Key result
Atypical clinical forms of acute myocardium infarction occurred in 18.7% of patients and were associated with high lethality, reaching 100% in arrhythmic and cerebral forms.
Observational (n=836)
Atypical presentations of acute myocardial infarction occur in nearly 20% of patients, predominantly in older individuals, and are associated with delayed diagnosis and extremely high mortality.
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Requires vigilance for atypical AMI presentations given high lethality; leaves open whether targeted diagnostics improve outcomes in prospective studies.
Purpose of study. To investigate age gender and clinical anamnestic characteristics of patients with atypical clinical forms of acute myocardium infarction.Materials and methods. The study was based on data of the WHO programs “The register of acute myocardium infarction”. The analysis comprised 836 cases of acute myocardium infarction. The atypical clinical forms of acute myocardium infarction were detected in 184 patients (18.7%). In the structure of atypical clinical forms of acute myocardium infarction the following alternatives were appropriated: asthmatic (32,6%), collaptoid (31,5%), abdominal (13.6%), arrhythmic (7.6%), peripheral (5.4%)б painless (4.9%) and cerebral (4.3%).Results of study. The most of the males (62.5%) found themselves in the group of patients with abdominal form of acute myocardium infarction and most of the females in the group with cerebral form of acute myocardium infarction. In all analyzed groups the individuals older than 60 years prevailed. In the group of patients with cerebral form were most of the individuals underwent earlier acute myocardium infarction (50.0%). The diabetes mellitus most frequently was registered in individuals with painless acute myocardium infarction (55.5%). In all cases, course of acute myocardium infarction was complicated. Under atypical clinical forms of acute myocardium infarction higher lethality was registered and in groups with arrhythmic and cerebral forms it reached 100%.The conclusion. The whole group of patients with atypical clinical forms of acute myocardium infarction was presented by over-age contingent, severe in clinical, anamnestic and prognostic layouts. The unsatisfactory diagnostic of atypical clinical forms of acute myocardium infarction resulted in higher lethality of the given group of patients. With regard to that a general tendency of alteration of age structure of population of Russia is a steady increasing of percentage of individuals of older age groups t5he rate of occurrence of atypical clinical forms of acute myocardium infarction will regularly increase.
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Округин et al. (2017) conducted an observational in Acute myocardium infarction (n=836). Atypical clinical forms of acute myocardium infarction vs. Typical clinical forms of acute myocardium infarction was evaluated on Lethality. Atypical clinical forms of acute myocardium infarction occurred in 18.7% of patients and were associated with high lethality, reaching 100% in arrhythmic and cerebral forms.
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