Myocardial infarction: Analysis and diagnosis

Aims: Acute Myocardial infarction (AMI) occurs during the period when circulation to a region of the heart is obstructed and necrosis ensues. The objective of this study was to analyze the various risk factors associated with AMI and estimate the levels of serum myoglobin and enzymes as cardiac marker for diagnosis of early myocardial Infarction.Methods: This study was conducted at Cardiac Care Center, wherein 183 patients suffering from chest pain were admitted and were taken immediately to Coronary Care Unit (CCU). Twenty five apparently healthy subjects were enrolled as control. The age ranged between 39-60 years. ECG, blood biochemistry and medical history of all the subjects under study was recorded including age, level of education, diabeties, hypertension, mental stress, physical exertion, psychological condition, patient history of MI, family history of MI and sudden death due to MI, time of onset of chest pain, smoking habits and ECG findings. Blood samples were collected for the estimation of myoglobin using fully automatic immunoanalyzer and cardiac marker enzymes were measured using spectrophotometer. Results: It was found that the major risk factor for AMI was smoking (74% of patients), followed by hypertension (60%) and diabetes mellitus (56%). Medical history of the patient’s family had an effect of upto 54% of the total enrolled patients for AMI. Physical exertion was noticed as one of the causes for AMI (46%). The incidence of myocardial infarction declined with increasing level of education over weight (70-90 kgs) was yet another contributing factor for AMI. Persons in the age group of 51-60 showed an increased incidence of AMI. Lipid profile including cholesterol, TAG, LDL-cholesterol was higher in the patients with myocardial infarction and HDL-cholesterol was much lower in patients as compared to control. Among the biochemical parameters mycoglobin showed a marked increase within six hours after onset of MI, followed by CK-MB and LDH, whereas AST and CK were not of diagnostic importance.Conclusion: This study indicated that smoking is the major contributing factor for AMI. Myoglobin and CK-MB are more sensitive cardiac markers compared to total CK, LDH and AST for the diagnosis of Myocardial Infarction. Key words: Acute myocardial infarction, myoglobin, Creatine kinase, Lactate dehydrogenase, Aspartate transaminase.