Prognosis in men and women coming to the emergency room with chest pain or other symptoms suggestive of acute myocardial infarction

1993 ◽  
Vol 4 (9) ◽  
pp. 761-768 ◽  
Author(s):  
Björn W. Karlson ◽  
Johan Herlitz ◽  
Marianne Hartford ◽  
Åke Hjalmarson
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Emergency Room ◽  
Men And Women

The Importance of Creatine Kinase Determination in Identifying Acute Myocardial Infarction among Patients Complaining of Chest Pain in an Emergency Room

Cardiology ◽  
1987 ◽  
Vol 74 (2) ◽  
pp. 100-110 ◽  
Author(s):  
Sami Viskin ◽  
Karin Heller ◽  
David Gheva ◽  
Avi Hassner ◽  
Itzhak Shapira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Emergency Room

scholarly journals Thrombolysis on first contact saves minutes and myocardium

2020 ◽  
Vol 52 (4) ◽  
Author(s):  
Muhammad saad Jibran ◽  
Muhammad Irfan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Emergency Room ◽  
Pain Clinic ◽  
P Value ◽  
Base Line ◽  
Chi Square ◽  
Cardiology Department ◽  
Chi Square Test

ABSTRACT OBJECTIVE: To compare the door to needle time (DNT), for thrombolysis in acute myocardial infarction, at the new chest pain clinic at emergency room, with the old CCU at the cardiology Department LRH Peshawar. METHODOLOGY: This was a retrospective study conducted at Lady reading Hospital, Peshawar. Two data sets were acquired from hospital records. One for CCU at the cardiology department covered the span from 1st July till 30th sept: 2010. The other for the chest pain clinic emergency department covered the span from 1st April to 15th May, 2017. All the patients having ST elevated acute myocardial infarction eligible for thrombolytic therapy were included in the study. Door to needle time was calculated in both the groups. Comparison of DNT between both groups was made by using student t-test with p-≤0.05 taken as significant. Comparison between other base line qualitative characteristics was made by using chi square test with p-≤0.05 taken as significant. RESULTS: Total of 140 patients were enrolled in CCU group with mean age of 57.96±13.5 years. Out of these 60% were male. While 209 patients were enrolled in ED group with mean age of 58.85±6.9 years. Of these 65.1% were males. Mean DNT in CCU group was 72.42±50.85 minutes while in ED was 31.96±16.6 minutes with p-value 0.0001 with a reduction of 41.30 minutes in the DNT. DNT of <30 minutes and between 30-60 minutes was achieved in 7.1% and 62.8% in CCU group while in rest it was more than 60 minutes. In ED group the DNT achieved was <30 minutes in70.8% and 30-60 minutes in 29.2% of patients while none fell in category of >60 minutes. CONCLUSION: The door to needle time for thrombolytic administration for acute myocardial infarction was significantly less at the chest pain clinic at emergency room than at the CCU at cardiology department.

STUDY OF RISK FACTORS AND CLINICAL PROFILE OF ACUTE MYOCARDIAL INFARCTION IN FEMALES

2021 ◽  
pp. 65-68
Author(s):  
Bhaurao D. Nakhale ◽  
Jitendra P. Bhagat ◽  
Abhijit Y. Nugurwar
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Central Obesity ◽  
Age Group ◽  
Men And Women ◽  
History Of ◽  
Artery Disease

Cardiovascular disease is the most important health issue facing mankind and continues to be major cause of morbidity and mortality.Women are disproportionately affected by coronary artery disease(CAD) compared with men.There are different clinical presentations of heart disease and acute myocardial infarction in women than in men.Also different studies shows that there is difference in the major cardiovascular risk factors amongst men and women at younger age.The present study was undertaken with a view to understand the clinical prole of acute myocardial infarction in women and observe the variations in acute myocardial infarction between men and women. Materials and methods-This observational and analytical study includes 118 female cases of acute myocardial infarction admitted to ICCU and randomly selected 118 male cases of acute myocardial infarction admitted to ICCU during the same tenure.Various necessary th investigations were carried out and risk factors of acute myocardial infarction were determined.All the cases were followed up on the 7 day of admission and one month after discharge from the hospital for various complications.Data thus collected was analysed at the end of study. Results-Maximum number of female cases were in age group 60-69 years(45.6%)while maximum number of male cases were in age group 50- 59 years(33.05%).Anterior wall myocardial infarction was the commonest type of acute myocardial infarction in both groups.ST elevation myocardial infarction was more common in males(94.9%)as compared to females(83.89%) whereas non ST elevation myocardial infarction was common in females(10%) as compared to males (5%).Atypical chest pain was more common in female cases(50.8%)whereas typical chest pain was more common with male cases(52.4%).Also dyspnoea as presenting symptom was signicantly more in female cases(51.6%)as compared to male cases(20.3%).Among the risk factors as Diabetes mellitus,signicant difference was observed in female(45.7%) vs male cases(30.5%).Other risk factors like lack of physical activity was signicantly more in female cases(84.7%) as compared to male cases(50%).Central obesity and family history of CAD were more common in female cases . 42(35.6%) female cases had arrthymias during hospital stay as compared to 50(42.4%) male cases.Post MI angina was present in 21 (20.38%) female cases and 12(11.11%) male cases during one month follow up.Mortality was more common in female cases(12.7%) compared with the male cases(8.47%)but it was not statistically signicant. Females suffer from coronary artery disease slightly at older age Conclusions- as compared to males.Atypical chest pain and dyspnoea are more common presenting symptoms in females compared to males.Diabetes mellitus,central obesity, lack of physical activity and family history of CAD are most common risk factors in female cases for acute myocardial infarction.ST elevation myocardial infarction is less common in females as compared to males.Complications like congestive cardiac failure ,arrthymias are more common in females as compared to males.The overall mortality with acute myocardial infarction are common in females than males.

scholarly journals Diagnostic markers for discriminating between acute aortic dissection and acute myocardial infarction during the pre-hospital phase: analysis of 3,195 cases

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Watanabe ◽  
H Yoshino ◽  
T Takahashi ◽  
M Usui ◽  
K Akutsu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Back Pain ◽  
Chest Pain ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Diagnostic Markers ◽  
Network Database ◽  
History Of ◽  
First Contact

Abstract   Both acute aortic dissection (AAD) and acute myocardial infarction (AMI) present with chest pain and are life-threatening diseases that require early diagnosis and treatment for better clinical outcome. However, two critical diseases in the very acute phase are sometimes difficult to differentiate, especially prior to arrival at the hospital for urgent diagnosis and selection of specific treatment. The aim of our study was to clarify the diagnostic markers acquired from the information gathered from medical history taking and physical examination for discriminating AAD from AMI by using data from the Tokyo Cardiovascular Care Unit (CCU) Network database. We examined the clinical features and laboratory data of patients with AAD and AMI who were admitted to the hospital in Tokyo between January 2013 and December 2015 by using the Tokyo CCU Network database. The Tokyo CCU Network consists of &gt;60 hospitals that fulfil certain clinical criteria and receive patients from ambulance units coordinated by the Tokyo Fire Department. Of 15,061 patients diagnosed as having AAD and AMI, 3,195 with chest pain within 2 hours after symptom onset (537 AAD and 2,658 AMI) were examined. The patients with out-of-hospital cardiac arrest were excluded. We compared the clinical data of the patients with chest pain who were diagnosed as having AAD and AMI. The following indicators were more frequent or had higher values among those with AAD: female sex (38% vs. 20%, P&lt;0.001), systolic blood pressures (SBPs) at the time of first contact by the emergency crew (142 mmHg vs. 127 mmHg), back pain in addition to chest pain (54% vs. 5%, P&lt;0.001), history of hypertension (73% vs. 58%, P&lt;0.001), SBP ≥150 mmHg (39% vs. 22%, P&lt;0.001), back pain combined with SBP ≥150 mmHg (23% vs. 0.8%, P&lt;0.001), and back pain with SBP &lt;90 mmHg (4.5% vs. 0.1%, P&lt;0.001). The following data were less frequently observed among those with AAD: diabetes mellitus (7% vs. 28%, P&lt;0.001), dyslipidaemia (17% vs. 42%, P&lt;0.001), and history of smoking (48% vs. 61%, P&lt;0.001). The multivariate regression analysis suggested that back pain with SBP ≥150 mmHg (odds ratio [OR] 47; 95% confidence interval [CI] 28–77; P&lt;0.001), back pain with SBP &lt;90 mmHg (OR 68, 95% CI 16–297, P&lt;0.001), and history of smoking (OR 0.49, 95% CI 0.38–0.63, P&lt;0.001) were the independent markers of AAD. The sensitivity and specificity of back pain with SBPs of ≥150 mmHg and back pain with SBPs &lt;90 mmHg for detecting AAD were 23% and 99%, and 4% and 99%, respectively. In patients with chest pain suspicious of AAD and AMI, “back pain accompanied by chest pain with SBP ≥150 mmHg” or “back pain accompanied by chest pain with SBP &lt;90 mmH” is a reliable diagnostic marker of AAD with high specificity, although the sensitivity was low. The two SBP values with back pain are markers that may be useful for the ambulance crew at their first contact with patients with chest pain. Funding Acknowledgement Type of funding source: None

Heparin Neutralizing Activity in the Diagnosis of Acute Myocardial Infarction

1975 ◽  
Author(s):  
J. R. O’Brien ◽  
M. D. Etherington ◽  
S. Jamieson ◽  
J. Sussex
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Acute Chest Pain ◽  
Platelet Factor 4 ◽  
Clotting Time ◽  
Platelet Factor ◽  
Neutralizing Activity ◽  
Platelet Poor Plasma ◽  
Activated Platelets

We have previously demonstrated that, relative to controls, patients long after myocardial infarction and patients with atherosclerosis have highly significantly shorter heparin thrombin clotting times (HTCT) using platelet poor plasma; but there was considerable overlap between the two groups.We have now studied 89 patients admitted with acute chest pain. In 54 of these a firm diagnosis of acute myocardial infarction (ac-MI) was made and the HTCT was very short (mean 12.8 sees) and in 48 it was less than 16 sees. In 34 patients, ac-MI was excluded and the diagnosis was usually “angina”; the HTCT was much longer (mean 25.1 sees) and in 32 it was over 16 sees. Thus there was almost no overlap between these two groups. It is suggested that this test should be adopted as a quick and reliable further test to establish a diagnosis of ac-MI (providing other reasons for very short HTCTs can be excluded, e.g. D. I. C., and provinding the patient’s thrombin clotting time is normal).This HTCT measures non-specific heparin neutralizing activity; nevertheless the evidence suggests that it is measuring platelet factor 4 liberated from damaged or “activated” platelets into the plasma. These findings underline the probable important contribution of platelets in ac-MI.

Sign in / Sign up

Export Citation Format

Share Document