Anandh Govindharaju
BACKGROUND Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality worldwide. The prevalence of CAD and the incidence of Acute Coronary Syndrome (ACS) are very high among Indians. ST Elevation Myocardial Infarction (STEMI) is one of the major presentations of Acute Coronary Syndrome. The data regarding the clinical presentations of STEMI is still lacking in the majority rural population of INDIA. MATERIALS AND METHODS All patients who were admitted with features of Acute ST Elevation myocardial infarction (STEMI) from 1st January to 30th September 2018 were included and analysed retrospectively in this study. The demographic features, Cardiovascular risk factors, Clinical presentation, Serial E.C.G findings & the 2-D Echocardiographic features were analysed and correlated with the clinical and E.C.G findings. RESULTS Out of 236 patients admitted with features of Acute STEMI 184 (77.97%) patients were male and 52(22.03%) were female. The commonly affected age group was 40-60years of age (51.27%). The female patients with STEMI increased with advancing age. Type II diabetes mellitus was the most common modifiable risk factor (36.01%). Smoking (9.75%) and alcoholism (7.63%) contributed as significant risk factors for male. Chest pain was the most common presenting symptom (72.88%). Majority of patients 98(41.53%) presented between 12-24hours after the onset of chest pain. AWMI (51.27%) was more common than IWMI (46.19%). RV infarction occurred in 33% of patients with Acute IWMI. There were more patients with LVEF <40% in AWMI group (64.46%) and in non-thrombolysed patients (66.67%). CONCLUSION Most of the patients with STEMI were male in the 40-60years of age. There were more female patients with STEMI with advancing age (>65years). Diabetes mellitus and systemic hypertension were the most common risk factors for STEMI. AWMI was more common than IWMI. 33% of patients with IWMI had RVMI. LV dysfunction with LVEF < 40% was more common in AWMI and in non- thrombolysed patients. The mortality is high among elderly female with multiple risk factors and more extensive STEMI.
