International Journal of Medical and Health Research

Authors
Dr. Venkatesh Desai, Dr. Chandrakala

Abstract
Background: Acute myocardial infarction (MI) in young patients is a significantly raising problem particularly in India. This has aroused considerable interest in recent years and being recognized with increasing frequency. The chest pain in younger age group may be misdiagnosed for other diseases. In addition, the various aspects of myocardial infarction such as risk factor profiles, clinical presentations and prognosis differ significantly in young people when compared to older patients. Objective: To study the clinical profile, risk factor profile and outcome of acute MI in young adults. Material and Methods: This was a prospective study carried out on around 50 young persons below the age of 40 years admitted in ICCU for acute MI under Khaja Banda Nawaz Teaching and General Hospital over a period of 3 years. The patients above the age of 40 years and below the age of 18 years along with those who had associated valvular heart disease and anemia have been excluded from the study. After a detailed history and thorough clinical examination routine investigations were done. Other investigations like ECG, serum cardiac markers such as CPK-MB, Troponin-I, LDH, SGOT and 2-D Echo was done to diagnose MI. A special attention was paid to risk profile. All the patients were given necessary treatment and they were followed up till the discharge from the hospital. These patients were also observed for development of any compli­cation after the myocardial ischemia. Results: Out of 50 young MI patients, 47 patients were male and 03 patients were female. The mean age of the patients with acute MI was 34.33 ± 5.67 years, with a maximum number of patients (21, 42.0%) belonging to the age of 31–35years. Majority of the patients (47, 94.0%) were male. The most common presenting symptom (45, 90.0%) was chest pain. One or more risk factors were found to be present in 42 (84.0%) patients. Smoking was the most common (32, 64.0%) risk factor for MI followed by hyperlipidemia (21, 42.0%), hypertension (12, 24%), obesity (12, 24%) and diabetes mellitus (10, 20%). The most common type of MI was STEMI which was present in 46 (92.0%) patients. In that, Anterior wall MI was the commonest type seen on ECG (37, 74.0%). Arrhythmias were the commonest complication followed by left ventricular failure. All the patients responded well to the medical line of treatment except 3 who died because of cardiogenic shock. Conclusion: The incidence of acute MI in young patients is increasing day by day which was thought earlier less common among young individuals. This may be because of their lifestyle. Young MI is found to be more common in male gender. Smoking, dyslipidemia and obesity are found to be most common modifiable risk factors for MI. It is important to recognize these patients for the purpose of risk factor modification and secondary prevention in younger patients. Education of patients about smoking cessation and also education about modification of other risk factors in youngsters can serve as primary prevention for the disease.