“Correlation between Electrocardiographic Left Ventricular Hypertrophy & Adverse Outcome Following Acute Myocardial Infarction in Hypertensive Patient”

Abstract

Introduction: Myocardial infarction is one of the most serious pathological condition in which the heart is irritated, inflamed and influenced by multiple factors to cause high mortality and morbidity in the developed and underdeveloped countries. Objectives: To see correlation between Electrocardiographic left ventricular hypertrophy and adverse outcome following acute myocardial infarction in hypertensive patient. Materials and Methods: A Cross sectional analytical study was carried out at the Department of cardiology, Mymensingh Medical College Hospital, Mymensingh Bangladesh from March - 2014 to February- 2015. Patients admitted into cardiology department with Acute Myocardial Infarction with hypertension who fulfill the inclusion and exclusion criteria of the study. Due to time and cost limitation, 65 cases were selected. Results: A total number of sixty five patients were studied of which 56(86.15%) were male and nine (13.84%) were female. The age range was 40 to 70 years. Mean age of male was 52.9±8.4 and female was 56.5±7.5. The patients were divided into two groups on the basis of presence of absence of electrocardiograph left ventricular hypertrophy. All patients had myocardial infarction with evidence of hypertension at admission or known case of hypertension. Group A consisted of 38 patients (58.45%) with ECG-LVH and group B with no ECG_LVH consisted of 27 patients (41.55%). The mean age of group A was 54.25 ±8.9 and group B was 52.55 ± 8.15. Majority patients (34) belonged to 40-50 years age group (52.30%). Twenty one patients belonged to 51-60 years group (32.30%). Ten patients belonged to 61-70 years age group (15.4%), male: female ratio was 6.2: 1. Out of total 68 patients, 43 patients (64.42%) had hypertension on admission and 24 cases (35.38%) had normal blood pressure on admission. Of the 38 patients of group A, 24 had anterior myocardial infarction (63.15%) and 14 had inferior myocardial infarction (36.84%) and 7 had both anterior and inferior myocardial infarction (10.76%). The statistical analysis was highly significant in between group A & group B. The incidence of QMI was highly significant (P= <0.01) between Group A & Group B. QMI was for more common in group A, the incidence was higher in presence of ECG –LVH. In group A hospital stay (days) was 6.74±1.53 days, and 14% had mortality. On the other hand, in group B, it was found that hospital stay (days) was 5.28±1.06 days, and 2% had mortality. 30 patients (81.89%) developed arrhythmia and 8 cases (21.05%) did not developed arrhythmia in group A. In Group B 16(51.85%) developed arrhythmia and 13 cases (48.14%) didn’t develop arrhythmia. Statistically, relation between Group A & Group B was significant (p <0.05). Statistical relationship between group A & group B was significant and this signifies the higher possibilities of occurrence of mortality in ECG-LVH due to hypertension with acute myocardial infarction than without ECG. Conclusion: The study concluded that ECG-LVH changes following acute myocardial infarction in patients with hypertension had more adverse in-hospital outcomes.