Background: Patients with acute coronary syndrome (ACS) may present with a
wide range of symptoms that may easily be misdiagnosed.
Methods: This cross-sectional, hospital-based, descriptive, retrospective audit of
medical records was based at the Ladysmith Provincial Hospital ED and consisted of
the last 160 consecutive patients (from the date of initiation of data collection) with
accessible medical records and with a final hospital discharge diagnosis of ACS.
Results: The frequency of patients presenting with ACS was approximately 53
patients per annum. There was a male to female ratio of 1.3: 1. The mean age was
55.8 years (SD 12.8 years). The study population consisted of Asian (103/160,
64.4%), black (36/160, 22.5%) and white (21/160, 13.1%). The majority of the study
patients were unemployed (98/160, 61.25%), urban resident (143/160, 89.4%), not
alcohol users (137/160, 85.6%), and not smokers (88/160, 55.0%). Risk factors and
comorbidity included previous acute coronary syndrome (44/160, 27.5%), family
history (29/160, 18.1%), previous cardiovascular surgery (10/160, 6.25%), obesity
(45/160, 28.1%), hypercholesterolemia (49/160, 30.6%), diabetes (42/160, 26.25%),
hypertension (76/160, 47.5%), and renal failure (27/160, 16.9%). Approximately
three quarters (119/160, 74.4%) of the study patients had typical chest pain, 16.3%
(26/160) had atypical chest pain, and 9.4% (15/160) had no chest pain. The median
length of hospital stay was 3 days and the in-hospital mortality was 8.1 % (13/160).
Conclusion: The relatively high frequency of ACS reported in this study, when
compared to other similar studies, is concerning. Also of concern in this study, is the
alarming proportion of Asians that presented with ACS