What are the symptoms of acute myocardial infarction?

Acute myocardial infarction, commonly known as a heart attack, presents with the following common symptoms:

1. Chest pain: This is the most common initial symptom, often occurring in the early morning. The location and nature of the pain are similar to angina pectoris, but the intensity is greater and the duration is longer, often lasting for several hours or more. Rest and sublingual administration of nitroglycerin usually do not relieve the pain. Patients often experience restlessness, sweating, fear, or a sense of impending doom.

2. Arrhythmias: Most patients develop arrhythmias within 1-2 days after onset, with ventricular arrhythmias being the most common. Severe arrhythmias such as ventricular fibrillation may lead to sudden death.

3. Shortness of breath: Patients may feel breathless or experience rapid breathing, even at rest.

4. Gastrointestinal symptoms: Frequent nausea, vomiting, and upper abdominal distension often accompany severe pain, which may be related to stimulation of the vagus nerve by necrotic myocardium, reduced cardiac output, and inadequate tissue perfusion.

5. Systemic symptoms: Patients may develop fever, typically occurring 24-48 hours after the infarction, with body temperature usually around 38°C, lasting about one week. Other possible manifestations include tachycardia, elevated white blood cell count, and increased erythrocyte sedimentation rate.