الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Type 2 myocardial infarction are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles, and short-term prognoses remain to be investigated. The aim of this study was to assess prevalence and differences in clinical features, current treatment strategies and outcome in patients with type 2 versus type 1 acute myocardial infarction.
Methods: This study was conducted on 350 Egyptian patients presented in a setting of myocardial infarction allocated to two groups; type I MI and type II MI based on their diagnostic criteria. All patients were subjected to history taking, clinical examination and investigations (ECG, Echocardiography, and routine laboratory investigations). Patients were compared as regard prevalence, patient characteristics, in hospital management and clinical outcomes especially mortality (in-hospital, 30 days and 6 months), MACE and heart failure hospitalization.
Results: The mean age of the studied cases was 56.35 ± 9.52 years, males represented 56.3% of cases, there were 54.9% of the studied cases smokers, 23.1% had a history of IHD, 20% with history of CHF, and 38.3% had a positive family history of heart disease. DM was present in 45.4% of cases while HTN was present in 75.1% of cases. Regarding the type of MI, most of the studied patients had type I (74.9%) and 25.1% had type II MI. There was a significant higher length of stay in type II (median 12 days compared to 5 days) in type I and occurrence of death (13.6% Vs 5.7%) in type I and stroke at 6 months also was significantly higher in type II (3.4% Vs 0.4%) in type I but at 1 month MACE didn’t differ significantly.
Conclusions: Type I myocardial infarction is more prevalent than type II, however type II MI is associated with higher mortality rates and longer duration of hospital admissions. The clinical presentation differs between both types where type I MI patients present with chest pain, type II patients present mainly with dyspnea, syncope and dynamic instability. Also, the management plan differs significantly showing that cardiac intervention is mainly directed for type I MI patients.