Metabolic acidosis in acute myocardial infarction

Amita A. Gandhi, Pankaj J. Akholkar


Background: Metabolic acidosis is known to occur in the early stages of an acute myocardial infarction but it is rarely severe except in the presence of profound cardiogenic shock; nevertheless, it could contribute to the development of dysrhythmias. The objective of present study was to ascertain the acid base status of patient of acute STEMI at the time of hospitalization.

Methods: Fifty patients of acute myocardial infarction were interrogated for history of presenting illness examined for vitals systemic examination and investigated by collection of blood sample and ECG.

Results: Mortality in patients with pH level <7.35 was 60% (3 out of 5). While in pH level of 7.35-7.45 was 16.6% (6 out of 36) and mortality in pH level more than 7.45 was 11.11% (2 out of 9) p value was significant (0.03). Mortality in patients with bicarbonate level less than 22 meq/l was 40 %, while in those with level 22-26 meq/l was 17.14% and in those with level >26 meq/l was 20%. Thus there is higher rate of mortality in patients with bicarbonate level <22 meq/l (p value 0.12).

Conclusions: The definite correlation was found between metabolic acidosis and mortality (p value was 0.03). As the blood pH was decreasing mortality was increasing and 100% mortality was found in pH level <7.3.


Myocardial infarction, Metabolic acidosis, Serum bicarbonate

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