ACUTE MYOCARDIAL INFARCTION;

Frequency of complete heart block in patients at a tertiary care hospital

Abstract

Background: Ischemic heart disease is the most common cause for complete heart block (CHB) and sudden death. Heart
blocks may occur as complications of acute myocardial infarction (AMI) and are associated with increased mortality. The aim of this
study is to determine the frequency of complete heart block (CHB) in acute myocardial infarction at a tertiary care hospital. Place and
duration: This study was conducted in Cardiology Department of Liaquat University of Medical and Health Sciences from 1st August
2009 to 31st January 2010. Study Design: Cross sectional and descriptive study. Materials and Methods: ST segment elevation equal to
or more than 1mm (0.1mv) in two of these leads II, III and aVF. Rise in serum creatinine kinase level (CPK Level) more than twice the
normal value along with CK-MB fraction more than 6% of CPK value. Patients with history of chest pain, shortness of breath, nausea,
vomiting and unconsciousness were enrolled in the study. The cardiac enzymes tropinin T was also performed at bed side by venous
blood sample. Results: Total of 87 patients were included, prevalence of heart blocks was 27.58%. Anterior wall MI was in 50(57.5%)
patients. Of these, 13(54.2%) had complete heart block. Inferior wall MI was in 37(42.5%) cases, of these, 11(45.8%) were found with
complete heart block. There was no significant difference between anterior wall MI and inferior wall MI with complete heart block (P value
> 0.05). Mortality was 2.3% with anterior wall MI. Conclusions: Development of complete heart blocks has important prognostic
significance. Complete heart block was frequent complication of myocardial infarction.