Abstract

Dr. Muhammad Ahsan Shafiq*, Dr. Waqas, Dr. Abdullah Mushtaq, Dr. Alina Ajmal, Dr. Khurram Irshad, Dr. Muhammad Irfan Jamil

ABSTRACT

The aim of our study was to evaluate clinical profile and in-hospital outcome of patients presented with Acute Myocardial Infarction. Methodology: It was a descriptive cross sectional study conducted at Department of Cardiology, Holy Family Hospital Rawalpindi. Duration of study was 6 months from February 2018 to July 2018. We enrolled 90 patients who fulfilled inclusion criteria. Patients with stable or unstable angina, congestive heart failure (CHF), congenital heart diseases, cardiomyopathies and valvular heart diseases were excluded from the study. Informed consent was taken from all the patients. Patients presenting to our emergency department with symptoms of acute myocardial infarction –chest pain, giddiness, shortness of breath, epigastric pain- were evaluated with 12 lead resting ECG and cardiac enzymes (CK MB and Trop I). Results: There were total 90 patients included in our study. Out of 90 patients, 46 (51.1%) were in 55-64 years of age group. Mean age in our study was 63.5±5.49 yrs. There were 59 (65.5%) male and 31 (34.5%) female with male to female ratio of 1.9:1. Chest pain 67 (74.4%) was the most common clinical symptom. Approximately 36.5% patients presented within 12 hours of onset of symptoms. And only 30 (33.33%) were thrombolysed. Smoking 54 (60%) was the most common risk factor involved in our study. Sixty three (70%) patients were diagnosed STEMI on ECG, while 18 (20%) NSTEMI at the time of presentation. We found that anterior wall MI 25 (30%) was the most common type of infarction. The most common post MI complication was Arrhythmia in 18 (20%) patients. The overall mortality rate in our study was 17 (18.8%). Conclusion: There was male preponderance in our study. Almost half of the patients belonged to the age group 55-64 yrs. Though the chest pain is the commonest symptom of myocardial infarction, but large amount of the elderly patients present with atypical symptoms such as Dyspnea, drowsiness, nausea perspiration confusion and epigastric pain. The high mortality rate (18.8%) in our study was mainly due to late presentation of patient to the hospital. Only thirty percent of patient were thrombolysed. It is important to avoid delay in the transit time from home to hospital, since thrombolysis in elderly confers more of a survival advantage. Higher frequencies of smoking, diabetes, hypertension and dyslipidemia was observed.