title: Management of acute myocardial infarction in the public sector in the Bahamas.
abstract: In 1996 and 1997, 52 patients were admitted to the Princess Margaret Hospital, Nassau, Bahamas, with a confirmed diagnosis of acute myocardial infarction (AMI). The average time to presentation after the onset of symptoms was 18 hours, with 56% of patients presenting within 12 hours. Risk factors identified for ischaemic heart disease were hypertension (77%), obesity (62%), diabetes mellitus (35%), tobacco smoking (25%), a family history of coronary artery disease (17%) and hypercholesterolaemia (8%). Medications administered in the treatment of AMI included oral nitrates (96%), intravenous heparin (90%), beta-blockers (65%), morphine (15%), thrombolytic agents (8%) and lignocaine (4%). In hospital post myocardial infarction complications were angina (23%), arrhythmias (12%) and cardiac failure (10%). The average hospital stay was eight days, with a mortality rate of 19%. These results show that there is considerable room for improvement, particularly in the use of thrombolytic therapy, to ensure that all patients receive optimal acute and post myocardial infarction care.
authors.affiliation: School of Medicine, University of the West Indies, Nassau, Bahamas.
authors.forename: S
authors.initials: S
authors.lastname: Khetan
authors.forename: R
authors.initials: R
authors.lastname: Maharaj
authors.forename: G K
authors.initials: GK
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001444:Bahamas / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D009566:Nitrates / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013997:Time Factors
chemical_list: D005343:Fibrinolytic Agents; D009566:Nitrates