POST MYOCARDIAL INFARCTION VENTRICULAR SEPTAL RUPTURE AND FACTORS ASSOCIATED WITH ITS MORTALITY: A RETROSPECTIVE STUDY

Khyber Medical University Journal. 2018;10(3):154-158

 

Journal Homepage

Journal Title: Khyber Medical University Journal

ISSN: 2305-2643 (Print); 2305-2651 (Online)

Publisher: Khyber Medical University

Society/Institution: KMU-Institute of Medical Sciences

LCC Subject Category: Medicine

Country of publisher: Pakistan

Language of fulltext: English

Full-text formats available: PDF

 

AUTHORS

Muhammad Adil (Department of Cardiology, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan)
Zohaib Ullah Zahid (Department of Cardiology, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan)
Muhammad Saad Jibran (Department of Cardiology, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan)
Shahzeb (Department of Cardiology, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan)
Muhammad Irfan (Department of Cardiology, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 20 weeks

 

Abstract | Full Text

OBJECTIVES: To determine the incidence of ventricular septal rupture (VSR) following acute myocardial infarction (AMI) and to find out factors associated with its mortality. METHODS: This retrospective study was done at Lady Reading Hospital, Peshawar, Pakistan in which 03years (January-2014 to December-2016) data of AMI patients was studied. Patients with VSR after AMI, diagnosed on echocardiography were included. Chi-square test was applied to correlate cardiovascular risk factors and clinical parameters with the mortality in post-MI VSR patients. RESULTS: A data of 6240 patients with AMI was analyzed in which 60 patients had VSR (incidence rate of 0.96%) with 64.7% having acute anterior MI. It is 8.5 times greater in first-MI and have a delayed onset. Twenty-six patients were excluded due to presence of concomitant complications and rest of 34 were studied in detail. Mean age of post-MI VSR patients was 63.21±8.9years, among them 52.9% were males. Mean time of development of VSR was 4.1±2.2days with the minimum of 01day and maximum of 10days after diagnosis of AMI. Nineteen patients (55.9%) didn’t receive streptokinase. The mortality rate was 38.2% which was significantly associated with diabetes, tachycardia, shock, high Killip class, renal impairment and multiple VSR’s (P-value of 0.012, 0.021, 0.032, 0.031, 0.036, and 0.016 respectively). CONCLUSIONS: VSR incidence after AMI in our study was 0.96% with 8.5 times greater in first-MI and have a delayed onset. Diabetes mellitus, multiple lesions, presence of shock, tachycardia, renal impairment and high Killip class after development of VSR are associated with high mortality.