Comparison of in Hospital Outcome of Patients with and without Distorted Terminal Portion of QRS Complex on Initial Electrocardiogram in ST Segment Elevation Myocardial Infarction

Abstract

Introduction:Ischaemic heart diseases is a global health burden including Bangladesh and one of the major cause of mortality and morbidity. In a study of WHO non communicable diseases country profile, 2014 showed 17% death was due to cardiovascular diseases 1 . For a long time the 12-lead electrocardiogram (ECG) is considered an essential part of the diagnosis and initial evaluation of patients with chest pain 2 . ECG reflects the physiology of the myocardium during acute ischaemia, where as the coronary angiography identifies vessel anatomy 3 . For this reason, coronary angiography remains the "gold standard" for identifying the infarct related artery and the ECG remains the gold standard for identifying the presence and location of acute myocardial infarction 3 . Patients presenting with STEMI requiring risk assessment shortly after admission, when only history, physical examination and the ECG are available 4 . The purpose of this study was to analyse admission ECG in patients of STEMI based on terminal portion of QRS complex and find out inhospital death, heart failure, cardiogenic shock and recurrent MI. This study provide information regarding prognostic value of interpretation of ECG. With this cost effective and easily available diagnostic tool, we can easily predict the outcome of patient and help in early referral, follow up and decision regarding early myocardial revascularization in patient with STEMI. Thus improve overall approach of management of the patients and prevent early cardiac death. Methods:Patients: This observational prospective study was conducted in BSMMU during the period of July 2014 to June 2015. We studied 60 patients of STEMI admitted within 12 hours of onset of chest pain which lasted for at