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
Durante o atendimento realizado a pacientes portadores de Infarto Agudo do Miocárdio (IAM), percebemos a complexidade de sua patologia. Atualmente com a utilização da terapia celular houve uma nova esperança para pacientes com este diagnóstico. Assim realizamos este estudo para aprimorarmos nossos conhecimentos, enquanto enfermeiros, à referida terapia e seus supostos benefícios.Trata-se do relato de caso de um paciente admitido em uma Unidade Coronariana(UCOR) com diagnóstico de Infarto Agudo do Miocárdio (IAM) anterior extenso e sua inclusão no protocolo para manipulação de Células Tronco (CT) de medula óssea (MO). O enfermeiro tem papel fundamental no atendimento deste paciente, esclarecendo suas dúvidas, atendendo expectativas, além de manter participação ativa nos procedimentos intra-hospitalares. A coleta de dados traduziu-se em pesquisa em prontuário e observação da evolução clinica. Durante todo este processo priorizamos as ações do nosso cuidado tentando avaliar as necessidades apresentadas pelo paciente.
During the process of care of patients who suffered acute myocardial infarction we observed how complex is this disease. Nowadays, stemcell therapy opens a new horizon and hope for these patients. We conducted this study to improve our knowledge as nurses in face of this new therapeutic model. This study is a case report of a patient who suffered an anterior acute myocardial infarction and was admitted in a coronary care unit and enrolled in stemcell transplantation study protocol. The nurse has a fundamental role in the process of care during the hospitalization period clarifying the patient's doubts and perspectives. The data was collected in patient's record.During the patient length of stay we emphasized our nursing care based on his individual value.
Subject(s)
Humans , Male , Adult , Tissue Therapy, Historical , Nursing Care , Bone Marrow Cells , Myocardial Infarction/methods , Stem Cell Transplantation/nursingABSTRACT
This is a case report about a 35 years old male farmer, who presented to the neurology outpatient clinic, of a 510 bed teaching hospital in Sanaa - Republic of Yemen -On 19.12.1991, with right sided weakness, inability to speak [stroke]. He spent 6 days out before being admitted by a Neurologist into the general medical ward on 25.12.1991. After his reassessment and investigations, he was found to have a slow pulse 24/min. ECG No. 1 on 25.12.1991 revealed sick sinus syndrome, 1st degree AV block, and inferior infarct. Repeat ECG No. 2 on 30.12.1991 after Atropine injections did not show any improvement in the rate. His mild left ventricular failure responded to amiloride hydrochlorthiazide combination [Moduretic]. The right sided hemiparesis and aphasia improved over three weeks on piracetam [Nootropil], Aspirin and Dipyridamole [Persantin]. On 8.1.1992 he was transferred to the intensive care unit for Halter's monitoring to watch any brady-tachyarrhythmia syndrome and re-evaluate atropine responses ECG No. 3 showed sinus arrest typical of sick sinus syndrome without response to atropine 0.5 mg Q.D.S. No bradytachycardia syndrome was recorded over one week on monitor. Salbutamol 2 mg Q.D.S. was started after stopping atropine orally which increased the heart rate by 25-50 percent i.e. the pulse 24 beat/min. became 30-36 beats/min ECG No 4. Many biochemical, blood tests were normal, chest P.A. film showed borderline cardiomegaly with mild pulmonary conjestion, ECHO did not show any valvular lesion. CAT scan was out of order, No pace maker. Patient was discharged to go abroad for more investigations and Pace-marker