Course of patients discharged early after myocardial infarction.

Gelson, A.; Carson, P; Tucker, Helen; Phillips, R. J. W.; Clarke, Malcolm; Oakley, G. D. G.

doi:10.1136/bmj.1.6025.1555

Cited by 20 publications

(3 citation statements)

References 12 publications

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“…On the morning of discharge (0900 to 1400 hours) the mean grade 225 2I00 1-75j w 1.50 ṽ 125 1-00 0.75 was higher (1-31 +0418) than in the hospital recordings (1-00 ±0416; p <0-05) but was lower than in the equivalent period of the home recording (1-81±0-18; p<0-005). After discharge (1400 to 0900 hours) the mean grade of ventricular arrhythmias in the peri-discharge recording (1-46+0-09) continued to be higher than in the hospital recording 9 (0.96 ±008; p < 0-001) but was similar to that seen in the later home recording (1.59 ±009; p > 0 05) (Fig. 5).…”

Section: Recordingsmentioning

confidence: 57%

Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

Morrison¹,

Kumar²,

Portal³

et al. 1981

Heart

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SUMMARYThe cardiac rate and rhythm were studied by 24-hour ambulatory electrocardiographic recording in 44 patients before, during, and after being discharged from hospital following an acute myocardial infarction. The first recordings were started 48 hours before discharge, the second on the morning of the day of discharge, and the third 48 hours after discharge (at home). While in hospital and after returning home the heart rate fell during sleep but there was no diurnal variation in the frequency of ventricular extrasystoles. Daytime heart rate and both the frequency and grade (severity) of ventricular arrhythmias were significantly raised 48 hours after discharge. The frequency of ventricular extrasystoles during sleep was also increased in the 48 hours post-discharge recording. Rises in heart rate and frequency and severity of ventricular extrasystoles were observed on the morning ofthe day of discharge, increasing up to the time of leaving hospital, but during the journey home they all diminished. No relation was found between ventricular arrhythmias during early convalescence and (i) ventricular arrhytbmias during the acute phase of acute myocardial infarction (including ventricular fibrillation); (ii) peak aspartate aminotransferase; (iii) the level of anxiety; or (iv) the personality type. Six patients taking beta-blocking drugs behaved similarly. Five patients taking anxiolytic drugs had significantly raised frequency of ventricular extrasystoles during each 24-hour electrocardiogram.In spite ofthe above findings, at the time ofleaving hospital after acute myocardial infarction there does not appear to be a serious risk from the development of major cardiac arrhythmias.The acute phase of myocardial infarction may be complicated by sudden arrhythmic death, often preceded by "warning" ventricular arrhythmias.' 2 Less attention has been given to the convalescent phase of acute myocardial infarction, though patients remain at risk from serious cardiac arrhythmias and sudden death.3-8 Some patients die within weeks of discharge from hospital9 10 and a relation has been observed between early post-hospital death and the occurrence of arrhythmias while in hospital8 11 12 On the day of discharge from hospital there might be heightened stress13 and a corresponding increased incidence of, and risk from, arrhythmias.'4This study was therefore designed to determine whether hospital discharge was associated with increased ventricular arrhythmias.

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Section: Recordingsmentioning

confidence: 57%

Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

Morrison¹,

Kumar²,

Portal³

et al. 1981

Heart

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show abstract

“…Their in-hospital mor tality was from 10 to 18% depending on whether the patient was without or with pul monary edema respectively and 70% in pa tients with hypotension and shock. Gelson et al [13] reported an in-hospital mortality of 15% amongst males with AMI and the mean age of their series was 56.9 years.…”

Section: Discussionmentioning

confidence: 99%

Lymphocyte Potassium and Magnesium Concentrations as Prognostic Factors after Acute Myocardial Infarction

Abraham¹,

Rosenmann²,

Zion³

et al. 1988

Cardiology

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215 patients admitted with acute myocardial infarction were prospectively evaluated for prognostic factors. When lymphocyte potassium concentration increased by up to twofold of normal, a high lymphocyte magnesium concentration was associated with a good prognosis. However, when the increase in lymphocyte potassium concentration was greater than twofold, the presence of a high lymphocyte magnesium made no difference to mortality. Age, the female sex, anterior wall infarction, high serum enzymes, heart failure, diabetes mellitus in females and serious arrhythmias were all bad prognostic signs.

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“…Thus, 62% could be discharged in accordance with the original plans. In previous studies with 7-9 days' hospital treatment, the corresponding proportion of uncomplicated infarctions has varied between 49 and 76 % (5,7,9). One patient in the 8-day group died on the fourth day and it is difficult to judge whether or not this death could have been prevented by a longer period of bed-rest.…”

Section: Discussionmentioning

confidence: 96%

A Controlled Study of Early Discharge after Uncomplicated Myocardial Infarction

Ahlmark

Ahlberg

Saetre

et al. 1979

Journal of Internal Medicine

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Out of 383 myocardial infarction (MI) patients aged below 70 years, 252 (66%) were judged after the third day in hospital to have had uncomplicated infarctions. These patients were allocated at random to two groups, one of which was given treatment for 8 days and the other for 15 days. No significant differences in mortality, morbidity or incapacity for work could be detected during the three‐month period of follow‐up. The findings thus support previous conclusions that early discharge from hospital after uncomplicated MI is not associated with greater risk for the patient than later discharge.

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Course of patients discharged early after myocardial infarction.

Abstract: SummaryTwo hundred and seventy-one (76",,)

Cited by 20 publications

References 12 publications

Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

Cardiac arrhythmias 48 hours before, during, and 48 hours after discharge from hospital following acute myocardial infarction.

Lymphocyte Potassium and Magnesium Concentrations as Prognostic Factors after Acute Myocardial Infarction

A Controlled Study of Early Discharge after Uncomplicated Myocardial Infarction

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