Prognostic Signifincance of Conduction Blocks in Cases of Acute Myocardial Infarction: A Prospective Observational Study at Tertiary Care Hospital

Authors

  • Srikanth Peddireddy Senior Resident, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
  • Archana Gupta Professor, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
  • Deepak Makwana Senior Resident, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
  • Suresh Jadi Senior Resident, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
  • Sanjay Rawat Senior Resident, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India

Keywords:

Acute myocardial infarction, conduction block, bundle branch block, atrioventricular blocks.

Abstract

Introduction: Conduction blocks are frequent complications of acute myocardial infection. Development of complete AV block is associated with poor prognosis likely owing to the extension nature of the infarction. Bundle branch block in acute MI carries poor prognosis. This has been attributed both to the extent of myocardial damage and to the frequency of ventricular asystole. Development of conduction block worsens the outcome of acute myocardial infarction. So recognition of conduction block at an early stage, helps in appropriate treatment including pacing can be institutes at an early stage. Aims and Objectives: To study various patterns of conduction blocks and prognostic implications of conduction blocks in acute myocardial infarction. Materials and Method: A prospective observational study was done on 100 myocardial infarction patients admitted in J.A. Group of Hospitals, Gwalior over a period of January 2019 to June 2020. ECG was continuously observed in CCU and daily ECGs were done. Cardiac markers, fasting blood sugar, lipid profile, serum electrolytes were performed and data was collected. The chi square test was used and p value < 0.05 was considered as statistically significant. Result: A total of 100 patients were included. Out of 100 patients 68 had conduction blocks, out of which 50 had bundle branch blocks whereas 18 had AV blocks. Most of the acute myocardial infarction patients were males (74%). Overall hypertension and smoking was the most common risk factor seen in this study. AV blocks were more common in inferior wall MI and bundle branch blocks were more common in anterior wall MI. There is common association of inferior wall MI with RBBB compared to that of which LBBB (p<0.0001). There was statistical association between type of block and location of MI. Cardiogenic shock was the common complication seen in patients of MI with conduction blocks. Past history of MI was found to be predominant risk factor among mortality seen in 33.3%. Among bundle branch block mortality more with LBBB (23%) and among AV block mortality more with 3o AV block (50%). Conclusion: Conduction blocks were associated with increased risk of in hospital morbidity and mortality in the form of other vascular events during hospital stay. Patients with acute myocardial infarction should be observed carefully for early recognition of conduction blocks and they need close monitoring and optimum clinical care to reduce mortality and morbidity.

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Published

2022-01-17

How to Cite

Srikanth Peddireddy, Archana Gupta, Deepak Makwana, Suresh Jadi, & Sanjay Rawat. (2022). Prognostic Signifincance of Conduction Blocks in Cases of Acute Myocardial Infarction: A Prospective Observational Study at Tertiary Care Hospital. International Journal of Health and Clinical Research, 5(2), 754–757. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/5229