INCIDENCE OF MYOCARDIAL INFARCTION AMONG KNOWN PATIENTS OF ISCHEMIC STROKE

Background Acute myocardial infarction in individuals who have had a cerebrovascular accident or transient ischemic attack (CVA-TIA) is a medical emergency, which must be examined and treated as soon as possible. Physicians face a significant problem in managing this scenario because early treatment of one ailment would surely postpone treatment of the other. Early detection and treatment will have an impact on the patient's morbidity and mortality in the future, as well as aid in the patient's rehabilitation.

Objective: To determine the incidence of myocardial infarction among known patients of Ischaemic stroke. Methodology: This prospective observational study was conducted on 103 patients who presented with stroke at the medicine outpatient department of Liaquat University Hospital (Hyderabad). On the basis of ECG alterations and cardiac biomarkers, Myocardial Infarction was diagnosed among patients who presented with altered sensorium. The diagnosis of stroke/TIA was based on the onset of a localized neurological loss that lasted for at least 24 hours (stroke) or recovering earlier (TIA). A CT/MRI scan of the brain was performed for a definitive diagnosis to identify ischemia/hemorrhage as the cause of ischeamic stroke.

Results: According to the age-based distribution, the highest rate of myocardial infarction (8%, 8) was observed in those aged 51-60 years. The male-to-female ratio is 1.86:1. Thirty-two patients had diabetes, among them 75% had only elevated creatine kinase MB (CKMB) with no myocardial infarction (MI), whereas 59 patients had hypertension of which 70% had only elevated CK-MB with no MI. ST-elevation myocardial infarction (STEMI) with high CKMB accounted for 14.78% (15) of the cases, but the majority (71%, 73) of the cases had elevated CKMB with no MI, and the rest presented with normal CKMB.

Conclusion: The study reported that the incidence of MI among patients of Ischaemic Stroke was found to be higher than that of the general population. This finding highlights the need for increased vigilance and monitoring for MI in this patient population. Keywords: Acute Myocardial Infarction, ST-Elevation Myocardial Infarction (STEMI), CK- MB, Transient Ischemic Attacks, Cerebro-Vascular Accident