Medical history (history of illness) is an important component in the diagnosis of myocardial infarction (heart attack). Family History
- Are there any people in your family who have had a heart attack or other vascular disease such as stroke?
Social history
- What is your profession?
- Is there smoking in your environment, i.e. you are a passive smoker?
- Is there evidence of psychosocial stress (work stress) or stress due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Do you have symptoms such as tenderness behind the sternum or pain radiating into the arm/jaw? *
- Do you have pain in your back, neck, or have abdominal pain? *
- Do you feel cold sweaty?
- Do you have a stomach ache?
- Do you feel nauseous? Do you need to vomit?
- Do you have shortness of breath? *
- Do you have severe anxiety? *
Vegetative anamnesis including nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Do you eat a balanced diet?
- Do you get enough exercise every day?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs (cocaine) and how often per day or per week?
Self history incl. drug history.
- Pre-existing conditions (heart disease)
- Operations
- Allergies
Medication history
- Clarithromycin – within 14 days of starting therapy, increased risk of myocardial infarction, among other things.
- Nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, diclofenac) including COX-2 inhibitors (synonyms: COX-2 inhibitors; commonly: coxibs; e.g. Celecoxib, etoricoxib, parecoxib); already in the first week of therapy, the risk of myocardial infarction increases by 20-50%NSAIDs led to a 3.4-fold increased risk of myocardial infarction in the presence of respiratory disease, respiratory disease alone increased the risk by 2.7-fold, whereas NSAID use alone increased the risk by 1.5-fold. Intravenous therapy with an NSAID for respiratory infections increased the risk of subsequent myocardial infarction by 7.2-foldNo significant increased rate of vascular death has been demonstrated for naproxen and acetylsalicylic acid. Both are inhibitors (inhibitors) of cyclooxygenase COX-1.
- Proton pump inhibitors (PPIs; acid blockers):
- In patients taking them for heartburnNote that many PPIs are degraded via the liver enzyme CYP3A4, which is also required for the activation of clopidogrel (antiplatelet agent). Accordingly, one study demonstrated that concomitant use of, for example, omeprazole with clopidogrel lowers the plasma level of clopidogrel.
- Long-term PPI users were 16-21% more likely to develop myocardial infarctions
Environmental history
- Heat
- Winter: Myocardial infarction frequency increased by 7% when daytime temperature dropped by 10°C
- Air pollutants
- “Asian dust” (sand particles, soil particles, chemical pollutants, and bacteria): acute myocardial infarctions were 45% more likely to occur one day after Asian-dust weather than on other days
- Particulate matter from wood burning – increased risk of myocardial infarction in those over 65 years of age; esp. during cold spells (< 6.4 °C three-day mean); neither NO2 nor air ozone levels significantly affected outcome
- Nitrogen dioxide and particulate matter pollution levels.
- Days with heavy pollen count (> 95 pollen grains per m3 air) (+ 5%).
- Weather:
- Low outdoor temperatures (four more heart attacks when the average temperature fell below 0°C than when it was above 10°C).
- High wind speed
- Little sunlight
- High humidity
* If this question has been answered with “Yes”, an immediate visit to the doctor is required!(data without guarantee)
