Complications of acute myocardial infarction in relation to the site of infarction

ABSTRACT

It has been suggested that infarction site may be significant determinant of clinical course and outcome after acute myocardial infarction [AMI].We aimed To assess the incidence of different sites of myocardial infarction [MI] and the different complications recorded according to the site of infarction, also to assess in-hospital mortality and its relation to age, sex, site of MI and other complications in patients with AMI. This study included all patients admitted to coronary care units of internal medicine and cardiology departments of Assiut university hospitals, Assiut government, Egypt, in the period from May 2007 to May 2008 with first AMI throughout one year [No=485 patients]. All patients were subjected to careful history and clinical examination, electrocardiography [ECG], laboratory investigations, echocardiography and hemodynamic monitoring. In addition, 50 age and sex matched controls were included in this study. The incidence of AMI was higher in the old age group >/= 60 years [59.38%] with a higher percentage in men than women [71.75% vs 28.25%] in all age groups. Extensive anterior location of MI had the highest incidence among our patients [44.7%] while the inferopostenior location had the lowest incidence [4.1%] in both genders. Then the overall, inferior [26.2%], antroseptal [10.1%], extensive [9.3%] and lateral location [5.6%] came in between the two sites. Patients with extensive MI experienced the highest incidence of serious complications as cardiogenic shock [13.3%], left ventricular [LV] aneurysm [35.5%], LV thrombus [35.5%], stroke [2.2%], atrial fibrillation [AF] [13.3%], premature ventricular ectopics [PVCs] [100%] and they also had the highest incidence of in-hospital mortality [17.7%].The incidence of the various sites of MI as well as the complications recorded in these patients are near to that recorded in other studies all over the world. Patients with anterior and extensive infarction experienced the highest incidence of complications and mortality than those with inferior and inferoposterior locations