Prevalence of myocardial infarction in congestive heart failure patient at emergency room of Rajavithi Hospital

Abstract

Background: Congestive heart failure is a common condition and along with myocardial ischemia is a global public health problem. In the emergency room, myocardial infarction and uncontrolled hypertension are also found among patients who present with dyspnea from congestive heart failure. Therefore, the researchers chose to study the prevalence of acute myocardial infarction in congestive heart failure patients who presented at the emergency room of Rajavithi Hospital. Improving the screening of patients presenting at the emergency room with congestive heart failure will produce better treatment in the future.

Objectives: To determine the prevalence of acute myocardial infarction and prevalence of preserved left ventricular function of patients who present at the emergency room of Rajavithi Hospital.

Method: The study enrolled 91 heart failure patients who presented at the emergency room of Rajavithi Hospital from 1 July 2011 to 31August 2012. A cross-sectional descriptive study was conducted to determine the prevalence of acute myocardial infarction based on universal definition of myocardial infarction and prevalence of heart failure with preserved left ventricular function. The data were collected from medical records of patients. Statistics and data analysis included percentage, mean and standard deviation using the SPSS version 11.5.

Results: Of the patients, 91 were female (53.8%), mean age was 66.406±12.52 years, main underlying diseases were hypertension and diabetes mellitus. The prevalence of myocardial infarction in this study was 14.13% (13 patients), and patients with an acute myocardial infarction association were male. The overall body height was higher than in subjects having diabetic mellitus with chronic kidney disease. Patients and CK-MB enzyme level elevations were higher compared with those without myocardial infarction. Mean left ventricular ejection fraction was 44.996±18.894%, and preserved left ventricular function was 51.6% (47 patients). Therefore, depressed left ventricular function was significantly found among male patients when compared with the preserved left ventricular function group.

Conclusion: The prevalence of myocardial infarction in congestive heart failure patients was studied. Male patients having diabetes mellitus or chronic kidney disease should be more concerned about myocardial infarction than other population groups. Preserved left ventricular function was associated with a few heart failure cases.  Males require earlier detection of the left ventricular function than females.