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Arrhythmia Manifested in the First (48) Hours of Myocardial Infarction

اضطرابات النظم المشاهدة في احتشاء العضلة القلبية خلال اليومين الأوليين

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 Publication date 2014
and research's language is العربية
 Created by Shamra Editor




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This research tries to the rate of arrhythmia manifested during the first (48) hours of heart infarction and define its nature as well as its relationship with heart infarction in regard to patients subjected to anti-coagulation (streptokinase) therapy and patients who were not subjected to it. Moreover, it also aims to detect the relationship between arrhythmia and the death rates of the patients during their stay in the Heart Intensive Care Unit. The study started in October 2012 and lasted twelve months, up to October 2013. The sample of study here consisted of (187) patients hospitalized in the Heart Intensive Care Unit having acute myocardial infarction. The sample included (142) males (76 % of the sample) and (45) females (24%). The research reached the following findings: A hundred and seven of the patients monitored in the study were smokers; and smoking was the most important risk factor causing myocardial infarction. Ventricular extra systole were the most common symptoms of acute myocardiac infarction arrhythmia during the first (48) hours of hospitalization reaching (79%). The second was increased auto ventricular rhythms rating (43 %). High rates of dangerous arrhythmia like (VT) and (VF) rating (9%) in patients who were not subjected to streptokinase (anti-coagulation) compared with those subjected to it (4. 5%), and (3.8) respectively. Decreased (EF) increased the possibility of life-threatening ventricular arrhythmia like (VT). Diabetes did not increase the dangers of arrhythmia monitored in this research

References used
Ventricular arrhythmias after acute myocardial infarction. Mayo Clinic College of Medicine, Rochester, M'1\7. USA - Am Heart J. L006. 151(4). 806-12
RUBERMN W,; WRIBLATT E.; GOLDBERF J.D. 1998- Ventricular Premature Complexes And Sudden Death After Myocardial Infarction. Complexes And Sudden Death After Myocardial Infarction. Circulatio64, 297
MAGGIONL A.P ZUANETTI F.; FRANZOSI M.G.; 1993 – Prevalence And Prognostic Significance Of Vetricular Arrhythmia After Acute Myocardial Infarction In The Thrombolytic Era (GISSI-2) Results Circulation, 87, 312
BERGER C.J MURABITO J. M.; EVENTS J. C.; 1992 – Prognosis After First Myocardial Infarction Comparision of Q- Wave And Non – Q- Wave Myocardil Infarction. Comparision of Q – W ave And Non – Q – W ave Myocardial In The Framingham Heart Study JAMA, 268, 1902
Supraventricular arrhythmias in the late hcspital phase of acute Q- wave myooardial infaration smmventricular arrhythmia in myocardial infarction T. Sugiura, T I wasaka, H Koito Y Kimura, M Inada and D H Spodick Chest 1987;92; 282-286 DOI 10.1378/chest.92.2.282

Artificial intelligence review:
Research summary
تهدف هذه الدراسة إلى تقدير نسبة حدوث اضطرابات النظم خلال الـ 48 ساعة الأولى من احتشاء العضلة القلبية وتحديد نوعها وعلاقتها مع نمط الاحتشاء وموقعه، سواء عند المرضى الذين طبق لهم علاج حال للخثرة أو الذين لم يطبق لديهم، وكذلك تحديد علاقتها مع نسبة الوفيات خلال فترة إقامة هؤلاء المرضى في العناية القلبية المشددة. بدأت الدراسة في أكتوبر 2012 واستمرت لمدة 12 شهراً، وشملت 187 مريضاً، منهم 142 ذكوراً و45 إناثاً. أظهرت النتائج أن التدخين هو العامل الأهم للإصابة باحتشاء العضلة القلبية، وأن خوارج الانقباض البطنية هي أشيع اللانظيمات الحاصلة خلال الـ 48 ساعة الأولى من الاحتشاء. كما بينت الدراسة أن اضطرابات النظم الخطيرة مثل التسرع البطيني والرجفان البطيني كانت أكثر شيوعاً لدى المرضى الذين لم يطبق لهم الستربتوكيناز مقارنة بالذين طبق لهم. وأظهرت الدراسة أيضاً أن الإصابة بالداء السكري لا تزيد من خطورة الإصابة باضطرابات النظم المراقبة في الدراسة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جداً لفهم العلاقة بين اضطرابات النظم واحتشاء العضلة القلبية، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الممكن توسيع عينة الدراسة لتشمل عدد أكبر من المرضى للحصول على نتائج أكثر دقة. ثانياً، لم تتناول الدراسة بشكل كافٍ العوامل البيئية والاجتماعية التي قد تؤثر على نتائجها. ثالثاً، كان من المفيد تضمين تحليل مقارن بين مختلف أنواع العلاجات المتاحة لاحتشاء العضلة القلبية وليس فقط التركيز على الستربتوكيناز. وأخيراً، كان من الممكن تقديم توصيات أكثر تفصيلاً حول كيفية تحسين الرعاية الطبية للمرضى الذين يعانون من احتشاء العضلة القلبية.
Questions related to the research
  1. ما هي النسبة المئوية للمرضى الذين كانوا مدخنين في الدراسة؟

    57% من المرضى كانوا مدخنين.

  2. ما هي أشيع اللانظيمات الحاصلة خلال الـ 48 ساعة الأولى من احتشاء العضلة القلبية؟

    أشيع اللانظيمات هي خوارج الانقباض البطنية بنسبة 79%.

  3. هل يزيد الداء السكري من خطورة الإصابة باضطرابات النظم؟

    لا، الإصابة بالداء السكري لا تزيد من خطورة الإصابة باضطرابات النظم المراقبة في الدراسة.

  4. ما هو تأثير الستربتوكيناز على نسبة حدوث اضطرابات النظم الخطيرة؟

    الستربتوكيناز يقلل من نسبة حدوث اضطرابات النظم الخطيرة مثل التسرع البطيني والرجفان البطيني.

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