Navreet Singh1, Anil Kumar2, Rajat Datta3, Prashant Bhardwaj4, Naveen Aggarwal5, D S Chadha6, S P Singh7, Prafull Sharma8, Parag Barwad9, Himanshu Gupta10. 1. Senior Advisor (Medicine) & Cardiologist, AFCME, Subroto Park, New Delhi, India. 2. Consultant (Medicine) & Cardiologist, 7 Air Force Hospital, Kanpur Cantt, UP, India. 3. Director General Armed Forces Medical Services, O/o DGAFMS, 'M' Block, MoD, New Delhi, India. 4. DGMS (Air), Air HQ, RK Puram, New Delhi, India. 5. Director (Cardiologist), Max Superficiality Hospital, Phase 6, Mohali, Punjab, India. 6. Professor (Cardiology), Manipal Hospital, Airport Road, Bengaluru, India. 7. Professor (Physiology), Army College of Medical Sciences, New Delhi, India. 8. Senior Advisor (Medicine) & Cardiologist, Military Hospital Jalandhar Cantt, Punjab, India. 9. Associate Professor (Cardiology), Post Graduate Institute of Medical Education & Research, Chandigarh, India. 10. Assistant Professor (Cardiology), Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Abstract
BACKGROUND: At our tertiary care cardiology center, we are receiving soldiers who sustained acute ST-Elevation Myocardial Infarction (STEMI) during the strenuous Battle Field Efficiency Test (BPET) and other such activities. METHODS: This was a single-center observational study to assimilate and analyze the precipitating causes, risk factors, symptoms, and the efficacy of the management protocols in soldiers sustaining STEMI during the BPET or other forms of strenuous military training. RESULTS: All 25 soldiers with documented STEMI following strenuous military training presented with chest pain as the primary symptom. 88% had symptoms either during or within 1st hour of the strenuous activity. 76% underwent thrombolysis with an angiographic success rate of 95%. Primary PCI was possible in only 3/25 (12%) of the cases, of which 2 (66%) did not require stenting after thrombus aspiration; 88% of soldiers reported "training for the event" for less than four times/week. CONCLUSION: STEMI precipitated by strenuous unaccustomed military training have exclusively single vessel affection with an excellent response to thrombolysis and thrombus aspiration. Thus, the timely institution of pharmacological or mechanical revascularization therapy has dramatic results in the preservation of ventricular function. The lack of training for the strenuous event provides strong evidence for comprehensive, graded, physical training prior to strenuous military activities to prevent acute coronary syndromes.
BACKGROUND: At our tertiary care cardiology center, we are receiving soldiers who sustained acute ST-Elevation Myocardial Infarction (STEMI) during the strenuous Battle Field Efficiency Test (BPET) and other such activities. METHODS: This was a single-center observational study to assimilate and analyze the precipitating causes, risk factors, symptoms, and the efficacy of the management protocols in soldiers sustaining STEMI during the BPET or other forms of strenuous military training. RESULTS: All 25 soldiers with documented STEMI following strenuous military training presented with chest pain as the primary symptom. 88% had symptoms either during or within 1st hour of the strenuous activity. 76% underwent thrombolysis with an angiographic success rate of 95%. Primary PCI was possible in only 3/25 (12%) of the cases, of which 2 (66%) did not require stenting after thrombus aspiration; 88% of soldiers reported "training for the event" for less than four times/week. CONCLUSION: STEMI precipitated by strenuous unaccustomed military training have exclusively single vessel affection with an excellent response to thrombolysis and thrombus aspiration. Thus, the timely institution of pharmacological or mechanical revascularization therapy has dramatic results in the preservation of ventricular function. The lack of training for the strenuous event provides strong evidence for comprehensive, graded, physical training prior to strenuous military activities to prevent acute coronary syndromes.
Authors: Cengiz Ozturk; Turgay Celik; Atila Iyisoy; Hamidullah Haqmal; Mustafa Demir; Ali Osman Yildirim; Sevket Balta Journal: Int J Cardiol Date: 2016-04-16 Impact factor: 4.164