ABSTRACT
Objectives: To determine the frequency of Acute Myocardial Infarction in patients with Diabetes Mellitus, and short term survival in these patients
Methodology: This study included 100 patients, was carried out in department of Cardiology, Liaquat University Hospital Hyderabad. Diagnosed cases of type 2 Diabetes Mellitus [DM] requiring Hospitalization with ST elevation, myocardial Infarction and meeting the criteria were enrolled in the study. The final diagnosis of Acute Myocardial Infarction was made within 48 hours of admission. The blood glucose level and glycosylated haemoglobin [HbA1c] were checked to evaluate the glycemic status. The short term survival was evaluated by recording in hospital mortality and mortality during follow-up period of 30 days; by contacting at their residential address or contact number
Results: In the present study total 100 consecutive diabetic cases with acute Myocardial infarction were selected. The males patients outnumbered females. On the ECG and echocardiogram findings 39% patients had anterior wall MI. All male [n=65] patients had short term mortality of 27.68%, stratification showed that 6.15% was between 1 -10 days, 9.23% between 11-20 days and 12.30% mortality was found between 21-30 days. The corresponding figures in female [n=35] patients was 25.33%, stratification showed 8.57% mortality between 1-10 days, 5.71% seen between 11-20 days and in the 11.4% mortality was noted between 21-30 days
Conclusion: The short term mortality after acute myocardial infarction in diabetic patients is significantly high, both male and female suffer almost equally
ABSTRACT
Background: Coronary artery disease [CAD] has a predilection for older age. However, both in developed and developing countries, an epidemiological shifts for CAD is observed and now it is more frequently seen in young adult population, but there is paucity of data regarding emerging clinical picture. Therefore, the present study was designed to determine the percentage of patients at 45 years of age and below afflicted with myocardial infarction. The study was also aimed to determine the sex distribution, associated risk factors and clinical features in young patients
Methods: This descriptive study conducted through convenient sampling technique at Coronary Care Unit of Liaquat University Hospital, Hyderabad and on all patients admitted with acute myocardial infarction during the period of one year to determine the frequency of acute myocardial infarction among younger patients aged
Results: The overall prevalence of acute myocardial infarction among young adults was 46.80%. The mean age of study subjects was 37.63 +/-6.26 years; male outnumbered [80.7%, n= 71] female [19.3%, n=17]. Most of the patients belongs to age group between 41 - 45 years [40.9%, n= 36] and the most common underlying condition that may linked to myocardial infarction was cigarette smoking [65.9%, n= 58]. Out of total 88 patients the mortality rate was [12.5%, n= 11] and ventricular arrhythmias were the most common [6.8%, n=6] complication
Conclusion: The acute myocardial infarction is not uncommon in younger aged male smokers
ABSTRACT
Objectives: to find out the frequency of right ventricular infarction [RVI] in patients with acute inferior wall myocardial infarction and also to see its clinical correlation and prognostic value
Methods: 198 consecutive patients with acute inferior wall myocardial infarction [MI] were enrolled. Elevated ST segments in V4R or V3R to V6R were used to diagnose RVI. We assessed the incidence of ST-segment elevation in these leads and their correlation on clinical ground
Result: in 96 patients [48.5%], RVI was present. Clinical correlation showed that raised JVP was present in 58.5% and raised JVP with hypotension in 34.5% of patients. Normal JVP was present in 41.5% of patients in which 22% of patients were with hypotension and 20% of patients were without clinical findings. Hypotension observed in 53% of patients. Complications were higher in patients with elevated ST segments in V4R [51%] in contrast to those without RVI [21%]. In-hospital mortality was more than double in RVI Group
Conclusion: RVI in acute inferior MI is common. Elevated ST segments in V4R or V3R to V6R can be used to diagnose RVI. Clinical correlation can help but may not be diagnostic and it has higher mortality compared to inferior MI alone
ABSTRACT
To determine the outcome of patients with acute ST segment elevated myocardial infarction [STEMI] versus non -ST elevated myocardial infarction [NSTEMI] in our setup. A descriptive study. Cardiology department, Liaquat University Hospital, Hyderabad - Sindh from 1st May 2005 to 31st July 2005. Out of 580 patients hospitalized for acute coronary syndrome, 428 patients of acute myocardial infarction were selected for the study. The patients were selected on the basis of raised biomarkers [CPK, CKMB, SGOT, and LDH/Trop-T] and one of the two i.e. electrocardiography [ECG] changes or history of chest pain. They were grouped into STEMI and NSTEMI. Mean age of the patients was 52 years [range 35-75 years]. Majority of patients [73%] was male and 27% were females. Out of 428 patients selected for study, 288[67.28%] had STEMI while 140 [32.72%] patients had NSTEMI. Recurrent chest pain was present in 85 [29.51%] patients of STEMI; 45 [52.94%] with ECG changes and 40 [47.05%] without ECG changes. In STEMI group, complications were common, more in patients with recurrent chest pain and evidence of ECG changes as compared to those without ECG changes i.e. 16% and 10% respectively. Mortality was also higher [10.5%] in patients of recurrent chest pain and ECG changes compared to those without ECG changes [6.8%]. Among 140 patients of NSTEMI, 48 [34.28%] had recurrent chest pain; 30[62.5%] with ECG changes and remaining 18[37.5%] without ECG changes. In NSTEMI and STEMI patients, recurrent chest pain and ECG changes are bad prognostic markers as compared to recurrent chest pain without ECG changes. These patients are more likely to suffer complications and can benefit from aggressive/invasive strategy than patients with recurrent chest pain without ECG changes. In NSTEMI group, complications and mortality are more frequent in patients with recurrent chest pain and ECG changes compared to those without ECG changes
Subject(s)
Humans , Male , Female , Electrocardiography , Chest Pain , Outcome Assessment, Health Care , Myocardial Infarction/methods , Risk FactorsABSTRACT
To determine risk factors associated with peripartum cardiomyopathy in our set up. Coronary care unit, cardiology department Liaquat University Hospital, Hyderabad- Sindh from February to April 2005. Thirty patients with signs and symptoms of heart failure including chest x-ray showing cardiomegally were included in the study. Detailed clinical review of the patients was undertaken. Diagnosis of cardiomyopathy was confirmed on M-Mode / 2D / Colour Doppler Echocardiography. All [30] patients belonged to poor socioeconomic class. Mean age was 29.1 years [range 21-42 years]. Mean parity was 4 [range 1-8] and included primipara 1[3%], multipara 25 [83.3%] and grand multipara were 4[13.3%] patients. Five [16%] patients had gestational hypertension. Twenty-five[83.3%] patients presented with shortness of breath and orthopnea [NYHA Class-IV], 5[16%] with shifted apex beat and 3rd heart sound. All [100%] patients had sinus tachycardia, raised JVP and oedema feet. All patients also showed cardiomegally on x-ray chest. Echocardiograpically, 21 [70%] were having dilated left ventricle [LVIDD>57mm] ranging from 55-75 and reduced ejection fraction i.e, [<40%] ranging from 18-40%. Nine [30%] cases had normal size left ventricle and generalized left ventricular hypokinesia with reduced EF [<40%]. Eighteen [60%] patients were having moderate MR on Colour Doppler Echocardiography. This preliminary study shows that peripartum cardiomyopathy is associated with multiple risk factors in our set up. The most common risk factor is poor socioeconomic status followed by pregnancy with increasing age [>29 years] and multiparity [para >4]