Emergency Medicine

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Browsing Emergency Medicine by Subject "Acute Coronary syndrome"

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    Clinical features and outcome of acute Coronary syndrome in patients presenting to the emergency departments in Addis Abeba, Ethiopia.
    (Addis Abeba University, 2019-08) Dr.Wakwaya, Rediet; Prof.Azazh, Aklilu(Internist and Professor of emergency and critical care); Dr.Worku, Tigist(Assistant professor of emergency and critical care)
    AIM: To assess the clinical features, identify risk factors; describe the management and outcome of patients who present with ACS in EDs in Addis, Ababa, Ethiopia METHODS: A multicentre prospective cross-sectional study was carried out from September 21, 2018 to July 1, 2019 among patients >18 years old presenting to the ED with ACS. RESULTS: 40 patients were enrolled during the study period. Majority of them were males (72.5%). The average age of patients affected is 58.03 + 11.831 years. The commonest presentations were easy fatigability (92.5%) followed by chest pain and diaphoresis 77.5%. Of those who had chest pain, most (45%) expressed it as squeezing and severe in quality (40%). 65% had radiation mostly to the arms(35%) followed by the shoulder(27.5%).The mean duration of illness prior to presentation to the ED of the study area was 4.41+2.83. The commonest risk factors identified were hypertension (60%) and type 2 DM (57.5%). STEMI was the major type of MI identified (67.5%) with 30% in Killip class I. NSTEMI was seen in 17.5% and Unstable angina in 15%. Heart failure was the commonest complication at presentation. The commonest echocardiography finding was wall hypokinesis (67.5%) followed by decreased Ejection fraction (37.5%). Patients with STEMI had higher increase in the cardiac markers than NSTEMI. None of the patients received thrombolytics/fibrinolytics. PCI was done for 42.5% with only 15% done as primary PCI. Most patients (70%) stayed in the ED for more than 24 hours up to 7days. Death within 7 days of admission to the hospital while in patient occurred in 10%. The live discharge rate was 90%. CONCLUSION: Patients present very late to the Emergency department; most of them with STEMI with heart failure as the commonest complication upon presentation. They then stay in the emergency department for prolonged period of time in limited technical facilities which pose major difficulties of their management and subsequently poorer quality of life.