Clinical features of acute myocardial infarction in patients with cor pulmonale

Objective

To investigate the clinical features of acute myocardial infarction (AMI) in patients with cor pulmonale.

Methods

Manifestations of AMI in 30 patients with cor pulmonale (observation group) was compared with that of 171 patients with AMI only (control group).

Results

There were more smokers in the observation group than in the control group (60.0% vs 35.1%, P < 0.05). The incidence of chest pain in observation group was significantly lower than that in the control group (16.7% vs 43.9%, P < 0.001), but the incidence of dyspnoea was significantly higher than that in the control group (50.0% vs 16.4%, P < 0.001). The serum albumin and ferrohemoglobin were lower in the observation group than those in the control group (33.2 ± 9.1 vs 37.8 ± 6.0 g/l, P < 0.01 and 127.2 ± 18.9 vs 134.9 ± 17.7 g/l, P < 0.05, respectively). Acute pulmonary edema was more common in the observation group than those in the control group (46.7% vs 22.2%, P < 0.01). Of 30 patients in the observation group 33.3% were accompanied with serious lung infection but only 8.8% in the control group. The mortality in the observation group was higher than that in the control group (23.3% vs 13.5%, P = 0.161), but there was no statistically significant difference between the two groups.

Conclusions

Infection, anemia and hypoproteinemia are important precipitating factors in acute myocardial infarction characteristic of painlessness in patients with cor pulmonale. Acute left ventricular failure can be the initial symptoms of AMI in patients with cor pulmonale. Because of its high mortality and poor prognosis, more attention should be paid to these symptoms.