Clinical profile of patients presenting with acute ST elevation myocardial infarction
Shahid Hafeez1, Asim Javed, Azhar Mahmood Kayani
1AFIC/NIHD Rawalpindi, Pakistan.
Insights
Acute ST Elevation Myocardial Infarction (STEMI) predominantly affects adult males, with smoking as the primary risk factor. Most patients present with chest pain within six hours, often showing normal examinations and cardiac rhythms, with inferior myocardial infarction being most common.
Area of Science:
- Cardiology
- Internal Medicine
- Epidemiology
Background:
- Acute ST Elevation Myocardial Infarction (STEMI) is a critical cardiovascular event requiring prompt identification of risk factors and clinical presentations.
- Understanding the patient profile is crucial for effective management and prevention strategies.
Purpose of the Study:
- To determine the key risk factors associated with STEMI.
- To describe the clinical characteristics of patients experiencing STEMI.
Main Methods:
- A prospective observational study involving 300 consecutive STEMI patients was conducted from April to September 2005.
- Data collected included patient demographics, risk factors, symptom presentation, physical examination findings, infarction location, and cardiac rhythm.
Main Results:
- The study population was predominantly male (78%), with a mean age of 58 years.
- Cigarette smoking was the most prevalent risk factor (46%), while obesity was least common (4%).
- Most patients (94%) reported typical chest pain, presenting within six hours (72%), with inferior myocardial infarction being the most frequent type (46%).
Conclusions:
- STEMI is more common in adult males, with smoking identified as the leading risk factor.
- Typical chest pain presentation within six hours is characteristic of STEMI patients.
- Normal physical examination and cardiac rhythm were common findings, with inferior MI being the predominant lesion.
Objective:
To identify risk factors and clinical profile of the patients presenting with acute ST Elevation Myocardial Infarction (STEMI).
Methods:
This prospective observational study was carried out from April to September 2005. The 300 consecutive patients presenting with typical electrocardiographic changes of acute ST elevation myocardial infarction to the Emergency Department of our hospital were recruited in the study. The physician (a fellow) on duty assessed the patients and documented the predefined independent variable and patients characteristics. The clinical history revealed information about age, gender, risk factors, modes of presentation and duration of symptoms. The details of physical examination including anthropometric data, vital signs and complete systemic evaluation were recorded. The regions of infarction and rhythm disturbances were also documented.
Results:
This study was predominantly male dominated 234 (78%) patients, with a mean age of 58 +/- 11 years. Cigarette smoking was identified as a major risk factor in 138 (46%) patients. The least common risk factor i.e. obesity (BMI >25) was present in 12 (4%) patients. Majority of the patients, 282 (94%) presented with typical chest pain and within first six hours of onset of symptoms 216 (72%). Most of the patients 240 (80%) had normal examination at presentation and 60 (20%) had signs of Left Ventricle Failure. Isolated inferior and anterior myocardial infarction was noted in 138 (46%) and 48 (16%) patients respectively. Normal electrocardiographic rhythms at presentation were observed in 282 (94%) patients.
Conclusion:
Acute myocardial infarction was more common in adult males with smoking being the major risk factor. Most of the patients presented with typical chest pain and within six hours of onset of symptoms. The majority of patients demonstrated normal physical examination and cardiac rhythm. Inferior myocardial infarction was the most common lesion.
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