Abstract

Manoj Kumar Jain*, Avadhesh Kumar Bhardwaj and Sudhish Sehra 

ABSTRACT

Introduction: After acute myocardial infarction myoglobin is released from the damaged heart muscle into the blood stream and is then cleared rapidly from the circulation and excreted in the urine. The detection of myoglobin in urine may be a useful diagnostic tool for myocardial infarction which is quick, easy to do and cheap. Aims and Objectives: To study the pattern of myoglobinuria in patients with acute myocardial infarction and to study the prognostic significance of myoglobinuria. Material and Methods: Sample includes 30 controls and 55 patients of acute myocardial infarction. Out of 55 cases, 45 were confirmed (30 uncomplicated and 15 complicated) and 10 were provisional. Patients having presence of renal failure, rhabdomyolysis, trauma, recent seizures, post-operative states and acute vascular occlusion of the extremities, patients having heamoglobin less than 10 gm % were excluded from the study. Pattern of myoglobinuria was observed and data collected were tabulated and analysed statistically. Results: All the 45 (100%) cases of confirmed acute myocardial infarction had detectable myoglobinuria at one or the other time during the study period. In 4 (40%) out of 10 provisional cases myoglobinuria was detectable as an indicator of acute infarction. Myoglobinuria was noted as early as 6 hours in 12 (70.4%) of the 17 cases and in 11 (24.4%) of the 45 cases it was detectable as late as 36 hours after the onset of chest pain. However, disappearance started at 96 hours in 2(4.4%) and at 120 hours in 20 (44.4%). Rest 18 (40.0%) had myoglobinuria at this stage. The mean peak was observed at 67.6 + 9.86 hours. Conclusion: Myoglobinuria is a useful additional test in the diagnosis of acute myocardial infarction.