Acute Prevention of the Heart Attack: The Identification of Prodromal Symptom Recognition as the "Rosetta Stone" in Decoding the Heart Attack Problem
Raymond D. Bahr, Frank Breuckmann
Critical Pathways in Cardiology, May 22, 2025
✅ Conclusion:
Prodromal symptoms are the “Rosetta Stone” of heart attack prevention. Early identification shifts intervention earlier in the ischemic timeline, offering a window to prevent progression to full-blown MI or sudden cardiac death.
🧠 Key Concepts:
-
Prodromal symptoms (e.g., intermittent/stuttering chest pain) occur hours to days before MI.
-
These correlate with:
-
Cyclic ST segment changes
-
Repeated spontaneous reperfusion and occlusion events
-
Presence of viable myocardium at risk
-
Recognizing these symptoms indicates a pre-infarction state that may allow intervention before irreversible damage.
💡 Clinical Implications:
-
Early Heart Attack Care (EHAC) programs emphasize public and clinician awareness of prodromal symptoms.
-
Recognition enables:
-
Early treatment (e.g., antiplatelet therapy, observation, risk stratification)
-
Reduction in heart attack deaths
-
Fewer inappropriate ED discharges
-
Reduced unnecessary hospital admissions
Bahr, R.D. and Breuckmann, F., Acute Prevention of the Heart Attack The identification of Prodromal Symptom Recognition as the “Rosetta Stone” in decoding the heart attack problem. Critical Pathways in Cardiology, pp.10-1097.