diabetes. Materials and methods. The study involved 36 patients with diabetes (22 men and 14 women) aged 44–86 years who were hospitalized urgently for ACS. Pain syndrome was assessed upon admission and immediately after coronary artery revascularization according to the following criteria: visual analog scale, numerical rating scale, clinical data, and biochemical markers. Results. Most patients (91.67 %) at the time of hospitalization complained of chest pain, the rest were not bothered by any pain. During the survey, patients described pain as “burning” (30.56 %), “squeezing” (30.56 %), “pressing” (25.0 %), “tingling” (5.56 %). There were also complaints of difficulty breathing (13.89 %), shortness of breath (11.1 %), palpitations (41.67 %). The appearance of excessive sweating was noticed in 16.67 % of cases. There was no statistically significant difference between the results of pain assessment by visual analog scale and numerical rating scale (p > 0.1). The average value of glycemia at the time of hospitalization was 8.19 ± 3.45 mmol/l (men — 8.17 ± 3.61 mmol/l, women — 8.28 ± 3.13 mmol/l). Glycemia greater than 10.0 mmol/l was detected in 8 patients, which was 22.22 % of all patients. Most people (62.5 %) in this category had severe pain. Conclusions. In patients with ACS and diabetes, the typical clinical picture of ACS prevailed (91.67 % of cases) over the painless form. Before revascularization, moderate and severe pain occurred with equal frequency; there is no statistical difference between blood pressure, heart rate and glycemia (p > 0.1) in patients with severe and moderate pain. Hyperglycemia (≥ 10.0 mmol/l) was found in 22.22 % of patients; among them, people with severe pain prevailed. |
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| ISSN: | 2224-0586 2307-1230 |