Vol. 2, Issue 8 (2015)
To study the clinical profile and outcome of myocardial infarction in Young’s
Author(s): Vijay Kumar Garg, Shivam Khare, Hemant Kumar Jain, Omprakash Jatav
Abstract: Introduction-coronary artery disease is a manifestation of many irregularities in the human body like atherosclerotic process, diabetes mellitus, dyslipedemia, hypertention, obesity, sedentary life style, many autoimmune diseases and connective tissue disorders etc., and younger population is not prevented from it. As the addiction of Alcohol, Tobacco use in many forms and many Recreational drugs (Eg. Heroin, cocaine) is going high in our Indian society our young population is at very high risk of CAD and myocardial infarction. So we decide to do research in this field and tried to understand the clinical profile of myocardial infarction in young and outcome of this entityrnAims and objectives -1 To study the symptoms, ECG and 2D Echocardiography finding in young patients of acute Myocardial Infarction (age < 40 years).,2-To study the risk factors in these patients.3-To study the complications during hospitalization and outcome of the patientsrnMaterial and methods -It was a prospective study conducted in patients admitted in ICU, in Department of Medicine, J.A.H., G.R.M.C., Gwalior for a period from June 2013 to October 2014 with Acute Myocardial Infarction (age <40years) and who were later confirmed of either STEMI or NSTEMI. These patients are compared with the patients of age group between 41to 60 years admitted with the same diagnosis. We have studied fifty patients of age < 40 years (group I -young) with the diagnosis of Acute Myocardial Infarction and compared with the patients of age 41-60 years (group II-elder). Clinical findings, laboratory tests, ECG and Echo was done and filled into preformed form and consent was taken from patients for inclusion in study.rnResults – In both groups male was predominantly involved and chest pain was major symptom, while atypical presentation was more common in elder age group patients. STEMI was significantly high in younger age group. NSTEMI was more common in group II patients (20%) as compared to group I patients (6%)Significant risk factor for MI in group I were smoking(68%), dyslipidemia (66%) followed by overweight (50%) while in group II, hypertension(42%) was the most common risk factor followed by dyslipidemia (32%), overweight (22%) and smoking (20%).In both the groups, 98% patients were in sinus rhythm at the time of admission. In group I, 2% patients had AF while in group II, 2% patients had wide complex tachycardia. In group I, patients had less complication during hospitalization. In group I, 20% patients had electrical complications and 18% patients had mechanical complications while, in group II, 34% patients had electrical complications and 28 % patients had mechanical complications. In group I, Majority of patients (86%) had normal or mild LV dysfunction while in group II, 62% patients had normal or mild dysfunction which is significant. In group I, 14% patients had moderate to severe LV dysfunction while in group II 30% patients had moderate to severe LV dysfunction. Mortality was only 2% in group I. So MI in young patients has better prognosis. rnConclusion- Myocardial infarction in young patients was more common in male, most common symptoms were chest pain followed by breathlessness and giddiness. Most common clinical presentation was in form of STEMI and Anterior MI was the commonest. current smoking, dyslipidemia and overweight found to be significant risk factor for Myocardial Infarction in young. Majority of patients had normal LV function or mild LV dysfunction, if timely intervention and proper management done, Myocardial Infarction in young has good prognosis.