Blood Glucose Level Determination in Acute Myocardial Infarction

INTRODUCTION: There are different theories regarding the cause of hyperglycaemia associated with infarct ion: (A) Increased adrenocortical hormon production as a response to stress and chest pain which causes increase gluconeogenesis, (B) A circulatory disturbance in the brain with funct ional changes in the hypothalamic region (Roab & Rabinowitz), (C) Hypersecretion of adrenaline due to stress causing mobilization of glycogen, (D) Liver cell necrosis due to shock upsetting CHO metabolism, (E) Suppression of insulin due to reduction in pancreatic blood flow as a conseq uence of Splanchic vaso-constriction following severe left ventricular failure and augmented circulating catacholamines due to high sympathet ic nervous system activity and (F) Recently,it has been suggested that hyperglycaemia is due to pre-existing latent undiagnosed diabetes rather than “Stress Hypergiycaemia”. MATERIAL AND METHODS: In this study a group of 14 consecutive patients with acute myocardial infarction were included, who fulfilled the WHO criteria of AMI. In addition the following requirements were also mandatory:Out of 14 patients only one patisnt developed heart failure and ventricular fibrillation from Group I, who was readmitted for 3 days in CCU and was discharged On 10th day at which time he was fully mobilized. The remaining patients were discharged without any complication on the 7th days. Results are summarized in Figs 1, 2 and 3. DISCUSSION: Many studies have been done on hyper glycaemia following infarction. But no one exact cause of hyperglycaemia is recognized Roab & Rabinowitz (1936) found hyperglycaemia and glycosuria in all 12 cases of AMI studied by them within two weeks of the attack.It must be pointed out that this was a small pilot study and is in no way a large scale definitive study on the various causes or mechanism of post infarction hypergelycaemia. Our purpose was limited only to comparison of I.V dextrose infusion versus simple I.V. heparin lock and blood sugar levels.