Study of rhythm disturbances in acute myocardial infarction in Government Dharmapuri Medical College Hospital, Dharmapuri

Background: Despite impressive strides in diagnosis and management of acute myocardial infarction in the past three decades, acute myocardial infarction continues to be a major health problem. About 50% of death from acute myocardial infarction occur within 1 hour of the event and are attributable to arrhythmias most often ventricular fibrillation. Ischemic injury can produce conduction blocks at any level of the atrioventricular or Intraventricular conduction systems. Such conduction block can occur in the atrioventricular node producing various grades of AV block. Conduction block can occur in either main bundle branch producing right or left bundle branch block or in the anterior and posterior fascicle of left bundle branch, producing left anterior &left posterior fascicular blocks respectively. Aim of The Study: To study the incidence of rhythm disturbances in acute myocardial infarction, to evaluate the age, sex distribution and various other risk factors in relation to rhythm disturbances occurring in acute myocardial infarction, to correlate between the different types of rhythm disturbances in relation to the location and type of acute myocardial infarction. Materials and methods: The study was conducted in Government Dharmapuri Medical College Hospital during the period from November 2016 to May 2017. The patients admitted to ICCU were taken up for study. A detailed history physical examination &laboratory work up was done in all patients. Results: 100 Patients of acute myocardial infarction were included in this study. They consisted of 77 male and 23 female patients. The youngest patient was a 23 year old male and the oldest patient was an 84 year old male. Out of 100 patients with myocardial infarction 80 were males and 20 were females. Out of 80 males 37 had rhythm disturbances with a percentage of 46.25 and out of 20 females 9 had rhythm disturbance with a percentage of 45. 8 patients had previous ischemic heart disease prior to present episode. Of these 4 developed rhythm disturbances. All female patients were postmenopausal. 6 patients had COPD and 3 developed rhythm disturbances. Out of 100 patients 25 patients had Intraventricular block, of these right bundle branch block was common with an incidence of 10. Conclusion: The distribution of rhythm disturbances were almost equal in males and females ( p value 0.3365). Rhythm disturbances were more common in the age group 50-59. The incidence of rhythm disturbances in patients with Diabetes mellitus and hypertension was high.