الفهرس | Only 14 pages are availabe for public view |
Abstract Our present study was planned to determine the site of myocardial lesion in, non insulin dependant diabetic subjects and its relation to the laboratory values by estimation of various metabolic parameters in these subjects. The work was carried out on sixty subjects with myocardial infarction. Subjects are catagorised into two groups. The first group include 40 patients with non insulin dependant diabetes. The second group include 20 non diabetic subjects. Both group are clinicaly examined with particular emphasis to cardisvoscular system and associated risk factors of coronary artery disease. laboratory tests were done to all subjects and data-Ore collected from s 1)Estimation of fasting and 2 hours postprandial blood sugar and 15 days after acute attack of myocardial infarction to nulify the effect of stress hyperglycemia. 2)Estimation of serum uric acid and serum cholesterol. 3)ECG tracing for all subjects. These data and risk factors are taken into consideration with different sites of myocardial infarction. These findings in the present work have established that inferior wall infarction represent the predominant lesion among diabetic in early ages. at 40 - 45 and extensive anterior and combined lesions are of highest incidence in later ages compared to nondiabetic subjects. In both groups sedentary life constitutes a risk factor in most of the patients. Also type A personality behavour is present in agreat number of both groups with myocardial infarction. from our work, men are vulnerable to coronary atherosclerosis than female of same age, and post-menopausal female are very susceptable to coronary artery disease. Smoking and hypertension have been considered as major risk factors in incidence of myocardial infarction diabetic subjects with smoking and atherosclerosis are susceptible to extensive anterior infarction as well as hypertensive subjects with diabetes mellitus. Simple anterior and anteroseptal infarction are commoner in non diabetics. Extensive anterior infarction is associated with fasting blood sugar more than 160 mg/100 Ma and is 100 % accompanied with heart failure and marked sensory polyneuropathy and weak dorsalis pedis artery pulsation. Inferior wall infarction inspite of normal hemo dynamics 50 % are suffering from heart failure and accompanied by arrythemias. Extensive anterior and combined are accompanied with high levels of fasting and 2 hours postprandial blood sugar and serum uric acid. Most of infarction sites have cholesterol level above 200 mg/100 MI and hyperuricemia. These findings are supported by Epestein who stated that ischemio heart disease was found not only in relation to overt diabetes but also in persons with a trace or more of glucosuria or slight hyperglycemia |