Objective: To determine the frequency of myocarditis in patients recovered from COVID-19 infection. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Cardiac Magnetic Resonance Imaging Department, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi Pakistan from Jul 2020 till Apr 2022. Methodology: All patients who underwent Cardiac Magnetic Resonance Imaging after recovery from COVID-19 were enrolled. Non-probability consecutive sampling technique was used for sample selection and was calculated on the basis of Gpower. Data of patients fulfilling the inclusion criteria was selected. All PCR positive cases of COVID-19 who recovered from COVID-19 and completed their 12 days of isolation not exceeding 60 days of 1st Polymerase chain reaction positive, and who have any symptoms of shortness of breath, fatigue and chest pain with reduced left ventricular ejection fraction (LVEF) on 2Dechocardiogram were included in the study. Data was recorded, stored, and analyzed by using SPSS version-21. Quantitative data was reported as Mean±SD. Categorical variables were reported as frequency and percentage. To determine theassociation between different variables Chi square test was used. Results: Total 83 patients were included in this study who recovered from COVID-19 and underwent Cardiovascular magnetic resonance. Mean age of the patients was 39.17±12.9 years. 67(80.72%) were male while 16(19.28%) were females.50(60%) had myocarditis after recovery from COVID-19. This study showed statistically significant association of all the Cardiovascular magnetic resonance imaging findings with Myocarditis (p<0.05) at 95% confidence interval and 5% margin of error. Conclusion: Early detection of COVID-19 related myocarditis will help in better management of patient. In such patients,cardiac Magnetic Resonance Imaging is the modality of choice, since it allows for noninvasive assessment of myocardial edema and fibrosis, as well as therapeutic guidance and improved patient outcomes.
Objective: To determine the In-hospital outcome of early versus late coronary intervention in patients undergoing thrombolysis after acute myocardial infarction (STEMI). Study Design: Analytical Cross sectional study. Place and Duration of Study: Department of Cardiology, Punjab Institute of Cardiology, Lahore Pakistan from Jul 2021 to Dec2021. Methodology: Total of (n=100) patients regardless of gender between 30-80 years of age, presented with acute ST-elevated myocardial infarction (STEMI) at emergency room of PIC, Lahore and undergo thrombolysis with a thrombolytic agent after taking the informed consents were selected by a consecutive sampling technique. The demographic information which includes (name, age, gender, H/O diabetes, duration of STEMI) was noted. Then patients were randomly divided in two groups (Group A & B). In Group-A, patients were undergone PCI within 24 hours of thrombolysis. In Group-B, patients were undergone PCI after 24 hours of thrombolysis. Then all patients were followed-up in coronary care units for 07 days. If reinfarction occurs or patient was died during hospital stay, it was recorded. All the information was noted in a preformed structured proforma. Results: Out of 100 patients, 10 % (n=10) were in age group of 30-45 years and 90 % (n=90) were in age group of 46-80 years. The mean age was calculated as 60.16 ± 7.13 years. There were 90 (90 %) males whereas 10 (10 %) were females. The frequency of Re-Infarction in early Intervention group was 2(2%) and in late Intervention group it was 10%. (p<0.05).The frequency of mortality in early Intervention group was 2 (02%) and in late Intervention group it was 10%. (p< 0.05).Conclusion: Frequency of re-infarction as well as mortality was comparatively low in Intervention group. Therefore, the immediate restoring the patency of occluded coronary arteries can prevent or decrease myocardial damage due to acute myocardial infarction and henceforth, decrease morbidity and mortality..
Objective: To evaluate the impact of post dilatation performed with Non- Compliant Balloon on Angiographical outcome (that is TIMI flow grade) in patients who underwent the primary percutaneous coronary intervention. Study Design: Retrospective cross-sectional study. Place and Duration of Study: At Tertiary Cardiac Care Center, Rawalpindi Pakistan from Nov 2020 to Apr 2021. Methodology: The retrospective data of the all the patients with STEMI was assessed via non-probability consecutive sampling technique and analyzed statistically. The study participants were classified into two categories based on whether they underwent post-dilatation or not, i.e., Category-I: patients who underwent post-dilatation with NC balloon and Category-II: patients who did not undergo post-dilatation. The primary study end-point was post-dilatation TIMI flow grade. Continuous study variables were expressed as Mean±S.D and categorical variables as frequencies and percentages. Chi square test was applied to find the association between study variables by keeping 95% CI and 5 % margin of error. p-value <0.05 was considered statistically significant. Results: The study included (n=410) eligible patients in total. Majority were males (n=303; 73.9%), 217 (52.9 %) patients underwent PD procedure. TIMI flow grade did not differ significantly between the two study categories (p-value > 0.05). Postprocedural success rate was 81.3% for patients with PD. Conclusion: The current study illustrates that PD does not adversely affect the final angiographic outcomes when performed after primary angioplasty.
Objective: To evaluate the patterns of left ventricular hypertrophy (LVH) and late gadolinium enhancement (LGE) inhypertrophic cardiomyopathy. Study Design: Analytical cross-Sectional Study. Place and Duration of Study: Tertiary Cardiac Care Center, Rawalpindi Pakistan from 01 June 2020 to 30 Dec 2021. Methodology: This study was carried out at a tertiary cardiac care center retrospectively from 1 June 2020 to 31 December 2021. Patients having LV hypertrophy due to aortic stenosis, hypertension, athlete’s heart, and infiltrative disorders were excluded from study. Cases were included using nonprobability consecutive sampling. Sample size estimated by taking 0.2- 0.5 % (1 in 200-500) prevalence of hypertrophic cardiomyopathy using open epi sample size calculator was (n=38) taking 99.99% confidence interval. For the purpose of study all patients with confirmed HCM undergoing CMR during given period were included in study.Approval from the ethical review committee with IERB (IERB letter # 9/2/R&D/2022/179) was sought. CMR was performed using MRI 3 Tesla. Data analysis was done on SPSS version-26. Quantitative variables were expressed as Mean±SD. Qualitative variables were expressed as frequencies and percentages. ANOVA and student t-test (95% CI and 5% margin of error) was applied to compare the study variables. p-vale <0.05 was considered statistically significant. Results: Majority 77(86.7%) of patients were males. Most common pattern of involvement for LV hypertrophy was asymmetrical septal hypertrophy in 47 (52.8%) followed by apical HCM in 29(32.6%). LVOT obstruction was observed in 30(33.7%) of patients. Mean maximum LV wall thickness was 22mm±5.47. Conclusion: Our study shows association, between the extent of Late Gadolinium Enhancement and LV wall thickness, myocardial mass index in HCM patients.
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