Trend of acute myocardial infarction prevalence toward younger ages in Ahvaz

The aim of this study was comparing the prevalence of ST elevation myocardial infarction in 1997 with the prevalence in 2010 considering age groups in the hospitals of Ahvaz Jundishapur University of Medical Sciences. We considered the patients admitted with acute coronary syndrome at hospitals of Ahvaz Jundishapur University of Medical Sciences and all the patients with ST elevation myocardial infarction were included. We categorized the patients into six groups according their ages. 400 patients in 1997 and 243 patients in 2010 were included in this study. The prevalence of myocardial infarction has increased in patients younger than 35 years. There were no significant changes in the group of 35-45 years and group of 65-75 years. The most important changes in age distribution of myocardial infarction during 2010 were prevalence increasing in age group of 46-55 years and decreasing in age group of 56-65 years. During 1997, 17% of patients were patients older than 75 years while 27% of patients were older than 75 years in 2010. Our data suggest that the prevalence of ST elevation myocardial infarction in age group of 46-55 years old has increased in Ahvaz. This change is especially prominent in male patients

Effect of discharge education on quality of life and hospital readmission in patients with heart failure: is it effective?

A relatively common disease, congestive heart failure has a significant effect on the quality of life. Given that hospital admission is an important problem in patients afflicted with congestive heart failure, we sought to evaluate the effect of discharge education on the quality of life and hospital readmission in this group of patients. Eighty patients admitted with decompensated heart failure were selected and divided into 2 matched groups. The quality of life scores were measured for each patient. Upon discharge and during the first week after that, the intervention group received 3 sessions of education. Both groups were followed for 6 months. Data on the readmission rate and quality of life scores were collected. The baseline quality of life scores in the control and education subjects were similar [p-value: NS]. The quality of life scores showed a significant improvement at 3 and 6 months' follow-up in the education group. The hospital readmission rate, however, was higher in the control group at 3 and 6 months' follow-up. The present study showed that discharge education could enhance the quality of life and reduce the rate of hospital readmission in those suffering from congestive heart failure. It is, therefore, advisable that self-care training and discharge education be incorporated in the heart failure management strategy

Apical ballooning syndrome or Tako- tsubo cardiomyopathy: What we know about it

Apical ballooning syndrome [ABS] is a reversible cardiomyopathy with presentation mimicking an acute coronary syndrome. So in clinical practice, it is essential to consider it in the differential diagnosis of patients presenting with chest pain, especially in postmenopausal women. Coronary angiography is usually indicated to achieve a proper diagnosis. Typically, patients do not have significant coronary artery lesions. Left ventriculography and echocardiography reveal a regional systolic dysfunction with akinesis of the midventricle, apex and compensatory hyperkinesis of the basal ventricular segments. Occurrence of an emotionally or physically stressful event is a feature of ABS but its absence does not exclude this diagnosis. Several pathophysiologic mechanisms had been proposed. The prognosis of ABS is good. In this review, we highlight the clinical manifestations, pathophysiology and management of this syndrome