Clinical Analysis of Acute Myocardial Infarction Induced by Gastrointestinal Hemorrhage
10.11969/j.issn.1673-548X.2018.05.010
- VernacularTitle:消化道出血诱发急性心肌梗死的临床分析
- Author:
Yan ZHU
1
;
Zhongyin ZHOU
;
Yan YANG
Author Information
1. 430060,武汉大学人民医院消化内科
- Keywords:
Gastrointestinal hemorrhage;
Acute myocardial infarction;
Clinical characteristics;
Risk factor
- From:
Journal of Medical Research
2018;47(5):39-42,38
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics and risk factors of mortality of acute myocardial infarction induced by gastrointestinal hemorrhage,and improve the diagnosis and treatment of this kind of disease.Methods The clinical data of 28 patients who admitted to renmin hospital of wuhan university between January 2015 and January 2017 was analyzed retrospectively,including general information,clinical features,laboratory examination,the changes of electrocardiogram,the treatment and prognosis of the disease.According to the prognosis,the patients were divided into survival group (13 cases) and death group (15 cases),and the related factors affecting the prognosis were analyzed.Results Among the 28 patients with acute myocardial infarction complicated by gastrointestinal hemorrhage (male 24,female 4),the mean age was (70.8 ± 11.0) years.The clinical symptoms of gastrointestinal hemorrhage included haematemesis in 5 cases,melena in 8 cases,haematemesis concomitant melena in 13 cases and vomiting of coffee-like substance in 2 cases.When acute myocardial infarction occurred,only 6 patients had typical chest pain,4 patients showed palpitation and chest distress and 18 patients had no obvious symptoms.In all patients,21 (75.0％) patients occurred non ST-elevation acute myocardial infarction,and 7 (25.0％) patients occurred ST-elevation acute myocardial infarction,including extensive anterior wall and inferior wall infarction in 2 cases (7.1％),extensive anterior wall infarction in 7 cases (25.0％),inferior infarction in 13 cases (46.4％),anterior wall infarction in 5 cases (17.9％) and posterior wall infarction in 1 cases (3.6％).After treatment,13 cases improved and 15 cases died.Severe anemia and liver cirrhosis had history statistically significant differences in the survival group and death group,logistics regression analysis showed that severe anemia (OR =11.67,P =0.018) was an independent risk factor of mortality.Conclusion Acute myocardial infarction induced by gastrointestinal hemorrhage has no chest pain and other typical symptoms of myocardial infarction,and most of the cases are non ST-elevation myocardial infarction.Such patients are critically ill and have high fatality rate.Severe anemia is an independent risk factor for death in such patients.
