To Study Prevalence Of Acute Myocardial Infarction With Atypical Presentation – A One Year Hospital Based Cross-Sectional Study

Abstract

Background and objectives Atypical myocardial infarction is characterized by lack of unequivocal objective signs of myocardial infarction and minimal, atypical, or no symptoms at all. This study was aimed to assess the prevalence of atypical MI. Methodology This one year hospital based cross-sectional study was carried out in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on patients presenting with atypical myocardial infarction. Patients were assessed for clinical signs and symptoms, and underwent ECG for the diagnosis. Results During the study period that is, from January 2013 to December 2013 there were 526 admissions with acute myocardial infarction. Of these, 64 patients had atypical acute myocardial infarction and the prevalence was 12.16%. Atypical myocardial infarction was seen more commonly among males (70.31%; male to female ratio was 2.36:1) and in the age group between 51 to 60 years (32.81%) and mean age was 58.28 ± 12.55 years. More than half of the study population that is, 56.25% of the patients presented with history of diabetes mellitus and personal history of smoking was noted in 31.81%. Breathlessness was the commonest clinical presentation noted in 64.06% and commonest clinical sign was heart failure present in 32.81%. The investigations revealed raised random blood sugar levels in 65.60%, raised CK MB in 90.62%, and troponin I was found to be raised in all the patients (100%). Most of the patients were diagnosed to have anterior wall myocardial infarction (43.75%) followed by anteroseptal MI (21.88%). Conclusion and interpretation Overall the present study showed higher prevalence of atypical myocardial infarction especially in males and aged above 50 years. Further, this subset of patients may present with history of diabetes mellitus and essential hypertension or hypertension with symptoms of breathlessness and sweating.