FREQUENCY OF MECHANICAL COMPLICATIONS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: To document the frequency of mechanical complications in patients
with acute myocardial infarction.
Methodology: The study was conducted from February 2009 to October 2011
in Cardiology department LRH. In this study, 5120 patients with acute ST
elevation myocardial infarction (STEMI) were evaluated for mechanical
complications. Acquired ventricular septal rupture (VSR), moderate to severe
mitral regurgitation (MR), free left ventricular wall rupture, were considered as
post-AMI mechanical complications. Diagnosis of VSR and MR were made on
2D and Color Doppler Echocardiography. Frequency, percentages and Mean±SD
were used for categorical and numerical variables, respectively.
Results:A total of 5120 patients were enrolled in the study,males were 54.4% ,
mean age was 61±9.7 years (45 to 85 years). Smokers were 21%, positive
family history for coronary artery diseases was in 32%, hyperlipidemia in 18.5%,
hypertensives were 14%, diabetics were 35% and 31.1% had history of coronary
artery disease. Among these 68 (1.32%) patients had either acquired VSR and/or
MR. VSR 44 (65.6%), MR 21(30.1%), while both VSR and MR were seen in
3(4.0%) patients. The number of patients who were timely thrombolysed with
streptokinase was 30 (44.1%), half of these had either VSR or MR. More patients
with mechanical complications had acute anterior MI, (52.9). The in-hospital
mortality was 17.4%.
Conclusion: Mechanical complications after acute myocardial infarction are a
less common finding. Majority of the patients were in advanced age group. More
patients with anterior MI had both VSR and MR. All those patients who died in
hospital had acquired VSR.