MYOCARDIAL INFARCTION IN PATIENTS WITH EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Tarek Dabash* and Ramadan Shawki**
Departments of Cardiology* and Chest Disease**
Faculty of Medicine, Al-Azhar University
Background: Exacerbation of chronic obstructive pulmonary disease (COPD) is a challenging health problem worldwide and usually associated with cardiovascular morbidity and mortality. Aim of the study: To estimate the incidence of myocardial infarction (MI) in patients with acute exacerbations of COPD and to investigate clinical and laboratory patterns of such patients. Patients and Methods: The present work included 184 patients with acute exacerbations of COPD and 200 control subjects. All were submitted to history taking, clinical examination examination, electrocardiogram (ECG) and laboratory investigations especially cardiac troponin. Results: MI was significantly increased in patients with exacerbations of COPD (9.8%) when compared to control subjects (1.5%). Patients in exacerbations group had significantly increased risk factors such as smoking, hypertension and diabetes. Spirometry confirmed the limitations of airflow in exacerbations group. Cardiac troponin was significantly increased in COPD group and in subjects developed MI. Cardiac troponin, sinus tachycardia, p pulmonale are predictors of acute MI in patients with exacerbations of COPD. Conclusion: About 10% of patients with exacerbations of COPD developed acute MI. Cardiac troponin and ECG changes are good predictors for occurrence of MI.