Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Abstract

BackgroundIncidence and prevalence of non-communicable diseases, including ischaemic heart disease (IHD) and associated acute myocardial infarction (AMI), are increasing in South Africa. Local studies are needed as contextual factors, such as healthcare systems, gender and ethnicity, may affect presentation and management. In AMI, reviews on time between onset of chest pain and initiation of urgent treatment are useful, as delays in initiation of thrombolytic treatment significantly increase morbidity and mortality.AimThe aim of the study was to determine the profile and management of patients admitted with ischaemic chest pain.SettingThe study was carried out in a busy urban-based district hospital in KwaZulu-Natal, South Africa. The population served is poor, and patients are mainly Indian with associated high risk of IHD.MethodsA chart review of all patients seen at the hospital with acute ischaemic chest pain between 01 March and 31 August 2014 was undertaken.ResultsMore male than female patients were admitted, with a wide variation in age. Most eligible patients received required thrombolytic intervention within an acceptable time period after arrival at hospital.ConclusionChest pain and AMI were a relatively common presentation at the study site, and urgent diagnosis and initiation of fibrinolytic therapy are essential. The encouraging door-to-needle time may have been influenced by the availability of specialist family physicians, trained as ‘expert generalists’ to provide appropriate care in a variety of settings and consultant support to junior staff. The role of the family physician and primary healthcare doctor in primary prevention are re-emphasised through the study findings.

Acute Coronary Syndromes in Sub‐Saharan Africa: A 10‐Year Systematic Review

“…Table 1 summarizes the characteristics of the 27 studies. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 In 6 studies, the patients included were exclusively STEMI. 15 , 19 , 29 , 34 , 35 , 37 Table S3 show the 12 studies including patients hospitalized for MI.…”

“…The clinical presentation of ACS is dominated by STEMI in most studies, as in Côte d'Ivoire 27 and Kenya 23 with 71.5% and 57.1%, respectively, but it was found in lower proportions in South Africa (41.1%). 38 Percutaneous coronary interventions (PCI) were performed in South Africa, 25 , 29 , 32 , 37 , 38 Kenya, 21 , 23 , 26 , 36 Côte d'Ivoire, 15 , 18 , 24 , 27 Sudan, 28 and Mauritania. 17 Fibrinolysis was the most widely reported and available means of revascularization in most of our studies (18/27 or 66.7%).…”

“…17 Fibrinolysis was the most widely reported and available means of revascularization in most of our studies (18/27 or 66.7%). 16 , 17 , 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 34 , 35 , 36 , 37 , 38 …”

“…In STEMI, the reported mortality was very low, varying from 1.2% to 1.8% of patients who underwent primary PCI 15 or early thrombolysis (median admission‐fibrinolysis time of 45 minutes). 25 …”

Lipid profiles of patients presenting with acute myocardial infarction in a South African regional hospital

“…Hyperlipidaemia, hypertension and cigarette smoking together, are associated with a 7-fold increase risk for ACS. (14) (15,16) In our study, hyperlipidaemia was the most prevalent risk factor, with 87.3% of all cases having abnormal lipid profiles. We found no gender predisposition for hyperlipidaemia.…”