FREQUENCY OF MECHANICAL COMPLICATIONS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective: : To document the frequency of mechanical complications in patients with acute myocardial infarction. Methodology: : The study was conducted from February 2009 to October 2011 in Cardiology department LRH. In this study, 5120 patients with acute ST elevation myocardial infarction (STEMI) were evaluated for mechanical complications. Acquired ventricular septal rupture (VSR), moderate to severe mitral regurgitation (MR), free left ventricular wall rupture, were considered as post-AMI mechanical complications. Diagnosis of VSR and MR were made on 2D and Color Doppler Echocardiography. Frequency, percentages and Mean +/- SD were used for categorical and numerical variables, respectively. Results: A total of 5120 patients were enrolled in the study, males were 54.4%, mean age was 61 +/- 9.7 years (45 to 85 years). Smokers were 21%, positive family history for coronary artery diseases was in 32%, hyperlipidemia in 18.5%, hypertensives were 14%, diabetics were 35% and 31.1% had history of coronary artery disease. Among these 68 (1.32%) patients had either acquired VSR and/or MR. VSR 44 (65.6%), MR 21(30.1%), while both VSR and MR were seen in 3(4.0%) patients. The number of patients who were timely thrombolysed with streptokinase was 30 (44.1%), half of these had either VSR or MR. More patients with mechanical complications had acute anterior MI, (52.9). The in-hospital mortality was 17.4%. Conclusion: Mechanical complications after acute myocardial infarction are a less common finding. Majority of the patients were in advanced age group. More patients with anterior MI had both VSR and MR. All those patients who died in hospital had acquired VSR.