A STUDY ON CLINICAL PRESENTATION OF ACUTE MYOCARDIAL INFARCTION IN ELDERLY DIABETICS AND NON-DIABETICS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 41
Abstract
BACKGROUND Coronary artery disease is an important cause of mortality in India, accounting for about more than 25% deaths. About 1/3rd of the acute coronary syndrome patients had diabetes mellitus. Elderly patients fare worse than young. Diabetic patients seek medical care late. However, there have not been sufficient studies on the influence of diabetes mellitus in the presentation of acute myocardial infarction in the elderly population. Diabetic patients with acute coronary syndromes may present with atypical symptoms like nausea, vomiting, fatigue, breathlessness, dizziness, altered sensorium or disturbances of glycaemic control. Silent myocardial ischaemia is also common. All these factors together result in a delayed presentation for recognition of symptoms. This study has been conducted to know the differences if any in the presentation of acute MI in elderly diabetic and nondiabetic patients. MATERIALS AND METHODS The study was a descriptive study. Persons satisfying the inclusion criteria based on age, definition of acute MI and Diabetes mellitus were assessed on the basis of history, clinical examination, ECG changes, cardiac biomarkers and diabetic status. Statistical analysis was done using Epi-Info software and Chi-square test for comparing categorical variables. RESULTS The mean age of the study population was 70.26 ± 13.44 years. Presenting symptoms in acute myocardial infarction were chest pain, sweating, breathlessness, epigastric pain, nausea and fatigue. 82 (82%) patients presented with chest pain, while 18 (18%) reported no chest pain. Of the 100 patients studied, 93 (93%) had ST elevation myocardial infarction and 7 (7%) had non-ST elevation myocardial infarction. 52 patients presented within 4 hours of onset of symptoms. 10 (19.23%) of them were diabetic. CONCLUSION Common presenting symptoms of acute myocardial infarction in the elderly were chest pain, sweating and breathlessness, irrespective of diabetic status. Of the 100 patients, 18 presented without chest pain. Of the patients presenting with chest pain, 36.59% had no radiation. Presence of radiation had no significant association with diabetic status.
Authors and Affiliations
Suresh Kanna S, Karunakaran N
Keywords
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- EP ID EP548361
- DOI 10.14260/jemds/2018/990
- Views 87
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