DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20221036
Published: 2022-04-22

A study of serum sodium and potassium levels in subjects of acute myocardial infarction in a tertiary care hospital in Eastern India

Siladitya Das, Satyendra Nath Saha

Abstract


Background: Cardiovascular disease is one of the most common causes of morbidity and mortality around the world. In countries like India, there is difference in the lifestyle and behavioural risk factors among different areas. There is existence of rural-urban, Eastern-Western-Northern-Southern zonal differences. Studies done in other parts of India may not completely be applicable to Eastern Indian population. Serum electrolytes play an important role in maintaining electrophysiological homeostasis of the myocardial membrane, and alterations of these electrolyte levels can affect the pathogenesis, complications of myocardial infarction. Major serum electrolytes affecting the myocardial electrophysiological properties are sodium, potassium. Hence, this study was undertaken keeping in mind the miniscule lacunae in current knowledge especially pertaining to diseases in Eastern Indian population.

Methods: 50 consecutive patients in the age group of 30-70 years admitted in the medicine department of Burdwan medical college with recent onset acute chest pain, diagnosed to be acute myocardial infarction were taken, their serum sodium, potassium levels were determined and these levels were compared among these patients with and without risk factors.

Results: Serum sodium was decreased among patients with history of smoking, hypertension, BMI ≥25, complicated by atrial fibrillations. Serum potassium was decreased in patients with hypertension, BMI ≥25, ventricular premature complexes and increased in smokers, alcoholics.

Conclusions: Electrolyte imbalances are common in patients of Acute Myocardial Infarction. Hypokalemia and hyponatremia were present and they were associated with cardiac complications. They adversely affect prognosis, so should be corrected.


Keywords


Acute myocardial infarction, Serum electrolytes, Serum sodium levels, Serum potassium levels

Full Text:

PDF

References


Cannon CP, Braunwald E. Unstable angina and non st-segment elevation myocardial infarction. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012.

Thygesen K, Alpert JS, White HD, Jaffe AS, Apple FS, Galvani M, et al. Universal definition of myocardial infarction. Eur Heart J. 2007;28(20):2525-38.

Hygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction. Circulation. 2018;138(20): e618-51.

Hosenfuss G, Mann DL. Pathophysiology of Heart Failure. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E eds. A Textbook of Cardiovascular Medicine. 11th ed. Amsterdam: Elsevier; 2016:442-60.

Schaller MD, Nussberger J, Feihl F, Waeber B, Brunner HR, Perret C, et al. Clinical and hemodynamic correlates of elevated plasma arginine vasopressin after acute myocardial infarction. Am J Cardiol. 1987;60:1178-80.

Hariprasad S, Basavaraj M. Electrolyte disfunction in myocardial infarction patients. Int J Adv Med. 2018; 5:1172-6.

Madias JE, Shah B, Chintalapally G, Chalavarya G, Madias NE. Admission serum potassium in patients with acute myocardial infarction: its correlates and value as a determinant of in hospital outcomes. Chest 2000;118(4):904-13.

Goldberg A, Hammerman H, Petcherski S, Zdorovyak A, Yalonetsky S, Kapeliovich M , et al. Prognostic importance of hyponatremia in acute ST elevation myocardial infarction. The Am J Med. 2004;117:242-8.

Skogestad J, Aronsen JM. Hypokalemia induced arrhythmias and heart failure:new insights and implications for therapy. Front Physiol. 2018;9:1500.

Ovbiagele B, Markovic D, Fonarowet GC. Recent US patterns and predictors of prevalent diabetes among Acute myocardial infarction patients. Cardiol Res Pract. 2011;145615.

Nathan DM, Genuth S, Lachin J.The effect of intensive treatment of diabetes on development and progression of long term complications in insulin dependant diabetes mellitus. N Engl J Med. 1993; 329:977-86.

Shah PKD, Saxena M, Khangarot D, Banerji K. Sudy of serum sodium in myocardial infarction and its relation to severity and complications. JPI J Assoc Physic. 1986;34(3):195-6.

Flear CTG, Hilton P. Hyponatremia and severity and outcome of myocardial infarction. Br Med J. 1979;1(6173):1242-6.

Wali V, Yatiraj S. Study of serum sodium and potassium in acute myocardial infarction. J Clin Diag Res. 2014;8(11):CC07-9.

Cavusoglu Y, Kaya H, Eraslan S, Yilmaz MB. Hyponatremia is associated with occurrence of atrial fibrillation in outpatients with heart failure and reduced ejection fraction. Hellenic J Cardiol. 2019; 60(2):117-21.

Wannamethee SG, Lever AF, Shaper AG, Whincup PH. Serum potassium, cigarette smoking and mortality in middle aged men. Am J Epidemiol. 1997; 145(7):598-606.

Ikram H, Espiner EA, Nicholis MG. Diuretics potassium and arrythmias in hypertensive coronary disease. Drugs.1986;31(4):101-8.

Foo K, Sekhri N, Deaner A, Knight C, Suliman A, Ranjadayalan K, et al. Effect of diabetes on serum potassium concentrations in acute coronary syndromes. Heart. 2003;89(1):31-5.

Solomon RJ, Cole AG. Importance of potassium in patients with acute myocardial infarction. Acta Medica Scand. 1981;647:87-93.