scholarly journals Case Report: Khat Chewing and Acute Myocardial Infarction in Two Young Men without Underlying Risk Factors

Author(s):  
Ahmed Abdulahi Hussen ◽  
Foziya Mohammed Hussien ◽  
Nejib Yusuf ◽  
Aragaw Yimer Ahmed ◽  
Hamid Yimam Hassen

Khat (Catha edulis) chewing is linked to several social, psychological, and health-related problems. Studies show that khat is associated with gastrointestinal and nervous system diseases. However, little is known about khat’s effect on the cardiovascular system. This case report describes acute myocardial infarction (AMI) among two young adults who chew khat frequently, but who do not have underlying cardiovascular disease (CVD) risk factors. Case 1 is a 29-year-old apparently healthy man who presented with severe, squeezing, left-side chest pain after consumption of khat. Most of the laboratory results were within the normal range except for his serum troponin level, which was 400 times more than the normal limit. The patient was diagnosed with Killip class IV, ST-segment elevation, anteroseptal AMI. Case 2 is a 25-year-old man who is a frequent khat chewer. He presented with sudden-onset, severe, squeezing, retrosternal chest pain after khat chewing and vigorous activity. The patient was diagnosed with (Killip class III) acute ST-elevation myocardial infarction with cardiogenic pulmonary edema. These case reports describe two young adult male patients who were confirmed of having AMI with no known risk factors. Both cases had a similar history of frequent khat chewing and the onset of AMI after it, implying that khat could be an important CVD risk factor among young adults. Hence, it is essential to explore further the epidemiology and association between khat use and AMI. Both molecular and population-level studies could help to establish the causal relationship of khat and CVD.

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.  


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Diana Benea ◽  
Valeria Raparelli ◽  
hassan behlouli ◽  
Louise Pilote ◽  
Rachel Dryer

Introduction: The extent to which race influences in-hospital quality of care among young adults with acute myocardial infarction (AMI) is unknown. We examined racial differences in in-hospital quality of AMI care in young adults and described the patient and/or clinical characteristics associated with potential disparities in care. Methods: Data from the GENESIS-PRAXY (Canada) and the VIRGO (U.S.) prospective cohorts of young adults with AMI were analyzed. Among a total of 4,048 adults with AMI (≤55 years) (median=49 years [IQR 44-52], 22% non-white, 58% women), we calculated an in-hospital quality of care score (QCS) for AMI (quality indicators divided by total, with higher scores indicating better care) based on AHA quality of care standards, reporting data disaggregated by race. We categorized race as white versus non-white, which included Black, Asian and North American Indigenous populations. Results: This cohort was comprised of 906 non-white individuals and 3142 white individuals. Non-white adults exhibited a clustering of adverse cardiac risk factors, psychosocial risk factors and comorbidities versus whites; they had higher rates of hypertension, diabetes, alcohol abuse and prior AMI and lower rates of physical activity. They were more likely to have a low SES and receive low social support, and were less likely to be employed, a primary earner, or married/living with a partner. Non-white individuals were also more likely to experience a NSTEMI and less likely to receive cardiac rehabilitation, smoking cessation counseling as well as dual antiplatelet therapy at discharge. Furthermore, non-white individuals had a lower crude QCS than whites (QCS=69.99 vs 73.29, P-value<0.0001). In the multivariable model adjusted for clinical and psychosocial factors, non-white race (LS Mean Difference=-1.49 95%CI -2.87, -0.11, P-value=0.0344) was independently associated with a lower in-hospital QCS. Conclusion: Non-white individuals with AMI exhibited higher rates of adverse psychosocial and clinical characteristics than white individuals yet non-white race was independently associated with lower in-hospital quality of care. Interventions are needed to improve quality of AMI care in non-white young adults.


2015 ◽  
Vol 67 ◽  
pp. S39-S40
Author(s):  
Shalini Garg ◽  
R. Thakur ◽  
C.M. Verma ◽  
R.P.S. Bharadwaj ◽  
M. Ahmad ◽  
...  

2013 ◽  
Vol 66 (9-10) ◽  
pp. 396-400
Author(s):  
Igor Ivanov ◽  
Jadranka Dejanovic ◽  
Olivera Ivanov ◽  
Milovan Petrovic ◽  
Robert Jung ◽  
...  

Introduction. Miopericarditis with clinical presentation of chest pain, electrocardiographic changes and positive cardio specific enzymes is often a differential diagnostic dilemma in relation to acute myocardial infarction. Literature data are very scarce and only case reports or small series of patients can be found in the literature so each case is a significant contribution to this issue. Case report. A 19-year-old patient was admitted to the intensive care unit, with chest pain, electrocardiographic signs of suspected myocardial lesion and highly positive cardio specific enzymes. Since echocardiography revealed segmental hypocinesia of the left ventricle, urgent coronary angiography was done, which diagnosed normal luminogram of coronary arteries. Having received the adequate therapy, the patient was subjectively asymptomatic, hemodynamically stable, sub-febrile at the beginning of hospitalization. Two weeks after admission, the patient was discharged in good condition with diagnosis of myopericarditis. Conclusion. This case shows that it is sometimes difficult to differentiate acute miopericarditis from acute myocardial infarction only according to anamnesis, clinical, electrocardiographic sings and echocardiography.


2020 ◽  
Vol 12 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Soraya Siabani ◽  
Patricia M Davidson ◽  
Maryam Babakhani ◽  
Nahid Salehi ◽  
Yousef Rahmani ◽  
...  

Introduction: This study aimed to evaluate the in-hospital mortality of patients with ST-segment elevation myocardial infarction (STEMI), according to gender and other likely risk factors.<br /> Methods: This study reports on data relating to 1,484 consecutive patients with STEMI registered from June 2016 to May 2018 in the Western Iran STEMI Registry. Data were collected using a standardized case report developed by the European Observational Registry Program (EORP). The relationship between in-hospital mortality and potential predicting variables was assessed multivariable logistic regression. Differences between groups in mortality rates were compared using chi-square tests and independent t-tests. <br /> Results: Out of the 1484 patients, 311(21%) were female. Women were different from men in terms of age (65.8 vs. 59), prevalence of hypertension (HTN) (63.7% vs. 35.4%), diabetes mellitus (DM) (37.7% vs. 16.2%), hypercholesterolemia (36.7% vs. 18.5%) and the history of previous congestive heart failure (CHF) (6.6% vs. 3.0%). Smoking was more prevalent among men (55.9% vs. 13.2%). Although the in-hospital mortality rate was higher in women (11.6% vs. 5.5%), after adjusting for other risk factors, female sex was not an independent predictor for in-hospital mortality. Multivariable analysis identified that age and higher Killip class (≥II) were significantly associated with in-hospital mortality rate.<br /> Conclusion: In-hospital mortality after STEMI in women was higher than men. However, the role of sex as an independent predictor of mortality disappeared in regression analysis. The gender based difference in in-hospital mortality after STEMI may be related to the poorer cardiovascular disease (CVD) risk factor profile of the women.


Author(s):  
Rajesh Kumar Singhal ◽  
Harsha Kumar Gowardhan

Background: The cardiovascular diseases (CVDs) have become the leading cause of mortality worldwide. There is an increasing burden on health care systems associated with MIs in the elderly, differences in clinical picture, and difficulties in dealing with elderly patients with myocardial infraction (MI). Aim: The aim of study is to evaluate the different clinical presentations, risk factors and complications of elderly patients presenting with acute myocardial infarction. Methods: This is a retrospective, cross sectional study done over a period of 1 year. A total of 100 elderly patients who were diagnosed as AMI were included in the study. We studied Demographic features, cardiovascular risk factors, varied clinical presentations Electrocardiogram (ECG) findings from the history proformas and documented. Results: A total of 100 patients diagnosed with MI were studied. Mean age of the study population was 69.41 years and were predominantly male (84%). The most common presenting symptom was chest pain (79%) followed by sweating (7%), followed by shortness of breath (5%), giddiness (4%) vomiting (3%) and palpitations (2%). hypertension was commonly seen in elderly (56%) followed by diabetes (39%), smoking (28%), dyslipidaemias (12%), history of CAD (9%) and obesity (6%).  Mortality rate was 26% and maximum (11%) patients belonged to age group >80 years. Conclusion: We conclude that chest pain is the most common presentation in elderly AMI patients, but other atypical symptoms such as shortness of breath, giddiness, vomiting, without chest pain can also be the common presenting signs. Early and prompt management as appropriate should be provided to avoid morbidity and mortality in elderly. Keywords: Clinical Profile, Mortality, Myocardial Infarction, Risk Factors.


Cor et Vasa ◽  
2019 ◽  
Vol 61 (6) ◽  
pp. 578-583
Author(s):  
Hala Fennich ◽  
Selsabille El Haddaji ◽  
Latifa Oukerraj ◽  
Jamila Zarzur ◽  
Mohamed Cherti

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Mohd Zhafri Mohd Razib ◽  
Azarisman Shah M.Shah ◽  
Jamalludin A.Rahman ◽  
Aszrin Abdullah ◽  
Aida N.S M.Shah ◽  
...  

Introduction: Acute myocardial infarction (AMI) is a major cause of death around the world. There are limited studies of risk factor profile in young adults with AMI. This study aimed to assess the risk factor profile of young adults with AMI at the emergency department of Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. This is a preliminary result of young adults (age between 18 to 45 years old) who presented to the emergency department of HTAA. Materials and Methods: This cross-sectional study was conducted in HTAA from the 31st July 2017 to the 11th June 2018 involving 709 patients who were diagnosed with AMI. Seventy seven patients were less than 45 years old. However, only 55 were recruited for analysis who fulfilled the inclusion and exclusion criteria. Results: The prevalence of young adults with AMI was 10.9% with mean age of 38.8 ± 5.1 years old and 96.4% were male. Eighty percent of the patients were Malay followed by 10.9% Chinese and 9.1% were Indian. 83.6% were married while 14.5% were unmarried and 1.8% were divorcees. Majority of patients (81.8%) had income less than RM4000. The common risk factors of young adults with AMI presented to HTAA was smoking (80%) followed by increased waist circumference (54.5%), obesity (52.7%), hypertension (40%), hypercholesterolaemia (27.2%), family history of ischaemic heart disease (27.2%), and diabetes mellitus (21.8%). Conclusion: AMI in young adults almost exclusively occurs in male. Smoking and obesity were the most common risk factors in young adults with AMI in HTAA.


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