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Myocardial infarction symptoms go unrecognized after hip fractures
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Before and after surgical treatment for hip fracture, some patients develop myocardial infarctions that may go unrecognized, according to this study.
“Patients with hip fracture often develop asymptomatic and clinically unrecognized perioperative myocardial infarctions,” Pauliina Hietala, MD, and colleagues wrote in the study abstract. “Earlier diagnosis and appropriate treatment of cardiac infarction may improve survival of hip fracture patients.”
Hietala and colleagues analyzed perioperative cardiac symptoms of 200 patients who underwent hip fracture surgery, measuring troponin T (TnT) and electrocardiographic (ECG) recordings before surgery and at 1-day and 2-day postoperatively, according to the abstract. TnT was significantly increased in 71 patients, and the researchers noted 25 patients had more than five times the normal limit for TnT. Prior to surgery, 36 patients showed signs of myocardial infarction (MI) through TnT elevation.
After surgery, seven patients had an elevated ST MI, 23 patients had new ST depressions, while 21 patients did not have ST segment changes. Heitala and colleagues noted symptoms of MI were the first signs of coronary artery disease in 40 patients.
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