500 PATIENTS WITH MYOCARDIAL-INFARCTION MONITORED WITHIN ONE HOUR OF SYMPTOMS
500 PATIENTS WITH MYOCARDIAL-INFARCTION MONITORED WITHIN ONE HOUR OF SYMPTOMS
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DOI：
10.1136/bmj.286.6375.1405
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发表时间：
1983-01-01
影响因子：
105.7
通讯作者：
CHAMBERLAIN, DA
中科院分区：
文献类型：
--
作者：
ODOHERTY, M;TAYLER, DI;CHAMBERLAIN, DA
Of 2886 patients monitored during acute myocardial infarction, 500 were observed within 1 h of the onset of symptoms. Half of the early admission group were admitted in response to emergency 999 calls and 435 of them traveled in resuscitation ambulances, where surveillance for arrhythmias was instituted. Pulmonary edema occurred in 130 patients (26%), cardiogenic shock supervened in 60 (12%) and 115 (23%) died in hospital. Ventricular fibrillation was observed in 98 patients (20%). Of them, 42 survived to be discharged, including 20 of 24 with primary fibrillation which had occurred first in hospital. In only 1 case did primary ventricular fibrillation occur after the 1st 10 h of onset of illness. Sinus bradycardia, atrial fibrillation, ventricular tachycardia and ventricular fibrillation were all observed more frequently in patients admitted within 1 h after the onset of symptoms than in those admitted later. An element of selection is inevitable when early admission is encouraged by the existence of a resuscitation ambulance system; this will depend in part on the early recognition of risk and the geographical location of the attack. These factors may bias the group towards relatively high risk. Prompt admission after myocardial infarction should improve survival by permitting successful management both of ventricular fibrillation and of other arrhythmias which may influence short- and long-term prognoses.
