Clinical Pictureand Tactics of Treatment of Non Q-Myocardial Infarction in a Specialized Hospital

Overview

The authors present an analysis of all patients treated at the cardiological department of thehospital Na Homolce in Prague on account of the diagnosis „non Q-myocardial infarction“ duringthe last two years and the period from the beginning of 1999 till Dec. 8, 2000 resp.During this period a total of 294 patients were hospitalized with the diagnosis of acutemyocardial infarction. Among them an unequivocal „primary“ non Q-infarction was diagnosedin 44 patients (= 14.9% of the total number of infarction treated in the department) who werealso included in this review.The authors investigated the time from the onset of complaints to admission to hospital andsubsequently the onset of invasive examinations, site of the infarction, ECG, ECHO andlaboratory findings, as well as intervention and conservative treatment and the incidence ofcomplications.As to sites non Q-myocardial infarction of the anterior wall predominated with only slightlyimpaired kinetics (hypokinesia) in the affected area and only with a mildly reduced leftventricular function. The course of hospitalization was in most instances not complicated, thepatients were discharged on the third to fifth day. Invasive examination was made in 75%patients incl. 55% who were catheterized within six hours after admission. As to intervention,angioplasty of one or two arteries predominated (64% patients). The mortality was 2.2%.Pharmacological treatment involved above all administration of low-molecular heparin, aspirin, possibly nitrates and beta-blockers. 77% patients had hypolipidaemic treatment wherestatin administration predominated.In the discussion the authors analyze the approach to patients with this diagnosis. The authorsrecommend invasive examination in the maximum number of patients after non-Q-myocardialinfarction along with thorough prevention. The most suitable period of catheterization has notbeen firmly established, it depends on the clinical condition of the patient and his reaction toinitial conservative treatment. The authors consider catheterization by the third day ofadmission as optimal.

Key words:
Q-myocardial infarction - primary treatment - angioplasty.