急性心肌梗死完全性心脏传导阻滞的可逆性频率

Esculapio Pub Date : 2023-05-13 DOI:10.51273/esc23.251917
Sajid Mahmood, Faiza Nazir, Sami Ullah Mumtaz, Ali Asad Khan, Somia Iqtadar, Sajid Abaidullah
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摘要

目的评价急性心肌梗死患者完全性心脏传导阻滞可逆性发生的频率。方法对在拉合尔旁遮普心脏病研究所急诊科以晕厥合并不典型胸痛主诉的138例患者进行分析。所有患者都接受了常规的冠状动脉造影,以确定潜在的慢速心律失常的缺血性病因。其中90%以上的患者有轻度冠状动脉疾病,并持续接受医疗管理。但是所有的患者在两周内仍然依赖TPM,然后用永久性起搏器治疗。结果本组患者平均年龄51.48±15.46岁,最小年龄18岁,最大年龄65岁。138例患者中,男性84例(61%),女性54例(39%)。糖尿病52例(37.7%),高血压75例(54.3%),吸烟58例(42.03%),有家族史41例(29.7%),血脂异常47例(34.1%),肥胖仅50例(36.2%)。患者分为两组;16-35岁年龄组发生完全性心脏传导阻滞的患者仅有6例(4.3%),而36-65岁年龄组发生完全性心脏传导阻滞的患者仅有10例(7.2%),男性8例(5.8%),高血压患者仅有5例(3.6%),糖尿病患者仅有4例(2.9%),1-12小时出现2例(1.4%),13-24小时出现7例(5.1%),p值>差异无统计学意义;0.05. ACS 2度房室传导阻滞与完全心传导阻滞患者肌钙蛋白水平p值< 0.05,差异有统计学意义。结论AMI患者房室传导阻滞往往是可逆的。因此,在AMI的情况下,永久起搏器的安装应该推迟。
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Frequency of Reversibility of Complete Heart Block in Acute Myocardial Infarction
Objective The aim of current study was to evaluate the frequency of reversibility of complete heart block in patients of acute myocardial infarction. Methods Total one hundred and thirty eight patients with complaint of syncope and atypical chest pain presented at emergency ward of Punjab Institute of Cardiology, Lahore. All patients underwent conventional coronary angiogram to roll out the ischemic etiology of underlying bradyarrhythmias. Among them more than 90% patients have mild coronary artery disease and they were kept on medical management. But all patients remained TPM dependant for two weeks which were then treated with permanent pacemakers. Results Results of the current study revealed that the mean age of patients was 51.48 ± 15.46 with minimum age 18 and maximum was 65 years. Out of 138 patients, 84(61%) were male while 54(39%) were female., 52(37.7%) patients diagnosed of diabetes mellitus, 75(54.3%) patients of hypertension and 58(42.03%) patients were smoker, 41(29.7%) have family history, 47(34.1%) patients have dyslipidemia and only 50(36.2%) obese patients. Patients divided into two groups; patients with complete heart block in the age grouped between 16-35 years, only 6(4.3%) as compare with age grouped 36-65 years only 10(7.2%) have complete heart block, male 8(5.8%), only 5(3.6%) hypertensive patients and 4(2.9%) diabetic patients suffering complete heart block, 2(1.4%) patients presented during 1-12 hours compare with 7(5.1%) presented between 13-24 hours, results showed statistically insignificant as p-value > 0.05. 2nd Degree AV Block and complete heart block showed significant difference between troponin level as p-value <0.05 in patients diagnosed with ACS. Conclusion Atrioventricular block is frequently reversible in people with AMI. As a result, in situations with AMI permanent pacemaker installation should be postponed.
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