THROMBOLYTIC THERAPY IN ACUTE MYOCARDIAL INFARCTION: THE SCOPE IN A DISTRICT GENERAL HOSPITAL

1987 ◽  
Author(s):  
R G Murray ◽  
J Jagger ◽  
M K Davies ◽  
W A Littler
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
General Hospital ◽  
District General Hospital ◽  
Peptic Ulcers ◽  
Hospital Data ◽  
Number Of Patients ◽  
Recent Acute Myocardial Infarction

Despite the interest in thrombolytic therapy in acute’ myocardial infarction, it has been reported.that only a small minority of patients considered for thrombloysis would be suitable. .To determine the demand for such therapy in a District General Hospital, data were collected for patients admitted with chest pain to our Coronary Care Unit over a six month period. Of 197 patients admitted with chest pain 131 patients (67%) were proven to have acute myocardial infarction. Criteria for thrombolytic therapy included presentation within six hours of the onset of symptoms, ST elevation ≥ 0.2 mV in 2 or more ECG leads and age ≤ 70 years. Sixty-seven (51%) of the 131 patients with subsequently proven acute myocardial infarction were eligible for thrombolysis. Criteria for thrombolysis were not fulfilled in 41 patients with acute myocardial infarction; 17 (13%) presented later than six hours, 15 (12%) failed to meet the ECG criteria and 9 (7%) were over 70 years. A further 12 (9%) patients were excluded for cardiogenic shock, patients had peptic ulcers, one patient sustained a recent acute myocardial infarction 2 weeks previously and data from 8 patients were lost.These results suggest that around 50% of patients with acute myocardial infarction and 34% of all patients presenting with chest pain would be suitable for thrombolytic therapy. These data do not support the view that such treatment may only be applicable to a small number of patients with acute myocardial infarction.

scholarly journals Thrombolysis for Acute Myocardial Infarction in a District General Hospital

1989 ◽  
Vol 82 (7) ◽  
pp. 394-395 ◽  
Author(s):  
H Dalton ◽  
D Chappel ◽  
R Climie
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
General Hospital ◽  
District General Hospital

We report our experience in establishing thrombolysis as a routine part of the management of patients with acute myocardial infarction in our hospital; with particular reference to the effectiveness of the policy, safety and delays in administration.

scholarly journals Clinical effectiveness of thrombolytic therapy with alteplase and double antiplatelet therapy in acute myocardial infarction

2011 ◽  
Vol 10 (6) ◽  
pp. 59-63
Author(s):  
D. N. Kuznetsov ◽  
V. V. Trusov ◽  
I. A. Kazakova
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Clinical Effectiveness ◽  
Minute Volume ◽  
Myocardial Salvage ◽  
Group I ◽  
General Weakness ◽  
Number Of Patients ◽  
Group Ii

Aim. To assess the clinical effectiveness of thrombolytic therapy (TLT) with alteplase in patients with acute myocardial infarction (AMI). Material and methods. The study included 54 AMI patients, divided into two groups: Group I (n=26), which underwent TLT, and Group II (n=28), which had contraindications to TLT. The TLT method was an accelerated alteplase infusion. Both groups were comparable by age and sex. In all patients, AMI biomarker levels and echocardiography (EchoCG) parameters were measured. Results. Successful thrombolysis was performed in 19 patients (73 %). The mean “symptom-to-needle” time was 3,7±0,6 hours. In Groups I and II, the 50 % reduction in the ST segment deviation from isoelectric line at 180 minutes was observed in 34,6 % and 0 % of the patients, respectively. In addition, in Group I, there was a reduction in the number of patients complaining of general weakness, dyspnoea, and recurrent angina attacks. The levels of cardio-specific AMI biomarkers were higher in Group II. According to the EchoCG results at 10 days after admission, the Group I patients demonstrated higher minute volume (by 28,8 %), higher ejection fraction (by 30 %), and higher end-diastolic dimension (by 23,8 %). Conclusion. The results obtained confirm high effectiveness of the in-hospital TLT with accelerated alteplase infusion. Alteplase therapy was associated with clinical and morphological myocardial salvage in AMI patients.

The Value of Temporary Electrical Pacing for Patients with Acute Myocardial Infarction

1984 ◽  
Vol 23 (01) ◽  
pp. 23-28 ◽  
Author(s):  
B. J. Northover
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Clinical Trial ◽  
General Hospital ◽  
Electrical Conduction ◽  
District General Hospital ◽  
Electrical Pacing ◽  
Formal Clinical Trial

SummaryFacilities for temporary electrical pacing were created in a district general hospital. In consequence, a more than twofold increased proportion of patients with acute myocardial infarction who developed electrical conduction defects were treated with temporary electrical pacing. Despite the increased use of pacing, however, the mortality among patients with conduction defects did not decline at all. It is concluded that the widespread reluctance to undertake a formal clinical trial of temporary electrical pacing among patients with acute myocardial infarction is no longer warranted.

scholarly journals Outcome of Thrombolysis in Acute Myocardial Infarction in a Tertiary Care Hospital

2019 ◽  
Vol 13 (2) ◽  
pp. 42-44
Author(s):  
Md Wali Ur Rahman ◽  
Syed Asif Iqbal ◽  
Syeda Aleya Sultana ◽  
Md Abdul Malek ◽  
Abu Yusuf Md Shahidul Alam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
Complete Resolution ◽  
Left Ventricular ◽  
Military Hospital ◽  
Care Hospital ◽  
Risk Of Death ◽  
Increased Risk

Introduction: The main purpose of thrombolysis in acute myocardial infarction is early and complete reperfusion. Incomplete or delayed thrombolysis is associated with an increased risk of death and left ventricular dysfunction. The time to reperfusion and complete reperfusion remain the key determinants for appropriate outcome of cardiovascular events. Objective: To find out the effect of thrombolytic therapy and its outcome in relation with timing of thrombolysis and associated risk factors in ST elevated myocardial infarction (STEMI) patients. Materials and Methods: This cross-sectional interventional study was carried out in combined military hospital, Dhaka from July 2017 to May 2018. Total 85 patients of acute STEMI having specified criteria were selected and treated with Streptokinase at a dose of 1.5 million units diluted in 100 mL normal saline. Twelve-lead ECG was recorded immediately before the start of thrombolytic therapy and 180 min afterwards. Results: Among 85 STEMI patients 65 were male and the age range was 40-80 years. Sixty nine patients (81.2%) underwent thrombolysis within 12 hours of onset of chest pain among them complete resolution of ST segment occurs in 45(65.2%) patients while 16 patients (18.8%) received thrombolysis after 12 hours among them complete resolution occurs only in 7(43.8%) patients.  Fully reperfused patients have no complications. Patients having diabetes mellitus, presented with atypical chest pain and received thrombolytic therapy after 12 hours had various types of complication. Conclusion: STEMI patients received thrombolysis therapy within 12 hours of onset of chest pain responded well to thrombolytic therapy. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 42-44

scholarly journals Effectiveness of thrombolytic therapy in patients with acute myocardial infarction within 12 hours of symptoms

2020 ◽  
Vol 8 (6) ◽  
pp. 1985
Author(s):  
Muneer Ahmad Siddiquei ◽  
Zafar Iqbal ◽  
Majid Bashir ◽  
Mudassar Iqbal ◽  
Syed Nouman Ali ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Thrombolytic Therapy ◽  
Female Gender ◽  
St Elevation Myocardial Infarction ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
St Elevation

Background: Atherosclerotic coronary artery disease particularly myocardial infarction is the leading cause of morbidity and mortality all over the world and its incidence is also on the rise in Pakistan. This study was done to assess the effectiveness of thrombolytic therapy in patients with acute myocardial infarction and comparison between diabetics and non- diabetics.Methods: This cross sectional study was conducted at Department of Cardiology, Bahawal Victoria Hospital, Bahawalpur from January to June 2019. Total 380 patients of aged 30-70 years either male or female with diagnosis of acute ST-elevation myocardial infarction presenting within 12 hours of the onset of chest pain were selected. Patients were given thrombolytic therapy with Streptokinase 1.5 MIU over 1 hour and post therapy, efficacy was assessed.Results: Mean age of the patients was 51.37±10.08 years. Mean duration of diabetes mellitus was 5.99±3.47 years. Duration of chest pain ranged from 1 hour to 12 hours with mean duration of 4.66±2.98 hours. Out of 380 patients of MI, treatment was found effective in 202 (53.2%) patients. Female gender, type of MI, and duration of chest pain were significantly associated with reduced efficacy (p value < 0.05). Presence of hypertension, smoking, dyslipidemia or family history of MI did not alter the efficacy significantly (p>0.05) while patients having diabetes had significantly reduced efficacy (p value < 0.001).Conclusions: There is reduced effectiveness of thrombolytic therapy in diabetic patients with ST elevation myocardial infarction.

scholarly journals Incidence of cardiac arrhythmias in patients with acute myocardial infarction during the first 48 hours of the onset of chest pain

2017 ◽  
Vol 4 (4) ◽  
pp. 1144
Author(s):  
Puneet Rajendra Patil ◽  
Pankaj Khatana ◽  
Dilip Ratan Patil
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Cardiac Arrhythmia ◽  
Cardiac Arrhythmias ◽  
Anterior Wall ◽  
Age Group ◽  
Eligible Study ◽  
Number Of Patients ◽  
Acute Mi

Background: It is predicted that there will be an increase of 111% in cardiovascular deaths in India by the year 2020 compared to the year 1990. This is much higher than that predicted in any other region both in Asia as well as outside Asia. The objective of this study was to study the incidence of cardiac arrhythmias in acute myocardial infarction during the first 48 hours.Methods: The descriptive study was conducted over a period of two years from April 2016 to January 2017. A total of 102 patients were studied. They were admitted to ICU. Their admission was done as soon as they had chest pain. They were first confirmed to have acute myocardial infarction. All eligible study subjects as per inclusion and exclusion criteria were considered in the present study. Detailed history was taken. A thorough physical examination was done with emphasis on the cardiovascular system.Results: Maximum number of patients was in the age group 51-60 years in both males (37.97%) and females (65.22%). Acute MI observed mostly in the postmenopausal age in all the females. Incidence of myocardial infarction was significantly more in men (77.50%) compared to women (22.50%). 52.90% were smokers. Almost half of the patients had shown anterior wall infarction. The incidence of cardiac arrhythmias was 78.70%. Arrhythmias were more common among elderly female. Maximum arrhythmias were observed in the age group ranging from 50 to 60 years (36.27%).Conclusions: The incidence of cardiac arrhythmia was found to be 78.7% in the present study. The incidence of cardiac arrhythmia was more in the age group 50-60 years (36.27%).

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