심근 경색증은 주로 중년기 이후에 반발하는 심장질환으로 구미에서는 발생빈도가 매우 높으며 단독 질환으로 가장 높은 사망률을 보이고 있다. 최근 우리나라에서도 급성 심근 경색증의 발생빈도가 증가하는 경향이 있고 급사의 상당부분이 이로 인한 것으로 생각된다. 이에 저자는 1972년부터 1976년까지 연세 대학교 부속 세브란스병원에 입원하였던 급성심근경색증환자 102예에 대한 임상적 관찰을 하여 다음과 같은 성적을 얻었다.
1. 총 102예중 남자 84예 여자 18예로 남녀비는 4.5:1이었고 50대가 가장 많았으며 855가 40∼69세 사이였고 평균연령은 57세였다.
8. 급성 심근 경색증의 치료도중 발견된 부정맥은 심실성기의 수축이 가장 많았고, 심방세농, 동성서맥의 순이었으며 총예중 49%에서 부정맥을 발견할 수 있었다.
9. 급성 심근 경색증의 치료도중 발견된 전도장애는 총예중 26.5%에서 발견할 수 있었으며 특히 전하벽 경색에서 높은 율로 발견되었다.
[영문]
A retrospective clinical study was done on 102 cases of acute myocardial infarction admitted to Severance Hospital from January 1972 to December 1976.The
The following results have been obtained :
1. The ratio of male to female was 4.5:1. Most patients were in the age group between the fourth and sixth decades(85%) and the average age was 57 years.
2. The most common preceding fisk factor was hypertension(37.3%). Then, diabetes, angina pectoris and previous myocardial infarction were common in the order named.
3. The number of patients admitted annually increased marrkedly in 1970's as compared with 1960's.
4. The mortality rate of 102 cases with acute myocardial infarction was 18.6%(19cases).
5. The time lapsed between the onset of symptoms and admission to the hospital seems to be an important determinant of the outcome in acute myocardial infarction.
Twenty one patients were admitted within 4 hours after onset of symptoms, and eight of them died with a mortality of 38.1%. The mortality rate declines rapidly with larger delays of admission from the time of onset.
6. The most common cause of death was cardiogenic shock. Sudden cardiac arrest, congestive heart failure and ventricular tachycardia were found in the order named.
7. The anterior wall infarction was 63.7% of all cases, inferior wall 21.6%, anterior-inferior wall 9.8% and posterior wall 2.0%.
8. Arrhythmias were found in 49% and conduction disturbances in 26.5% of all cases of acute myocardial infarction.
9. In view of the proven usefulness of coronary care units for early detection, prevention and treatment of arrythmias, it would be desirable to set up at least one coronary care unit in Seoul, Korea.