Background: Cardiac pain arising from acute coronary syndrome (ACS) is a\nmulti-factorial phenomenon. Historically, episodes of cardiac pain have been\ncaptured using a one-dimensional numeric pain rating scale. Lacking in clinical\npractice are acute pain assessments that employ a comprehensive evaluation of\nan emergent ACS episode. Aim: To examine the sensory-discriminative, motivational-\naffective and cognitive-evaluative dimensions of ACS-related pain. Methods:\nA descriptive-correlational, repeated-measure design was used to collect\ndata on 121 ACS patients of their cardiac pain intensity. The (numeric rating\nscale-NRS 0-10 scale) measured chest pain ââ?¬Å?Nowââ?¬Â and ââ?¬Å?Worst pain in the previous\n2 hours over 8 hoursââ?¬Â and the McGill Pain Questionnaire Short-Form\n(MPQ-SF) measured pain at 4 hours. Results: Mean age was 67.6 Ã?± 13, 50%\nwere male, 60% had unstable angina and 40% had Non-ST-elevation myocardial\ninfarction. Cardiac pain intensity scores remained in the mild range from 1.1 Ã?±\n2.2 to 2.4 Ã?± 2.7. MPQ-SF: 66% described pain as distressing and 26% reported\npain was horrible or excruciating. Participants described ACS pain quality as\nacute injury (nociceptive pain: heavy, cramping, stabbing ), as nerve damage\n(neuropathic: gnawing, hot-burning, shooting) and as a mixture of acute and\nchronic pain qualities (aching, tender and throbbing ). Conclusions: Patients reported\nboth nociceptive and neuropathic cardiac pain. It is unclear if pain perceptions\nare due to: i) pathophysiology of clot formation, ii) occurrence of a\nfirst or repeated ACS episode, or iii) complex co-morbidities. Pain arising from\nACS requires an understanding of the interplay of ischemic, metabolic and neuropathophysiological mechanisms that contribute to complex cardiac pain\nexperiences.
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