FREQUENCY OF COMPLETE HEART BLOCK IN PATIENTS PRESENTING WITH ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION

Authors

  • Muhammad Ali Khan Department of Cardiology, Ayub Medical College Abbottabad-Pakistan
  • Kinza Sammar Department of Physiology, Abbottabad International Medical College Abbottabad-Pakistan
  • Raisa Naz Department of Physiology, Ayub Medical College Abbottabad-Pakistan
  • Shazia Tauqeer Department of Physiology, Abbottabad Medical College, Abbottabad-Pakistan
  • Maria Shafiq Department of Physiology, Ayub Medical College, Abbottabad-Pakistan
  • Shabana Naz Department of Pathology, Ayub Medical College, Abbottabad-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-13024

Keywords:

(Key words: Complete heart block (CHB), Acute anterior wall myocardial infarction (AWMI).

Abstract

Background: Complete heart block (CHB) is a relatively common complication in post-acute myocardial infarction (AMI) patients. Data on the incidence and consequences of CHB in patients with ST-segment elevation myocardial infarction (STEMI) are limited. Besides serving as an indicator of widespread myocardial injury, the development of CHB in STEMI is also associated with a higher risk of sudden cardiac death. Although there has been an observed increase in the incidence of CHB complicating STEMI over the past few decades, attributed to improved reporting and timely diagnosis, the absolute or true incidence of CHB in STEMI patients receiving current management is underestimated. The present study aimed to determine the frequency of complete heart block in patients presenting with acute anterior wall myocardial infarction (AWMI). Methods: This was a descriptive study conducted in the Cardiology Department of Ayub Teaching Hospital, Abbottabad, from February to July 2020. All patients (N=244) presenting with acute Anterior Wall ST-segment elevation Myocardial Infarction were included, with ages ranging from 20 to 80 years and both genders (males and females) considered. Results: The mean age of the patients was 55.98±12.224, ranging from 20 to 80 years, out of a total of 244 patients. In terms of gender distribution, there were 160 (65.6%) males and 84 (34.4%) females. Regarding the frequency of smokers, 63 (25.8%) were smokers, and 181 (74.2%) were non-smokers. The frequency of complete heart block was 8 (3.3%), while 236 (96.7%) did not have acute anterior wall myocardial infarction-associated heart block. Conclusion: Patients admitted with inferior wall MI and right ventricular (RV) infarction were at an increased risk of mortality. The high incidence of heart block in AWMI suggests that underlying infarction and tissue damage may be extensive, leading to increased mortality secondary to complete cardiac failure.

Author Biography

Raisa Naz, Department of Physiology, Ayub Medical College Abbottabad-Pakistan

 

References

Adam AM, Rehan A, Waseem N, Iqbal U, Saleem H, Ali MA, et al. Prevalence of Conventional Risk Factors and Evaluation of Baseline Indices Among Young and Elderly Patients with Coronary Artery Disease. J Clin Diagn Res 2017;11(7):OC34.

Bally M, Dendukuri N, Rich B, Nadeau L, Helin-Salmivaara A, Garbe E, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ 2017;357:j1909.

Cardoso R, Alfonso CE, Coffey JO. Reversibility of High-Grade Atrioventricular Block with Revascularization in Coronary Artery Disease without Infarction: A Literature Review. Case Rep Cardiol 2016;2016:1971803.

Hameed DN, Shabbir DM, Khadim DR, Khattak DT, Khan DZ, Aziz DZ, et al. Comparison of in-hospital mortality in patients with ST elevation myocardial infarction with and without 3rd degree AV block. Pak Armed Forces Med J 2019;69(Suppl 1):S123–7.

Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018;39:119–77.

Fan X, Maharjan P, Liu P, Bai L. Effect of primary PCI on the recovery of atrioventricular block in inferior STEMI patients with late presentation (>12 hours): insights from a single center 10-year experience. J Investig Med 2020;68(5):1011–4.

Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, et al. Acute Myocardial Infarction in Women A Scientific Statement From the American Heart Association. Circulation 2016;133(9):916–47.

Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR. et al. 2018 ACC/AHA/HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. J Am Coll Cardiol 2019;74(7):932–87.

Abuzaid A, Fabrizio C, Felpel K, Al Ashry HS, Ranjan P, Elbadawi A, et al. Oxygen Therapy in Patients with Acute Myocardial Infarction: A Systemic Review and Meta-Analysis. Am J Med 2018;131(6):693–701.

Namana V, Gupta SS, Abbasi AA, Raheja H, Shani J, Hollander G. Right ventricular infarction. Cardiovasc Revasc Med 2018;19(1 Pt A):43–50.

Kumar V, Sinha S, Kumar P, Razi M, Verma CM, Thakur R, et al. Short-term outcome of acute inferior wall myocardial infarction with emphasis on conduction blocks: a prospective observational study in Indian population. Anatol J Cardiol 2017;17(3):229–34.

Sakboonyarat B, Rangsin R. Prevalence and associated factors of ischemic heart disease (IHD) among patients with diabetes mellitus: a nation-wide, cross-sectional survey. BMC Cardiovasc Disord 2018;18(1):151.

Hashmi KA, Shehzad A, Hashmi AA, Khan A. Atrioventricular block after acute myocardial infarction and its association with other clinical parameters in Pakistani patients: an institutional perspective. BMC Res Notes 2018;11(1):329.

Afreen A, Khan MN, Khan MB, Ahmad A, Akbar MS, Danyal SM. S82 risk factor assessment in patients undergoing coronary angiography at army cardiac centre Lahore. Pak Armed Forces Med J 2019;69(Suppl 1):82–6.

Rashid NA, Nawi AM, Khadijah S. Exploratory analysis of traditional risk factors of ischemic heart disease (IHD) among predominantly Malay Malaysian women. BMC Public Health 2019;19(Suppl 4):545.

Aguiar RS, Timóteo AT, Ferreira L, Carvalho R, Oliveira M, Cunha P, et al. Complete atrioventricular block in acute coronary syndrome: prevalence, characterization and implication on outcome. Eur Heart J Acute Cardiovasc Care 2018;7(3):218–23.

Kristian T, Joseph AS. Fourth universal definition of myocardial infarction. Eur Heart J 2018;40(3):237–69.

Hashim M, Zeb S, Shah GA, Rizvi SNH. In-hospital mortality in patients of ST-elevation MI. Pak Heart J 2017;50(4):241–7.

Linssen PBC, Veugen MGJ, Henry RMA, van der Kallen CJH, Kroon AA, Schram MT, et al. Associations of (pre)diabetes with right ventricular and atrial structure and function: the Maastricht study. Cardiovasc Diabetol 2020;19(1):88.

Gorter TM, Streng KW, van Melle JP, Rienstra M, Dickinson MG, Lam CSP, et al. Diabetes mellitus and right ventricular dysfunction in heart failure with preserved ejection fraction. Am J Cardiol 2018;121(5):621–7.

Chapman AR, Lee KK, McAllister DA, Cullen L, Greenslade JH, Parsonage W, et al. Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome. JAMA 2017;318(19):1913–24.

Choudhury M, Kumar N, Chalil S, Abozguia K. Refractory hypertensive emergency associated with complete heart block resolved after permanent pacemaker implantation: A case report. Clin Case Rep 2022;10(6):e5964.

Lévy S. Bundle branch blocks and/or hemiblocks complicating acute myocardial ischemia or infarction. J Interv Card Electrophysiol 2018;52(3):287–92.

Kubra G, Saghir T, Rasheed S, Rehan FH, Ali A, Abbas S. In-Hospital Outcomes of Female Patients With Inferior Wall Myocardial Infarction. Cureus 2021;13(2):e13274.

Khan M, Khan IA, Samore NA, Kamran J, Janjua AF, Mustafa A, et al. Clinical outcome of patients admitted with acute anterior versus acute inferior wall myocardial infarction. Pak Armed Forces Med J 2021;70(Suppl-4):S892–6.

Ullah Z, Khan I, Khan W, Khan MA. Frequency of Complete Heart Block in Patients with Acute Inferior Wall Myocardial Infarction. Pak J Med Health Sci 2022;16(5):89–90.

Downloads

Published

2024-06-30