Résumé
The role of CRP as a predictor of acute coronary syndrome [ACS] and its complication is controversy. This study was performed to evaluate the relationship between serum c- reactive protein [CRP] levels with complication of Acute MI. This study was performed on 100 patients with Acute MI who were admitted in heart department of Babol Shahid Beheshti hospital. The level of CRP measured on third day of admission. Prevalence of CRP level in patients group with complication included electrical, mechanical and hemodynamical compared with uncomplicated group. CRP was increased in 85% of patients. Complications of AMI were observed in 64% of patients. The mean level of CRP in complicated group was significantly higher than uncomplicated group [110.8 +/- 61.2 and 32.2 +/- 38.3 respectively, p<0.001]. The mean CRP levels in patients with electrical, mechanical and hemodynamical complications were 80, 139.6 and 137.4 micg/ml respectively, which was significantly higher than uncomplicated group [p<0.001]. The results of this study show that there was an association between serum CRP levels and cardiac complication in early phase of AMI. CRP can predict the complication of AMI at early phase
Sujets)
Humains , Infarctus du myocarde/sang , Protéine C-réactive , Protéine C-réactive/sangRésumé
With regard to the extensive use of digoxin in patients with heart disease and its high prevalence of toxicity, this study was done to measure the digoxin serum level [DSL] in patients with or without symptoms of poisoning and determine its relation with age. This study was performed on 441 patients who used digoxin in Babol Shahid Beheshti hospital in 1999-2003. Digoxin has been used for a long time by these patients and the cause of hospitalization was symptoms related to digoxin and primary disease. DSL was measured after history taking and information about the presence of poisoning symptoms. From 441 patients, 63 cases were toxic and 378 cases were non-toxic. Among 63 toxic cases, DSL in 27 cases was more than 2 ng/dl in serum that 82% of them were under 70 years old and DSL in 36 cases was less than 2 ng/dl in serum that 95% of them were over 70 years. From 378 non-toxic cases, 42 cases [11%] were over 70 years that DSL in all of them was less than 2 ng/dl and 336 [89%] were under 70 years that DSL in 3 [4%] and 323 [96%] was more and less than 2 ng/dl, respectively. Although, the most DSL in non-toxic patients was more than 2 ng/dl but DSL less than 2 ng/dl can also cause digoxin toxicity [Especially in patients more than 70 years]
Résumé
Ventricular septal defect [VSD] is one of the mechanical complications after acute myocardial infarction [AMI]. VSD was recognized by color Doppler echocardiography. The aim of this report was early diagnosis of this complication after AMI with echocardiography and its relation with thrombolytic therapy. The first patient was a 54 year old man who presented to emergency ward with chest pain and he was admitted to CCU with diagnosis of acute anterior AMI and received streptokinase therapy [SK], he had a systolic murmur with thrill in LSB [Left sternal border] and had moderate size muscular VSD with echocardiography. Second patient was 66 year old women who presented which chest pain and she was admitted to CCU with diagnosis of inferior MI and anterior ischemia at distance. She had pansystolic murmur with thrill at LSB and had muscular type VSD with echocardiography. 3rd and 4th and 5th patients who were 75, 80 and 52 years old, respectively were referred with chest pain and with diagnosis of AMI, they had systolic murmur with thrill at LSB, diagnosis of VSD after AMI was confirmed with echocardiography and 5th patient received SK. Selective coronary angiography, cardiac catheterization and oxymetry were done. VSD is one of important complication of AMI. They were recognized with physical examination and echocardiography. Thrombolytic therapy accelerates the time from AMI to VSD formation