Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi.

Published

Journal Article

OBJECTIVE: Acute Myocardial Infarction (AMI) is a rising epidemic in developing countries. While studies in the West have established the characteristics and management of AMI patients, comprehensive data reflecting these issues in the Pakistani subjects is scarce. This study examined the profile and management of AMI in patients hospitalized at a tertiary care hospital in Karachi, Pakistan. METHODS: Three hundred forty four patients admitted in 1998 with the diagnosis of AMI met our inclusion criteria. Data on presentation, investigations, monitoring and therapy was obtained. Chi-square and t tests were used to analyze the data. RESULTS: Out of 344 patients with AMI, 71% were males; 58% had a Q wave MI. Majority of the patients who presented within 2 hours of symptom onset (36%), had chest pain. Patients with dyspnea and no chest pain were more likely to present after 12 hours of the onset of symptoms. In-house mortality was found to be 10.8%. Low HDL and diabetes was associated with in-hospital complications. Twenty nine percent of patients were given thrombolytic therapy with a mean door-to-needle time of 1 hour 36 minutes; 33% of patients who were eligible of Streptokinase did not receive it. Cardiac catheterization was performed in 28% patients. Echocardiography and Exercise Tolerance Test, both under utilized, were performed in 67% and 16% of patients, respectively. Two hundred sixteen (70%) patients discharged from hospital were contacted via telephone and the 1-year mortality rate among them was 28%. CONCLUSION: The profile and management of AMI was in coherence with earlier, Western studies. Chest pain units need to be established in the Emergency Room. Patients should be risk stratified prior to discharge. Public awareness regarding primary and secondary prevention and symptoms of AMI needs to be increased.

Full Text

Duke Authors

Cited Authors

  • Samad, Z; Rashid, A; Khan, MAU; Mithani, S; Khan, MH; Khan, MSM; Malik, SS; Nehal, US; Sami, S; Karim, M

Published Date

  • January 2002

Published In

Volume / Issue

  • 52 / 1

Start / End Page

  • 45 - 50

PubMed ID

  • 11963586

Pubmed Central ID

  • 11963586

International Standard Serial Number (ISSN)

  • 0030-9982

Language

  • eng

Conference Location

  • Pakistan