Management of acute myocardial infarction in general medical wards in Sri Lanka
G R Constantine, J I P Herath, A A P T Chang, P Suganthan, B S L Hewamane, P N Thenabadu
National Hospital
of Sri Lanka, Colombo, Sri Lanka
Correspondence to: GR Constantine, 21/4, First Lane Kirullapone, Colombo 5, Sri Lanka
Accepted 23 June 1999
The study was designed to evaluate the management of acute
myocardial infarction in the general medical wards of the National Hospital of Sri Lanka. All patients with acute myocardial infarction admitted from September 1996 to August 1997, were evaluated with regard
to the time delay in admission and drug treatment. The facilities for
monitoring and resuscitation were also assessed. A total of 259 patients were included in the study, 173 males and 86 females. The
median time delay from the onset of the pain to admission at the
out-patients department was 12 hours and that between out-patients
department admission and ward admission was 20 minutes. The median
delay in obtaining a 12-lead electrocardiogram when the patient was in
the ward was 90 minutes. Review of the data showed that thrombolytic
therapy, beta-blockers and angiotensin-converting enzyme inhibitors are
underused. Complications were common. All the medical wards had
adequate monitoring and resuscitation facilities. With adequate
training of doctors and the availability of specialised cardiac nurses,
thrombolytic therapy can be used effectively in medical wards.
Keywords: myocardial infarction; Sri Lanka; thrombolysis
© 1999 by The Fellowship of Postgraduate Medicine
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