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Case Report



Acute myocardial infarction in a resource-poor setting: a case report in Awka, Nigeria

Innocent C. Okoye, Ernest N. Anyabolu.

Abstract
The incidence of acute coronary syndrome (ACS) is increasing in Sub-Saharan Africa. Predisposing factors to ACS in Nigeria are not completely known. The management of ACS is influenced by its timely detection and availability of medical and reperfusion intervention facilities. We thus document a case of acute myocardial infarction (AMI) in 3 years that was successfully managed medically in Awka, Nigeria, albeit a debacle of resource-poor setting. The patient was a 42 year-old man who presented with retrosternal, stabbing chest pain of 4 hours duration. He has obesity, hypertension and a sedentary life style. He was in painful and respiratory distress; blood pressure was 140/80mmHg. Oxygen therapy, intravenous morphine 10mg was given. Oral Isosorbide dinitrate 20mg bd, oral Clopidogrel 300mg bd initially then 75mg daily, oral Aspirin 150mg bd, oral Simvastatin 20mg daily and oral Lisinopril 2.5mg were instituted. Resting electrocardiography showed evidence of ST elevations in the inferior leads. Cardiac enzyme markers were elevated. Following medical therapy, his condition improved. On the 3rd day he was discharged and subsequently followed up in the clinic. This case of AMI in a man who, has risk factors for AMI and, presented as the first case in three years in a Cardiology Unit in a tertiary hospital in Awka suggests that AMI is rare in this area. A resource-poor setting such as ours might still provide valuable medical therapy to ACS patients especially with prompt referrals from peripheral hospitals.

Key words: Awka, Acute myocardial infarction, Nigeria, Resource-poor setting, Risk factors


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