EFFECT OF TYPE OF ST SEGMENT ELEVATION IN ACUTE ANTERIOR MI ON LEFT VENTRICULAR FUNCTION

Abstract

Objective: To see the correlation between acute ST segment anterior wallmyocardial infarction on ECG and LV function on echocardiography.st Methodology: This cross-secitonal study was conducted on 1st January to 31Mar 2017 in the Cardiology Department of Jinnah Hospital Lahore. ECG patternwere categorized into three grades of changes. In grade 1 there were only hyperacute T waves(concave type), in grade 2 there were hyper acute T waves and STsegment elevation(straight type) and in grade 3 there was tombstone appearanceon ECG with the changes involving T waves and ST segment and QRScomplex(convex type). We had assumed that there was maximum damage ingrade 3, which was assessed on echocardiography. Patients with the diagnosisof anterior wall myocardial infarction who presented within 12 hours ofpresenting complaints and were thrombolysed by streptokinase were included.

Results: About 50 patients with acute anterior wall MI were included in the study.Majority of the patients were between the 46 to 60 years, while 34% were below45 years and 16% were above 65 years with mean of 52.66+10.87 years. Maleswere 88%. There were 20 patients who were falling in the category 1with themean EF 48.25+ 8.926%, while 11 patients in grade 2 had mean EF 35.45-+6.502% and19 patients were in grade 3 who had maximum decrease in EF withmean of 31.05+7.375%.

Conclusion: In patients who presented with acute anterior MI and werereperfused with SK, left ventricular function was preserved or there was lessdamage in grade 1, intermediate damage in grade 2 and maximum damage ingrade 3. This simple classification is useful for the prediction of left ventricularfunction at discharge.