Acute Myocardial infarction in patients under 45 years old

Abstract

Introduction and objectives: Acute myocardial infarction in young patients (under 45 years old) is a clinical situation with specific characteristics that differ from those of adult patients. The aim of this research was to characterize the behavior of this disease in young patients, identify the main hazard factors, the most frequent topographic locations, the treatment used, and analyze mortality. Method: A descriptive, retrospective, longitudinal study was conducted in patients under 45 years of age with acute myocardial infarction who were admitted to the Coronary Care Unit of the University Hospital of the Inter-American Open University in the city of Buenos Aires during the period from December 15, 2005 to March 18, 2015. Results: In the period analyzed we have 29 patients under 45 years old. The 87.3 % corresponds to male sex. The predominant cardiovascular hazard factors were SMKG 72%, HBP 13.79 %. DLP 20.68 %, DBT 3.44%.- The average age of major events was 44 years old. The type of infarction corresponded in 83% with ST elevation. The predominant electrocardiographic location 31.03% corresponded to the anterior face. The responsible artery in 44.82 % corresponded to the LAD. Clinical medical interventions: angioplasty in 17 patients (61%) and thrombolytics in 7 patients. (24%). There were 4 angioplasties with door-to-balloon less than 12 hours, the rest was programmed. Of the patients with thrombolysis, there was 1 with door-to-needle less than 30 mins, the rest more than 60 mins. There were 2 patients with thrombolysis with RCS - a rescue angioplasty was performed in 1 of them. There was 0% mortality during hospitalization. Conclusions: Male sex, smoking, ST-segment elevation infarction, involvement of the anterior aspect, and angioplasty as a reperfusion strategy predominated. Key words: Myocardial infarction, hazard factors, angioplasties, responsible face, responsible artery, thrombolysed.

 Resultados: En el período analizado  tenemos 29 pacientes   menores  de 45 años de edad. El 87.3 % corresponde al sexo masculino. Factores de riesgo cardiovasculares  predominantes  TBQ  72%,  HTA 13,79 %. DLP 20.68 %, DBT 3.44%.- La edad promedio de mayores eventos es a los 44 años. El tipo de infarto correspondió en un 83% con elevación del ST. La localización electrocardiográfica  predominante  31.03 %  correspondió a la cara anterior. La arteria responsable  en un  44,82 % correspondió a la DA. Intervenciones clínico médicas: angioplastias  en 17 pacientes (61%) y  tromboliticos en 7 pacientes. (24%). Angiosplastiados 4 con PB menos de 12 hs.,el resto programado. De los trombolizados 1 con PA menos de 30 minutos, el resto mayor de 60 minutos. 2 pacientes trombolizados con SCR – en 1 se realizo angiosplastia de rescate.  

Mortalidad del 0% durante la internación.

 Conclusiones: Predominaron el sexo masculino, el hábito de fumar, el infarto con supradesnivel del ST, la afectación de la cara anterior y como estrategia de reperfusion la angioplastia.  Palabras clave: Infarto del miocardio, factores de riesgo, angioplastias, cara responsable, arteria responsable, trombolisados