• Title/Summary/Keyword: myocardial infarction

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The knowledge and Learning Needs of the Patients with the First Onset Myocardial Infarction (심근경색증 초발 환자들의 질병관련 지식과 교육요구도)

  • Moon Jung Soon;Jeong Hye Sun
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.275-284
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    • 2001
  • In order to assess the knowledge and learning needs. 72 patients with the first onset myocardial infarction were interviewed by the structured questionnaires during the period of September, 1999 to July, 2000. The results were as follows 1. As a whole. $57.9\%$ of patient had correct knowledge in relation to myocardial infarction. As for the knowledge score in terms of general characteristics, the patients who were in higher education and living with spouse were significantly higher point than those who were in lower education and living alone. 2. The mean scores of learning need of the subjects was 4.13 measured by Likert 5 point scale, No significant differences were shown in the score of learning need in terms of the general characteristics. As for the learning need according to domain, the subjects had higher leaning needs in the domain of diet, risk factors and activity and exercise. 3. There was no significant correlation between the learning need and the knowledge of myocardial infarction. The results of finding show that education program should be consider the general characteristics. the level of knowledge and learning needs of the myocardial infarction patients.

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The impact of comorbidity (the Charlson Comorbidity Index) on the health outcomes of patients with the acute myocardial infarction(AMI) (급성심근경색증 환자의 동반상병지수에 따른 건강결과 분석)

  • Lim, Ji-Hye;Park, Jae-Yong
    • Health Policy and Management
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    • v.21 no.4
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    • pp.541-564
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    • 2011
  • This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

Transatrial Repair of Post-infarction Posterior Ventricular Septal Rupture

  • Lee, Weon-Yong;Kim, Sung-Jun;Kim, Kun-Il;Lee, Jae-Woong;Kim, Hyoung-Soo;Lee, Hee-Sung;Cho, Sung-Woo
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.186-188
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    • 2011
  • Ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction. The event occurs 2~8 days after an infarction and often precipitates cardiogenic shock. Post myocardial infarction VSR is known for difficult to repair. Especially, Transmural myocardial infarction involved in the posterior VSD area, exposure of the affected site is difficult and postoperative mortality rate is high. We have experienced a case of a 75-year-old female patient who suffered posterior VSD due to acute myocardial infarction, and attained good result by approaching the lesion through right atrial incision and repaired the defect by using patch closure technique.

Case Report: Cardiac tamponade in a patient with isolated posterior myocardial infarction presenting with syncope (실신으로 내원한 후벽 단독 심근경색 환자에서 발생한 심장눌림증 1례)

  • Kang, Min Seong;Oh, Seong Beom;Kim, Ji-Won
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.235-241
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    • 2021
  • Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

Awareness of Early Symptoms and Emergency Responses to Myocardial Infarction and Stroke in People with Diabetes Mellitus Compared to Non-diabetic Population in the Community: A Propensity Score-Matched Analysis (지역사회 당뇨병 유병자와 비유병자의 심근경색증 및 뇌졸중 조기증상과 대처방안 인지도 비교: 성향점수매칭 분석)

  • Kim, Mina;Lee, Young-Hoon;Kim, Nam-Ho
    • Health Policy and Management
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    • v.30 no.3
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    • pp.386-398
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    • 2020
  • Background: We determined the differences in awareness of myocardial infarction and stroke according to the presence or absence of diabetes mellitus in the community. Methods: The 2018 Community Health Survey identified 20,812 people with diabetes mellitus aged 40-79 years. Using 1:1 matching by propensity score, 20,812 people without diabetes mellitus but with similar sociodemographic characteristics were selected as a comparison. Outcome variables were awareness of early symptoms of myocardial infarction and stroke and awareness of coping strategies in case of occurrence. Results: There was no significant difference between nondiabetic and diabetic people in terms of recognizing all early symptoms of myocardial infarction (nondiabetic, 42.7%; diabetic, 43.0%; p=0.43) and stroke (nondiabetic, 49.4%; diabetic, 49.4%; p=0.91). In addition, no significant difference was found between nondiabetic and diabetic people in the proportion of knowing correct emergency response to myocardial infarction (nondiabetic, 84.6%; diabetic, 84.4%; p=0.56) and stroke (nondiabetic, 81.3%; diabetic, 81.4%; p=0.77). Conclusion: Since people with diabetes are at greater risk of cardiovascular disease than the general public, it is important to lower the risk of disability and death by improving their awareness of early symptoms and correct emergency response to myocardial infarction and stroke.

Comparison of Emergency Tc-99m Sestamibi Myocardial Perfusion SPECT and ECG in the Diagnosis of Acute Myocardial Infarction (급성심근경색증 환자에서 응급으로 시행한 Tc-99m Sestamibi 심근관류 SPECT와 심전도의 비교)

  • Cho, Ihn-Ho;Lee, Hyoung-Woo;Park, Jong-Sun;Won, Kyu-Chang;Do, Jun-Young;Sin, Dong-Gu;Yoon, Kyung-Woo;Kim, Young-Jo;Shim, Bong-Sup;Lee, Hyun-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.104-111
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    • 1996
  • We did Tc-99m sestamibi myocardial perfusion SPECT in 36 patients with acute myocardial infarction when they arrived at the emergency room. And we compared myocardial perfusion images with ECG findings. Then we obtained the follows. The myocardial infarction by the obstruction of left coronary descending artery and right coronary artery showed a good concordance in the diagnosis and infarction site between myocardial perfusion images and ECG findings. The 7 patients with myocardial infarction by a left circumflex coronary artery showed a perfusion defect in the lateral wall in myocardial perfusion SPECT images. But 4 patients of them showed ST segment elevation, 2 patients showed ST depression and 1 patient showed normal ECG findings. The diagnostic sensitivity of Tc-99m sestamibi myocardial perfusion SPECT was 100% by a qualified analysis. The perfusion defect site in the myocardial perfusion SPECT were corresponded with the infarct related coronary artery in 31 patients which was diagnosed by coronary angiograpy. The size of perfusion defect in the po1ar map was $31{\pm}18%(M{\pm}SD)$, in the myocardial infarction with left anterior descending coronary arery obstruction, $31{\pm}13% (M{\pm}SD)$ in the myocardial infarction with right coronary artery obstruction and $25{\pm}5.9%(M{\pm}SD)$ in the myocardial infarction with left circumflex coronary artery obstruction. We concluded that emergency myocardial perfusion SPECT images are useful in the diagnose of myocardial infarction and it's very useful when we are difficult to diagnose with ECG like as lateral wall infarction or left bundle branch block.

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Study of Clinical Characterized of Acute Myocardiac Infarction Patients on Youth & Adults Age in Emergency Room (응급실로 내원한 청장년층 급성심근경색증 환자의 임상특성 연구)

  • Hong, Hae-Sook;Jang, Yu-Ryang
    • Journal of forensic and investigative science
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    • v.3 no.1
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    • pp.50-59
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    • 2008
  • The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.

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Perioperative Myocardial Infarction after Coronary Artery Bypass Grafting - Detection by serial electrocardiograms and analysis of risk factors - (관상동맥 우회로 이식술후의 심근경색 -심전도에 의한 진단 및 위험인자 분석-)

  • 김성완;이응배;서강석;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.7-12
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    • 1998
  • The study in detection of perioperative myocardial infarction by serial ECGs and the analysis of risk factors involved was carried out from January 1994 to July 1996 on 87 consecutive patients undergoing coronary artery bypass grafting. There were significant differences in the mean CK-MB peaks and frequencies of flipping in LDH1/LDH2 among the 3 groups(group I: new Q-wave, group II: S-T change, group III: no ECG change). The ECG was considered positive for postoperative myocardial infarction if the new Q-waves appeared in the postoperative period or if S-T segment changes persisted for more than 48 hours. The hospital mortality rate was 3.3% and the perioperative infarction rate was 17.2%. The following risk factors of the perioperative MI were found: endarterectomy, decreased ejection fraction($\leq$40%) and prolonged aortic cross clamping time. Left main disease, triple vessel disease, 3 or more graft, unstable angina and hypertension did not correlate with myocardial infarction. This study suggests that serial ECGs could be used as means of detecting the perioperative myocardial infarction after coronary artery bypass grafting.

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Acute myocardial infarction with a giant left main aneurysm in atypical Kawasaki disease (비전형적인 가와사키 병 환자에서 발생한 좌주간지 거대 동맥류를 동반한 급성심근경색)

  • Kim, Min Wook;Kim, Hyun Soo;Lee, Myung Dong;Jung, Hyun Sook;Yoon, Seong-Bo;Kim, Young Woo
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.106-110
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    • 2017
  • Kawasaki disease (KD) is an acute vasculitis of small and medium sized arteries. Even many years after onset, aneurysms and stenosis in coronary arteries may lead to an acute myocardial infarction, which is described as atypical or missed KD in childhood. KD is an underlying disease of young adults with acute myocardial infarction. We report on a rare case involving a total occlusion in the proximal left anterior descending coronary artery combined with a giant left main aneurysm in a young adult patient with acute myocardial infarction ascribed to antecedent KD that is undefined but almost certain.