Pattern of Acute coronary syndrome (ACS) at the Emergency Department of tertiary hospital, Addis Ababa, Ethiopia

Abstract

BACKGROUND: Acute coronary syndrome (ACS) is the leading cause of death and disability-adjusted life years globally, with low- and middle-income countries (LMIC) bearing a high proportion of the burden. In this study, we aimed to assess the pattern of ACS  at  St Paul's hospital Emergency department.

METHODS: A cross-sectional study was carried out from September 1, 2017, to October 31, 201at St Paul's Hospital Millenium Medical College . Patients age >18 years old,  presented to the Emergency department  and had diagnosis of Acute Coronary Syndrome were included. Structured checklist were used to collect data from patient charts. Data was analayzed  using SPSS version 25.

RESULTS: 103 patients were enrolled during the study period. The majority were males (n = 69, 64.5%). The average age was 55.65 ±13.96 years. The majority of patients (n = 67, 65.1%) arrived to the emergency department by taxi, and 60 patients (58.3%) were referred. The most common chief complaints were chest pain (n = 79, 76.7%), easy fatigability (n = 58, 56.3%) and epigastric discomfort (n = 44, 42.7%).The mean duration of symptoms before presentation to the ED was 3.4 ± 2.83 days. The most common risk factors identified were hypertension (n = 47, 45.6%) and diabetes mellitus (n = 31, 30.1%). Types of ACS included ST-elevation myocardial infarction (STEMI)(n = 74,71.8%),non-ST-elevation myocardial infarction (NSTEMI)(n = 22, 21.4%) and unstable angina (n = 7, 6.8%). Heart failure was the most common complication at presentation. The most common echocardiography findings were wall motion abnormalities (85.4%) and decreased ejection fraction (60.2%). The ED mortality rate was 6.8%.

CONCLUSION: The majority of patients with ACS used taxi and arrived at the hospital late.The most common presentations were chest pain and easy fatigability. STEMI was the most common type of ACS identified.