scholarly journals Study on emerging risk factors of acute myocardial infarction patients in Kumaon region of Uttarakhand, India

2018 ◽  
Vol 5 (3) ◽  
pp. 738
Author(s):  
Ashu Gupta ◽  
Arun Joshi ◽  
Ashok Kumar ◽  
Paramjeet Singh

Background: Cardiovascular disease is a major global health problem reaching epidemic proportions. Along with the developed nations, underdeveloped and developing countries are now facing this burden. Keeping this in mind various emerging risk factors in patients with documented evidence of acute myocardial infarction attending a tertiary care hospital in the Kumaon region of Uttarakhand were studied.Methods: This study is a prospective study done in the department of Medicine, Sushila Tiwari Government Hospital, Haldwani over a period of 2 years. Patients were enrolled from the Medical Emergency/ OPD who had documented evidence of Acute Myocardial Infarction. Informed consent was taken from each study subject.Results: The mean age was 54.27 years (SD- 13.062). Among the risk factors, high triglyceride is significantly higher in younger patients as compare to older patients. Lipid profile distribution when they compare to any addiction, it has been found in the study that LDL is significantly higher in those who were having any addiction. Hypertension was significantly higher in patients who smoke (p=0.04). The major contributing risk factor was any addiction (smoking, alcohol, tobacco consumption in any form) followed by dyslipidemia.Conclusions: The challenge is to develop appropriate strategies to prevent coronary artery diseases and promote healthy lifestyles.

Author(s):  
Sandhya S. ◽  
Mohanraj P.

Background: Myocardial Infarction is one of the most common causes of mortality and morbidity among the elderly patients. Also, it is known for wide range of clinical presentations other than chest pain. This article enlightens the clinical features, risk factors, complications, prognosis and outcome of Acute myocardial infarction in elderly patients. The objective of this study was to assess the risk factors, various symptoms, complications, prognosis and outcome of elderly patients with Acute myocardial Infarction (AMI).  Methods: This is a prospective study done over a period of two years in a tertiary care hospital in South India. 80 elderly patients who were diagnosed as AMI were included in the study.Results: Among the eighty patients the majority of the patients belonged to the age group 60-69 years. Twenty percent of the patients presented without chest pain. The atypical presentations included dyspnoea, giddiness, vomiting, sweating and epigastric pain. Mortality rate was 20%.Conclusions: This study showed that even though chest pain was the most common presentation in elderly AMI patients, they were also found to have atypical presentations like shortness of breath, giddiness, vomiting, sweating and epigastric pain. This signifies the need of examining physicians to meticulously identify acute myocardial infarction in elderly though they may not present typically.  


2019 ◽  
Vol 9 (2) ◽  
pp. 19-26
Author(s):  
Maryam A. Maryam A. Jabali ◽  
Rana A. Nabalawi Nabalawi ◽  
Ibtihal O. Alsahabi ◽  
Maram F. Almutairi ◽  
Fatimah I. Alsannat ◽  
...  

Objectives: This study aimed to assess the clinical profile of myocardial infarction in a tertiary care hospital in Saudi Arabia, and to determine the differences in presentation, risk factors, complications, and mortality between old and young patients. Methods: Retrospective analysis of demographic and clinical data of adult myocardial infarction patients treated in King Abdulaziz University Hospital between 2010 and 2018. Results: A total of 543 acute myocardial infarction patients (79.4% males) were included in the analysis. There were 64 patients aged ≤ 45 years and 479 patients aged > 45 years. The most common presenting symptom was chest pain in both groups. Current smoking was the most common risk factor in the younger group, whereas diabetes mellitus and hypertension were the most common risk factors in the older group. On electrocardiography, ST-elevation myocardial infarction was more common in the younger group. Mitral regurgitation, followed by congestive heart failure, were the most common complications in both groups. The overall mortality rate was low, but it was higher in the older group. Conclusion: Risk factors and electrocardiogram findings differ significantly between younger (≤ 45 years) and older (> 45 years) patients. Smoking cessation must be stressed in young adults. Population awareness regarding the modifiable risk factors of myocardial infarction could help in decreasing its incidence.


2019 ◽  
Vol 6 (4) ◽  
pp. 1164
Author(s):  
Rangamanikandan M. ◽  
Balasubramanian S. ◽  
Veeramani S. R. ◽  
Sivakumar G. S. ◽  
Saravanan R. R. ◽  
...  

Background: Acute myocardial infarction (MI) is a significantly raising problem particularly in India. The various aspects of myocardial infarction such as risk factor profiles, clinical presentations and prognosis differ significantly in south Indian people when compared to others. This study was undertaken to study the association of socio-demographic and life-style factors with acute myocardial infarction in South India.Material: This was a prospective study included 100 patients admitted in ICCU for acute MI in Government Rajaji Hospital Madurai over a period of 1 year. History, ECG, CPK-MB, and 2-D Echo was done to diagnose MI.Results: In this study, 68% patients were males. In this study, 34% patients had diabetes, 42% had hypertension, 58% were smokers. In our study 70% patients had BMI between 25-30kg/m2. In this study, 86% patients had TGL more than 200mg/dl, 28% patients had LDL more than 100 mg/dl and 78% patients had NON-HDL more than 130 mg/dl. In this study, 9 patients had depression. In our study 61% male patients had waist hip ratio more than >1 and in females 69% patients had waist hip ratio more than >0.85. In our study, 22% patients had hemoglobin >16g/dl.Conclusion: Prevention of coronary artery syndrome by modifying the risk factors were crucial. Serum cholesterol, LDL cholesterol, BMI were not significant to predict ACS in our study Waist Hip ratio, Triglyceride, Non-HDL cholesterol, smoking and Depression were significant to predict acute coronary syndrome in this study.


2013 ◽  
Vol 20 (03) ◽  
pp. 332-340
Author(s):  
ATIF SITWAT HAYAT ◽  
MUHAMMAD ADNAN BAWANY ◽  
JAWAD AHMED QADRI ◽  
Kiran Khalil

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heartblocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of thisstudy is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place andduration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal toor more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice thenormal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venousblood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found withcomplete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognosticsignificance. Complete heart block was frequent complication of myocardial infarction.


Author(s):  
CH Karthik Reddy ◽  
Mahesh Krishnamurthy ◽  
Ashray Vasanthapuram ◽  
Girish Narayan ◽  
SS Narendra

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young has been increasing globally. Research in this population has been limited in developed countries or urban areas in developing countries. Identifying the various epidemiologic features in this age group is crucial to understand the disease. Aim: To describe the clinical characteristics of young adults presenting with ACS in a rural tertiary care hospital. Materials and Methods: This cross-sectional study included 50 patients diagnosed with ACS. Data were collected from consecutive patients between the ages of 18 to 45 years diagnosed with ACS between January 2014 to January 2015 in the Emergency Medicine Department of a tertiary care hospital in Davanagere, India. Data were collected on demographic characteristics, risk factors, laboratory tests, and angiographic findings. Range, mean and percentages were calculated for continuous and categorical variables, respectively. A 95% confidence intervals were calculated for all variables. Results: The mean age was 38.1±5.8 years with male preponderance 46 (92%). Risk factors were smoking 36 (72%), diabetes 17 (34%), hypertension 6 (12%) and Body Mass Index (BMI) >23 kg/m2, 36 (72%). Anterior Wall Myocardial Infarction (AWMI) was observed in 35 (70%) of subjects with angiography revealing Single Vessel Disease (SVD) 28 (56%), Double Vessel Disease (DVD) 5 (10%), Triple Vessel Disease (TVD) 3 (6%) and Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) 11 (22%). Three patients died during their course of treatment before initiating an interventional procedure. Conclusion: Smoking, diabetes mellitus and elevated BMI are associated with ACS among young patients. Interventions targeting these risk factors among younger individuals should be developed.


2018 ◽  
Vol 09 (01) ◽  
pp. 019-025 ◽  
Author(s):  
Kirti Gupta ◽  
Charul S. Purani ◽  
Anirban Mandal ◽  
Amitabh Singh

ABSTRACT Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India. The primary objective was to assess the clinical presentation and etiology of AFE while the secondary objectives were to correlate the clinical and etiological findings and to determine the risk factors associated with mortality. Results: Out of the ninety children with AFE included in this study, male:female ratio was 1.2:1; most of them were aged between 1 and 5 years and came with a history of <7 days (82.2%). All of them had altered sensorium, about 2/3rd had seizures and 47.8% having a Glasgow Coma Score (GCS) <8. Etiology remained elusive in about 40% of the cases, and viral infections were the most common among the ones with an identifiable cause. A variety of morbidity (shock, disseminated intravascular coagulopathy, respiratory failure, etc.) and high mortality (40%) was observed with risk factors associated with mortality being GCS <8, the presence of raised intracranial pressure, shock, and respiratory failure. Conclusion: AFE, though a rare diagnosis in children, is associated with significant morbidity and high mortality in a developing country like India.


Author(s):  
Jyoti Meena ◽  
Richa Vatsa ◽  
Sunesh Kumar ◽  
Kallol K. Roy ◽  
Anshu Yadav ◽  
...  

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality. For surgical management, laparoscopy is preferred option. In developing world for ruptured ectopic pregnancy laparotomy is done at most of places. In this study we have assessed feasibility of laparoscopic management in both ruptured and unruptured ectopic pregnancy.Methods: A prospective study, conducted over period of 1 year from July 2014 to July 2015 in Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. In 110 patients of ectopic pregnancy parameters studied were age and parity, symptoms, risk factors, diagnostic methods, site of ectopic, management and its outcome. Primary objective was to evaluate management outcome of ectopic pregnancy and to assess feasibility of laparoscopy in ectopic pregnancy. Ruptured ectopic pregnancy with massive hemoperitoneum were analyzed separately. Secondary objective was to study demographic characters and risk factors of ectopic pregnancy.Results: Surgical management was required in 93.6% patients, out of which 86.4% were managed laparoscopically. Unruptured ectopic pregnancy was managed successfully by laparoscopy in 96.6% (29/30) patients. Ectopic was ruptured in 73 (66.3%) cases, laparoscopy was attempted in 91.7% (67/73). In 10.4% (7/67) patients laparoscopy had to be converted to laparotomy and it was successful in 89.5%. Out of 16 patients with massive hemoperitoneum, 12(75%) were managed laparoscopically. There was no mortality.Conclusions: In most of cases laparoscopy is safe and successful. Laparoscopy is feasible in ruptured ectopic cases including selected cases with massive hemoperitoneum thus avoiding unnecessary laparotomy and associated morbidity. Timely diagnosis and management prevents mortality.


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