Liaqat Ali, Naeem Asghar, Abdul Rehman.
In Hospital Outcome of Acute Inferior with Right Ventricular or Posterior Wall Myocardial Infarction.
Ann Pak Inst Med Sci Jan ;9(4):219-24.

Objective: To study the in hospital outcome of patients with acute inferior wall MI with or without right ventricular and posterior wall MI. Study Design: Observational study Place and Duration: The study conducted at the Faisalabad Institute of Cardiology, Faisalabad from March 2013 to October 2013 Materials and Methods: A total 168 patients with acute Inferior wall MI were recruited in this study. All patients presenting with acute ST elevation Inferior wall myocardial infarction and fulfilling inclusion and exclusion criteria were included in this study. A full history including age, sex, occupation, history of IHD, hypertension, diabetes mellitus, smoking, family history of IHD, obesity and hperlipidemia was taken. Primary end point was death while secondary end points were mechanical, ischemic or electrical complications or all them. Results: Total 168 patients with inferior wall myocardial infarction were included in this study. There were 122(72.62%) males and 43(25.6%) females. 118(70.23%) patients had isolated inferior myocardial infarction, 33(19.64%) had RVMI and 17(10.1%) posterior wall MI. There were 71(42.26%) diabetics, 71(42.26%) hypertensive and 96(57.14%) smokers. Family history of IHD was present in 32(19.04%). Obesity was observed in 72(42.85%). Dyslipidemia was observed in 47(27.97%). Overall Streptokinase therapy was given in 119(70.83%). ECG was the diagnostic modality to diagnose acute RVMI in 87% of patients. V4R was the most sensitive lead for RVMI diagnosis with sensitivity of 80%. Echocardiography was diagnostic in 11(33.33) patients. Most common non-fatal complication was bundle branch blocks. It was seen overall in 48(28.52%) patients and was more common in patients with RVMI 14(42.42%) and PMI 5(29.4%) as compared with isolated Inferior wall MI 29(24.5%). Overall in-hospital mortality was 16(9.52%). Hospital mortality was observed more in patients have RVMI 4(21.6%) and PMI 3(17.64%) as compared with isolated Inferior wall MI 9(6.8%). Conclusion: Patients with RVMI and PMI had longer hospital stay with more in hospital complications and death as compared with isolated inferior wall MI.

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