Emergency Complications of Patients with Acute Myocardial Infarction in Babylon Governorate
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Background: Acute myocardial infarction remains a major cause of morbidity and mortality worldwide and is frequently complicated by life-threatening conditions such as arrhythmias, cardiogenic shock, and heart failure. These complications significantly worsen clinical outcomes and increase in-hospital mortality and morbidity. Aim of the Study: To evaluate the incidence, clinical presentation, and management of emergency complications in patients with acute myocardial infarction. Patients and Methods: Prospective observational study conducted at Merjan Teaching Hospital, Shahid Al-Mehrab cardiac center and Al-Sadiq Teaching Hospital in Babil, Iraq, over one year from May 2025 to May 2026 and included 150 patients diagnosed with Acute myocardial infarction. Data were collected using a questionnaire including demographic characteristics, risk factors, clinical presentation, diagnostic findings, complications, management strategies, and outcomes. Statistical analysis was done to identify predictors of complications. Results: The mean age of patients was 61.8 ± 12.4 years, with male predominance (67.3%). Major risk factors included hypertension (55.3%), smoking (51.3%), diabetes mellitus (36.7%), and hyperlipidemia (37.3%). NSTEMI was more frequent (59.3%) than STEMI (40.7%). Complications occurred in 40.7% of patients, with arrhythmias being the most common, particularly premature ventricular contractions (16.7%) and atrial fibrillation (10.7%). Hemodynamic complications included heart failure (15.3%) and cardiogenic shock (12.7%), while mechanical complications were rare. Cardiac arrest occurred in 8.0% of patients, with ventricular fibrillation as the most common rhythm. Reperfusion therapy was achieved in most patients (PCI 52.7%, thrombolysis 38.7%), with a mean door-to-balloon time of 78.3 minutes. In-hospital mortality was 12%, and 71.3% of patients were discharged in stable condition. Independent predictors of complications included diabetes mellitus, family history, previous myocardial infarction, STEMI presentation, delayed presentation, smoking, and reduced ejection fraction. Conclusions: Emergency complications of acute myocardial infarction remain common and are associated with significant morbidity and mortality. Arrhythmias and hemodynamic instability are the most frequent complications. Early presentation, diagnosis, and reperfusion therapy play a crucial role in improving outcomes. Recommendations: Improving public awareness regarding early symptoms of myocardial infarction is essential. Strengthening emergency cardiac care systems and ensuring rapid access to reperfusion therapy are critical with strict control of cardiovascular risk factors such as smoking, diabetes, and hypertension.
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