“A CROSS SECTIONAL STUDY OF ECG CHANGES IN ACUTE MYOCARDIAL INFARCTION PATIENTS TREATED WITH THROMBOLYTIC THERAPY AT A TERTIARY CARE CENTRE IN WESTERN INDIA.â€

Abstract

Background: When it comes to identifying an acute myocardial infarction, ECG is both sensitive and specific. For a prompt evaluation of the effectiveness of reperfusion treatment in acute ST- elevation myocardial infarction (STEMI), simple and quick assessments are required. Although successful recanalization of the epicardial vessel is a prerequisite, micro vascular flow is the factor that most closely predicts the outcome. ST segment changes, which reflect myocardial rather than epicardial flow, provide prognostic information beyond that offered by a coronary angiogram alone. It has been demonstrated that failure to resolve ST segment
alterations after thrombolysis is a predictor of a worse long-term result in comparison to the cohort with resolution. There hasn't been a lot of research on using ECG to gauge the state of LV function or ST segment changes following thrombolytic therapy for AMI. We thus conducted this study to evaluate the ECG changes in AMI patients treated with thrombolytic therapy at a tertiary care centre in eastern Gujarat.
Methodology: This was a retrospective, descriptive, cross-sectional study at a tertiary care medical college and hospital in Eastern Gujarat. A baseline conventional 12 lead ECG was performed on admission and at 1 hr, 3 hr, 6 hr and 12 hr following thrombolysis and in between if the patient showed arrhythmias. Data was collected for each patient using hospital records. Demographic and clinical data was collected in a pre-structured proforma. All the data was tabulated in Microsoft Excel and Statistical analysis was done using SPSS program
(version20).
Results: Majority were from the age group of 51 to 70 years with 38 cases (38%). There were 68% males. We observed that the most common cases were from inferior wall MI with 42 cases (42%), Inferoposterior wall M.I. with 26 cases (26%). Out of 42 patients with Inferior wall MI, we observed that 26 patients had >50% regression at 1 hour. Out of 26 patients with Infero-posterior wall MI 9 patients had >50% regression in 1 hours. Antereoseptal wall M.I. there were 16 cases with Antereoseptal wall M.I. 7 patients had >50% regression in 1
hour post SK ECG.
Conclusion: Premature recording of the ST segment and T wave after acute myocardial infarction is a sensitive, reasonably specific, and easily recognizable ECG manifestation. Also, reperfusion is associated with accelerated evolution and deepening of the T waves following acute myocardial infarction. So, efforts to improve the delivery of thrombolytic therapy in the emergency department should include a focus on electrocardiographic interpretation skills