Abstract

Introduction: Ischaemic Heart Diseases are becoming progressively commoner in the younger persons of third and fourth decade. A massive rise in the levels of SGOT, LDH, CPK, during myocardial infarction suggest large infarct with poor prognosis. Earlier and rapid fall in the pseudocholinesterase level may have a poor prognosis.

Aims and Objectives: To Study incidence, levels and patterns of Pseudocholinesterase Activity In Acute Myocardial Infarction.

Material and Methods: 75 subjects were included in the study. 25 cases were controls and 50 cases were patients of Acute Myocardial Infarction admitted within 48 hours of onset of Acute Chest Pain in Intensive Coronary Care Unit of Department of Medicine. Out of 50, 44 were confirmed (34 complicated and 10 uncomplicated) and 6 were provisional cases. Subjects were studied for incidence, levels and pattern of pseudochlinesterase activity and data collected were analysed statistically.

Results and Observations: 1).The normal value of pseudocholinesterase activity ranged from 138.74 to 302.70 µmol/ml (mean value of 192.78 ± 46.64). 2). All 44 (100%) confirmed cases and 4 (66.66%) out of 6 provisional cases of acute myocardial infarction had significant fall in the values of pseudocholinesterase activity at one or other time during the study period. 3). Levels of pseudocholinesterase started falling after 12 hours of chest pain in all 44 confirmed cases and 4 provisional cases. Lowest values were seen in 22 (59.46%) out of 37 cases on 1st day, 17 (39. 53%) out of 43 cases on 2nd day and 5 (11.9%) cases on 3rd day. Levels started rising thereafter and minimum normal values were attained on7th day. Mean lowest value was 80.50±34.59.4). Mean lowest value in complicated group was 73.94 ±34.07 while in uncomplicated group it was 96.99 ± 16.53 (P<.01). Lowest values in complicated and uncomplicated groups were seen on 1st and 2nd day respectively. 5). The mean value in complicated group (73.94 ± 34.07, 77.97 ± 20.00 and 92.48 + 20.88 on 1st, 2nd and 3rd day respectively) was much lower than uncomplicated group (104.28 ± 26.18, 96.99 ± 16.53 and 120.21 ± 22.97 on, 1st, 2nd and 3rd day respectively) following myocardial infarction (P < .00l). 6). 3 (75%) out of 4 cases who expired had lowest value of pseudocholinesterase activity on the day of death.

Conclusion: In myocardial infarction, earlier and rapid fall in the pseudocholinesterase level may have a poor prognosis, a persistent low level in patients having complication may be a grave prognosticsign.

Keywords: Ischaemic Heart Diseases, pseudocholinesterase activity.