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2019 | 73 | 119-129
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Mechanical complications of acute myocardial infarction considering risk factors, treatment and survival of patients in 10-year clinical observation

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Mechaniczne powikłania ostrego zawału serca z uwzględnieniem czynników ryzyka, leczenia i przeżywalności chorych w 10-letniej obserwacji klinicznej
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INTRODUCTION: Cardiovascular diseases, including coronary disease and its complications, are the most common cause of death. Myocardial infarction is usually caused by a blood clot cosing the lumen of a coronary artery at the site of an unstable atherosclerotic plaque. MATERIAL AND METHODS: All the analyzed patients with mechanical complications of acute myocardial infarction (AMI) were hospitalized at the 2nd Department of Cardiology and Department of Anaesthesiology and Intensive Care of the Upper-Silesian Medical Centre in Katowice in 2006–2016 and the database was based on the medical records of the patients. The study group comprised 52 (100%) patients. There were 23 (44.2%) women and 29 (55.8%) men, aged 54 to 84 years with a mean age of 69.8 years. RESULTS: Ventricular septal rupture (n = 36; 69.2%) was the most frequently observed complication but papillary muscle rupture (n = 4; 7.7%) and tendinous chord rupture (n = 4; 7.7%) were the least frequent. Hypertension and hypercholesterolemia were the most common risk factors for coronary heart disease in the study group. An increased mortality rate was observed in patients who received pharmacological treatment compared to surgically treated patients (87.5% vs. 61.4%). The majority of patients had one risk factor for coronary heart disease (28; 53.8%). CONCLUSIONS: 1. In the study group, ventricular septal rupture and the cardiac free wall rupture were the most frequently observed mechanical complications of AMI. 2. Patients with AMI had numerous risk factors for coronary heart disease, of which hypertension and hypercholesterolemia were the most common. 3. Patients with mechanical complications of AMI had both higher mortality rates than survival and they were higher in the pharmacologically treated group.
PL
WSTĘP: Choroby układu krążenia, w tym choroba wieńcowa i jej powikłania, stanowią najczęstszą przyczynę zgonów. Zawał mięśnia sercowego spowodowany jest zwykle pęknięciem blaszki miażdżycowej i zamknięciem tętnicy wieńcowej skrzepliną. MATERIAŁ I METODY: Badaniem objęto 52 chorych (100%) z mechanicznymi powikłaniami ostrego zawału serca, hospitalizowanych w II Oddziale Kardiologii oraz Oddziale Anestezjologii i Intensywnej Terapii Górnośląskiego Centrum Medycznego w Katowicach w latach 2006–2016, wtym 23 kobiety (44,2%) i 29 mężczyzn (55,8%) w wieku 54‒84 lat (średnia wieku 69,8 roku). WYNIKI: Najczęstszym powikłaniem było pęknięcie przegrody międzykomorowej (n = 36; 69,2%), natomiast do najrzadszych należały pęknięcie mięśnia brodawkowatego (n = 4; 7,7%) i pęknięcie ścięgien (n = 4; 7,7%). Nadciśnienie i hipercholesterolemia były najczęstszymi czynnikami ryzyka wystąpienia choroby niedokrwiennej serca w badanej grupie. Zwiększoną śmiertelność zaobserwowano u pacjentów leczonych farmakologicznie (87,5%), podczas gdy śmiertelność pacjentów leczonych operacyjnie wynosiła 61,4%. U większości pacjentów występował jeden czynnik ryzyka choroby wieńcowej (n = 28; 53,8%). WNIOSKI: 1. Najczęstszymi powikłaniami były pęknięcie przegrody międzykomorowej i pęknięcie ściany serca. 2. U pacjentów występowało wiele czynników ryzyka dla choroby niedokrwiennej serca, spośród których najczęstszymi były nadciśnienie i hipercholesterolemia. 3. Śmiertelność w badanej grupie chorych z mechanicznymi powikłaniami ostrego zawału serca znacznie przewyższała przeżywalność i była większa w grupie leczonych zachowawczo.
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73
Pages
119-129
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Contributors
  • Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland, jdabek@sum.edu.pl
  • Students’ Scientific Club, Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  • Students’ Scientific Club, Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
author
  • Students’ Scientific Club, Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  • 2nd Department of Cardiology and Department of Anaesthesiology and Intensive Care, Independent Public Clinical Hospital No. 7, Leszek Giec Upper-Silesian Medical Centre, Medical University of Silesia, Katowice, Poland
  • Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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article
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bwmeta1.element.psjd-a4c81903-b56e-43f0-b8cd-cbbc99b1db1d
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