Electrolytes Unchained: The Hidden Threat in Acute Coronary Syndrome

Abstract

Introduction: Acute coronary syndrome (ACS) encompasses a range of urgent heart conditions characterized by a sudden reduction in blood flow to the heart, potentially causing unstable angina or myocardial infarction. Rapid diagnosis and treatment can restore blood flow, minimizing heart damage.

Rationale of the Study: ACS remains a leading cause of mortality worldwide. Recent evidence suggests that serum electrolyte variability analysis could offer new insights into the pathophysiology of ACS.

Background and Statement of the Problem: Cardiac arrhythmias, common in ACS patients, are often linked to electrolyte imbalances. These abnormalities can exacerbate the severity of the condition, making it crucial to understand their role in patient outcomes.

Aim of Current Study: This study aims to establish the association between various electrolyte abnormalities in patients with ACS, particularly focusing on their potential role in disease severity and prognosis.

Objectives: To determine the relationship between electrolyte imbalances and disease severity in ACS patients and evaluate their potential use as biomarkers for prognosis.

Methodology: The study was conducted on patients diagnosed with ST-elevation myocardial infarction (STEMI) at SBMCH. Serum levels of magnesium, sodium, calcium, chloride, and potassium were analyzed, alongside ECG and Troponin I levels. The study spanned two years from October 2022 to September  2024 and included comparative analysis of electrolyte levels in patients with different forms of ACS.

Results: The study found that electrolyte imbalances are prevalent in ACS patients. Hyponatremia was observed in 45% of STEMI patients, while hypocalcemia and hypokalemia affected 37%. In NSTEMI patients, hyponatremia was present in 41%, with hypocalcemia and hypokalemia affecting 31% and 33%, respectively. These imbalances were associated with worse clinical outcomes, such as reduced ejection fraction and increased mortality rates.

Conclusion: Electrolyte abnormalities, particularly hyponatremia and hypokalemia, are common in ACS and are associated with adverse outcomes. Early recognition and management of these imbalances are crucial for improving patient prognosis. Further studies are needed to enhance the understanding of these complex interactions and develop targeted treatments.