INTRAVITAL AND POST-MORTEM DIAGNOSIS OF MYOCARDIAL INFARCTION: URGENT CARDIOLOGY DEPARTMENT LETHAL CASES ANALYSIS

Abstract

To estimate an accuracy of methods of myocardial infarction diagnostics (ECC, echocardiography, biomarkers) 41 case history reports of patients with Q(+) and Q(-) myocardial infarction and lethal outcome were analyzed. ECG and echocardiography were proved to be most accurate in case of anterior (67 % and 67 %), lateral (71 % and 67 %) and inferior (46 % and 79%) localizations of myocardial infarction. Interventricular septum and posterior localizations were not detected on ECG (0%). Complete coincidence of ECG and echocardiography with autopsy results was detected only in 4 %. CPC and CPC-МВ levels were elevated in 97%, troponins were positive in 70 %. Risk factors of lethal outcome in case of myocardial infarction include sex (male), comorbid pathology (arterial hypertension, cerebrovascular disease, diabetes mellitus type 2), complications (rhythm disorders, cardiogenic shock, congestive heart failure), absence of thrombolytic therapy and its inefficacy. Myocardial infarction hypo- and hyperdiagnosis were detected.

Keywords

• myocardial infarction
• mortality
• methods of diagnosis