Acid‐base Disturbances in Patients With Acute Myocardial Infarction

Abstract

In two years 417 cases of AM1 without pulmonary disease were treated in a CCU. During this period arterial blood gas samples were drawn by routine on the first day. The tape-stored data from the first day at the CCU were compared to pH, standard bicarbonate (SB) and base excess (BE) values. Low SB, BE and p H values were associated with high mortality and also with a high incidence of hypotension, shock and frank pulmonary oedema during the first day. Left heart failure without frank pulmonary oedema showed no such relation. As regards various arrhythmias, left bundle branch block was more common in patients with low pH, SB and BE values. Supraventricular tachycardia was a more frequent finding in patients with low SB and BE values. High values of pH, SB and BE were not combined with an increased incidence of any arrhythmia. currence of various arrhythmias during the first day in the CCU. The age and sex distributions in the pH, SB and BE groups did not differ from those for the whole material. DefinitionsLeft heart failure. B a d rales, a third heart sound or chest X-ray findings of central vascular enlargement.Frank pulmonary oedemn. Patients with rales heard all over the chest in association with frothy sputum. Hypotension.A systemic BP of 90 mmHg or below.Shock. Hypotension in combination with clinical signs of shock such as cold skin, deterioration of sensorium, oliguria.Acta med. scand. I94