Some remarks on acute MI mortality. The postmortality examination of 79 cases diet of MI at Huu Nghi Hospital has allowed the authors to find: a/ the high risk factors of death were: over 60 years of old, large anterior MI (43.83%), left ventricular anterio-posterior MI (21.93%), stenosid of left coronary artery (30.4%), reinfarction (35.45%). b/ the main harmful complications is cardiogenic shock (30.38%), heart failure (26.585%), ventricular arrhythmia (11.39%), lung infective diseases (5.06%), cerebro-vascular diseases (8.86%), cardiac rupture (13.92%). c/ the various measure to decrease the mortality of MI
Myocardial Infarction ; mortality

After myocardial infarction, there is a high mortality, patient needs a proper treatment. The medications include a group of antiagglutination of thrombocytes, anticoagulants, a group of beta receptor suppressor, a group of antimetabolism inhibitors, a group of calci channel suppressor, the medication of antiarrhythmia, treating blood lipid dysturbation. Supportive measures such as the change of living stype, stop smoking, proper diet and exercises were effective. Specially, it must treat activelyassociate factors such as diabetes, hypertension. Antioxidants such as vitamin A, vitamin E, folat, vitamin B and hormone therapy for menopause women are also helpful
Myocardial Infarction ; Patients ; mortality

Ventricular septal rupture (VSR) is a disastrous mechanical complication of myocardial infarction. Although several surgical interventions have been developed, mortality due to surgical management remains high, especially in the case of posterior VSR. We report a successful case of repair of posterior VSR using an alternative transatrial approach to avoid the complications related to ventricular incision.
Mortality ; Myocardial Infarction ; Ventricular Septal Rupture*

Ventricular septal rupture (VSR) is a disastrous mechanical complication of myocardial infarction. Although several surgical interventions have been developed, mortality due to surgical management remains high, especially in the case of posterior VSR. We report a successful case of repair of posterior VSR using an alternative transatrial approach to avoid the complications related to ventricular incision.
Mortality ; Myocardial Infarction ; Ventricular Septal Rupture*

To assess the prognostic value of the 14 ECG variables obtained from the pre-discharge ECG, 35 patients were followed up for at least one year among the 80 patients of the acute myocardial infarction admitted at Seoul Paik Hospital from Sep. 1983 to Aug. 1986. The following results were obtained. 1) The overall in-hospital mortality rate was 20% and the mortality rate tended to decline year by year. 2) The one-year mortality and morbidity rate of the followed patients was 31.4%. 3) Among the 14 variables obtained from the pre-discharge ECG, T-negativity was the only statistically significant (p<0.05) one to predict the one-year prognosis in the patients after the first myocardial infarction, and we could not derive any meaningful datd from the analysis of the combined effects of the three ECG variables (PTF, ST depression and ST elevation).
Depression ; Electrocardiography* ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Prognosis ; Seoul

BACKGROUND/AIMS: It has been suggested that admission hyperglycemia is associated with poor clinical outcomes in patients with acute myocardial infarction (AMI). The aim of this study was to assess the relationship between admission hyperglycemia and short-long term prognosis in patients with AMI. METHODS: A total of 6,030 AMI patients without a previous history of diabetes were enrolled between Nov. 2005 and Jan. 2008. The patients were divided into three groups according to the levels of admission glucose levels: group I (<140 mg/dL, n=3,307), group II (140~199 mg/dL, n=1,946), and group III (> or =200 mg/dL, n=777). In-hospital and one-year mortality were compared among three the groups. RESULTS: The mean age was 64.3+/-13.3, 65.9+/-12.7, and 67.7+/-13.0 years in group I, II and III, respectively. The proportion of female gender (23.9%, 29.5%, 35.0%; p<0.001), Killip class III-IV (8.9%, 12.3%, 28.3%; p<0.001), ST-segment elevation myocardial infarction (54.6%, 71.5%, 71.7%; p<0.001), and in-hospital mortality (3.5%, 7.5%, 19.7%; p<0.001) increased with higher tertiles of elevated values of initial serum glucose. Hazard ratio (HR) for mortality rate were significantly increased in group II [HR=1.19, 95% confidential interval (Cl) 1.02~1.40, p=0.032], and in group III [HR=1.91, 95% Cl 1.59~2.30, p=0.001], compared with group I. And also significant differences were existed between group II and group III [HR =1.55, 95% Cl 1.27~1.88, p=0.001]. CONCLUSIONS: Admission glucose in patients with AMI provides incremental prognostic value, and significantly correlates with in-hospital and one-year mortalities.
Female ; Glucose ; Hospital Mortality ; Humans ; Hyperglycemia ; Myocardial Infarction ; Prognosis

Rupture of the interventricular septum is a serious complication of acute myocardial infarction, accounting for 5% of death due to acute myocardial infarction. The mortality with medical therapy alone exceeds 90%. Accurate diagnosis, urgent management, and early operative correction are necessary for survival. We report cases of 3 patients with ventricular septal rupture after acute myocardial infarction.
Diagnosis ; Humans ; Mortality ; Myocardial Infarction* ; Rupture ; Ventricular Septal Rupture*

Morbidity and mortality rates associated with acute myocardial infarction accompanying chronic total occlusion are comparatively high. European guidelines recommend primary intervention for the causative lesion in patient with acute myocardial infarction. Therefore, it is important to identify the culprit lesion. We report two cases of myocardial infarction with concurrent chronic total occlusion in an emergency setting.
Emergencies* ; Humans ; Mortality ; Myocardial Infarction* ; Percutaneous Coronary Intervention*

BACKGROUND: Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. However, nearly 50% of patients suffering inferior infarction will have complications such as heart block, concomitant precordial ST-segment depression and right ventricular infarction or distinguishing features associated with an increased mortality that will substantially alter an otherwise favorable prognosis. METHODS: Clinical characteristics, electrocardiograms, and angiographic findings of coronary artery were viewed in 47 patients with inferior myocardial infarction. Significant ST-segment change was defined as > or =0.1mV horizontal or down sloping depression in acute inferior myocardial infarction patients with ST-segment elevation on leads II, III, aVF measured with reference to the TP segment, 80ms after J point. A group=no precordial ST-segment depression. B group=sum of ST-segment depression in leads V1 to V3 equal to or more than the sum of ST-segment depression in leads V4 to V6. C group=maximal precordial ST-segment depression in leads V4 to V6. RESULTS: 1) Incidence of multi-vessel disease in group A and in group B were 23% and 22%, respectively, compared with 60% for those of group C(p<0.05). 2) Incidence of Killip class III and IV rates in patients with group A and B were 8% and 12%, respectivly, compared with 47% for those patients with group C(p<0.05). 3) No significant difference of sex, age, peak CK level were found among three groups(p>0.05). CONCLUSION: The patients with acute inferior myocardial infarction with the maximal ST-segment depression in leads V4 to V6 would be at high risk for congestive heart failure and multi-vessel disease.
Coronary Vessels ; Depression* ; Electrocardiography ; Heart Block ; Heart Failure ; Humans ; Incidence ; Infarction ; Inferior Wall Myocardial Infarction* ; Mortality ; Myocardial Infarction ; Prognosis

PURPOSE: Right ventricular (RV) infarction is associated with increased morbidity and mortality in patients with acute inferior wall myocardial infarction (MI). A 12-lead electrocardiogram (ECG) has a poor tendency to identify RV involvement. Our objective was to evaluate the diagnostic accuracy of 80-lead body surface mapping (BSM) for RV infarction and to compare diagnostic accuracy of 12-lead ECG criteria and 80-lead BSM for RV infarction in patients with acute inferior wall MI. METHODS: Between September 2002 and January 2003, 96 patients visited to our emergency center with AMI. All standard initial 12-lead ECG and 80-lead BSM were examined and compared with angiographic and echocardiographic findings. RESULTS: Thirty-one patients were confirmed as inferior wall MI. With the use of exclusion criteria, sixteen patients included in this study. RV infarction accompanied in 5 patients of these 16 patients. BSM showed a high sensitivity (60%), specificity (82%), high positive and negative predictive values (60%, and 82%, respectively), and high diagnostic accuracy (75%) in diagnosing RV infarction in patients with acute inferior wall MI. BSM showed increase in the sensitivity for RV infarction from 40% to 60% when compared with the 12-lead ECG. CONCLUSION: The 80-lead BSM is a more useful test in diagnosing RV infarction in patients with acute inferior wall
Body Surface Potential Mapping* ; Echocardiography ; Electrocardiography* ; Emergencies ; Heart Ventricles ; Humans ; Infarction ; Inferior Wall Myocardial Infarction ; Mortality ; Myocardial Infarction* ; Sensitivity and Specificity