HYPOTENSION ON PRESENTATION AS A PROGNOSTIC FACTOR IN ACUTE CORONARY SYNDROME

Abstract

INTRODUCTION: Coronary heart disease (CHD) is the major cause of death in developing countries like India. Acute Myocardial Infarction
(AMI) is the most important form of CHD. Cardiogenic Shock (CS) is a dreaded clinical condition with a high mortality rate of 50 - 80% in patients
of CS due to acute myocardial infarction. It is an established fact that inpatients with CS, complicating acuteMI, one year survival is better in those
receiving early revascularisation versus initial medical stabilization; however, data demonstrating longterm survival was lacking.
METHODOLOGY: 60 Cases of Acute Coronary Syndrome (ACS) presented as cardiogenic shock and 60 patients with Acute coronary
Syndrome (ACS) without shock admitted in GGH from September 2015 to September 2016.
RESULTS: In present study majority of patients presented with anterior wall MI (33% in MI without CS group; 41% in MI with CS group). overall
incidence of ventricular tachycardia was 22.5% as compared to retrospective study incidence of arrhythmias (13% to 19%). Elderly age, Obesity,
Delayed presentation to hospital, Past history of IHD , High TIMI risk score on presentation and unsuccessful thrombolysis drastically increase the
risk of cardiogenic shock in patients with M.I. Incidence of mortality in present study is 13.33% in MI without CS group and 68.33% in MI with CS
group, which directly states that cardiogenic shock is strongest predictive risk factor for patients of MI.