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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

PREVENTION OF HEART FAILURE IN ACUTE MYOCARDIAL INFARCTION
.A. Arslanagić, Ž. Raić and H. Čengić
Clinic for Heart Diseases and Rheumatism, Clinical Centre University of Sarajevo, Bosnia and Herzegovina

Acute myocardial infarction frequently causes heart failure due to systolic dysfunction of left ventricle. Large infarcions and those lead to AV conduction disturbances or frequent ventricular premature complexes, single or multiple, also lead to heart failure. That's why attempt to reduce size of actual infarction is essential, with fibrinolitic therapy or with dilatation of ocluded vessel with catheter, to obtaine reperfusion as soon as possible. That procedures decreases risk of death and heart failure. Then, ACE inhibitors or beta blockers, and in clinically severe failure diuretics were given. In first 3.5 months, on Coronary Unit on our clinic 285 patients were recived. 180 patients had acute myocardial infarction within 12 hours of beginning of symptoms and other were recived later in course of infarcion, acute heart failure, first or prolonged cardiac chest pain, severe rhythm disturbances, subacute infarction, or immidiate after PTCA after significant stenosis found on previous coronarography. 45 patients were recived within 3 hours of beginning of symptoms, 39 patients recived Streptokinasie by our protocol: 1 500 000 I.U. with 200 ccm of saline I.V. during 60 minutes. All patients recived Aspirin 100 mg to 300 mg first day, continued with 100 mg/day. 6 patients did not recive fibrinolytic treatment: 2 with extremly high blood pressure, 2 in dolorous phase of duodenal ulcer, 2 because of age. No one patient underwent dilatation because in acute myocardial infarction that procedure is not performing interventionally on our clinic. Hospital period of 39 patients was followed. Three patients had signs of heart failure, one patient died, two patients had signs of heart failure, dissmised after recompensation. In this group 7.7% patients were with heart failure. All patients recived ACE inhibitor (Lizinopril 2.5 mg to 10 mg daily). Occasionally we applied diuretics (Furosemid). 8 patients recived Atenolol 25 mg/day. 135 patients with acute myocardial infarction did not recive Streptokinase because they came late in Coronary Unit. Those patients recived Heparin, Aspirin 100 mg/day, ACE inhibitors and nitrates. 26 patients had signs of heart failure during hospitalisation (19.2%). We concluded that patients with myocardial infarction sholud come to Coronary Unit as soon as possible and recive fibrinolytic treatment what reduce percent of heart failures.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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