Nausea and Vomiting in Acute MI Don't Predict Infarct Site

From Reuters Health Information

NEW YORK (Reuters Health) Jan 08 - Nausea and vomiting in a patient with acute myocardial infarction (AMI) do not predict the site of the infarct, new research shows.

The investigators note in their paper that some studies say nausea and vomiting are more common when the inferior portion of the left ventricle is involved, but "other studies have found just the opposite."

In email to Reuters Health, senior researcher Dr. Mark Feldman from Texas Health, Presbyterian Hospital, Dallas, pointed out that knowing the location of the infarct can be "important because anterior AMI has a worse prognosis than inferior AMI."

Therefore, he and his colleagues re-examined the relationship between infarct location and nausea and vomiting in 180 patients with either acute ST-segment elevation AMI or AMI associated with left bundle branch block.
Forty percent of the infarctions were in the anterior wall.

Nearly two thirds of the patients (64%) presented with nausea and almost one third (31%) presented with vomiting, the investigators report in the December 15th issue of the American Journal of Cardiology.

Although there was a trend toward higher rates of nausea and vomiting with inferior AMI, the difference was not statistically significant.
Rates of nausea and vomiting, respectively, were 69% and 33% in patients with inferior AMI, and 57% and 26% in patients with anterior AMI.

Dr. Feldman said he was not surprised at the lack of association between nausea and vomiting and infarct location, "but a study was needed to confirm or refute my impressions."

Am J Cardiol 2009;104:1638-1640.