Coronary artery disease is the major cause of mortality world wide. The potentially modifiable risk factors for coronary artery disease were increased concentrations of low density lipoprotein cholesterol, decreased concentrations of high density lipoprotein cholesterol, hypertension, hyperglycemia, and smoking. This cross sectional study which included all UGC employees was conducted in the department of cardiology of BSMMU between January 2007 and December 2007. Detailed clinical history, family history, lifestyle, smoking habit, diabetes mellitus, and hypertension, regular use of any medication or any previous cardiac intervention was taken. Physical examination, Blood pressure measurement, ECG, Echocardiography, fasting blood sugar and fasting lipid profile was done to all subjects.163 subjects (all UGC employees), mean age 44.8±8.3 years were included in this study. (20.9%) presented with angina pectoris, 3.7% were having palpitation, and 8.6% were having shortness of breath and 5.5% with nonspecific chest pain. 16.6% subjects presented with hypertension, 12.3% with diabetes mellitus, and 20.9% with dyslipidemia. 3.1% subjects had previous myocardial infarction. ECG shows 8.0% subjects had inferior ischemia, 6.1% had anterior ischemia and 2.5% had bundle branch block. Echocardiography shows 4.9% subjects were having regional wall motion abnormalities Prevalence of risk factors for CAD is increasing, and with the clinical and cost burdens mounting, identifying and treating those at risk remains a national priority. Abbreviations UGC, University Grants Commission, BSMMU, Bangabandhu Sheikh Mujib Medical University doi: 10.3329/uhj.v5i1.3436 University Heart Journal Vol. 5, No. 1, January 2009 20-23
Background: Left main coronary artery disease constitutes highest risk lesion subset of CAD population. Flow dynamics and pathophysiology in the left main coronary artery are different from that of the other coronary arteries. So traditional risk factors might interact differently with left main artery resulting in different clinical and angiographic characteristics compared to others. Anatomic pattern evaluation in left main coronary artery disease is important in deciding best management options. However, their pattern and profiles were variably shown in different studies with discrepant Results suggesting geographic variation and lead to evaluation of characteristics in our own population. Better understanding this specific problem might lead to further improvement in its management. Methods: It was an observational cross-sectional study. Ninety-one adult coronary artery disease patients over the period of one year who underwent invasive coronary angiogram were studied. Study subjects were divided into two groups after coronary angiogram: Left main (Group 1) and Non-left main (Group 2) CAD. Demographic data, risk factor profiles and angiographic patterns of both groups were compared to see if any statistically significant difference present or not. Results: The mean age and standard deviation in group 1 is 55.2±9.4 and in group 2 is 55.5±12.9; the comparative analysis showed no statistically significant difference. Most of the patients were male 69 (76%) and the comparative study showed statistically significant differences (p=0.046) which showed left main disease tended to be higher in male. Majority (64%) had BMI in normal range with no significant difference. Among the risk factors comparison, diabetes and family history of CAD showed significant association with the left main cohort (p<0.05). Non-ST elevated ACS was the most common presentation and significantly associated with the left main group (p<0.05). On coronary angiogram, there were 80 patients (87.92%) who had no left main artery involvement while 11 patients (12.08%) had left main disease. The comparative study of coronary artery involvement among the two groups reveals no statistically significant differences (p>0.05) but triple vessel disease was found more commonly than single and double vessel disease. Distal lesions (64%) were found more frequently than other types of left main stenosis followed by ostio-proximal lesion (36%). Conclusion: In the patients with left main coronary artery disease, male gender, diabetes mellitus, positive family history and presentation with non-ST elevation ACS were found to be significantly associated. Distal left main lesion and triple vessel disease were commonly found. University Heart Journal 2022; 18(1): 3-9
Ventricular noncompaction is a kind of cardiomyopathy which is called Noncompaction Cardiomyopathy (NCC). In this condition in which the muscular wall of the main pumping chamber of the heart -the left ventricle (LV) appears to be spongy and non-compacted, consisting of a meshwork of numerous muscle bands called trabeculations. Here, anatomically LV wall has deep trabeculations. This condition is associated major clinical problems like systolic and diastolic dysfunction, arrhythmia and even systemic embolism. Sudden cardiac death may occur in this group. Early detection of this condition may help to plan the management. DOI: http://dx.doi.org/10.3329/uhj.v7i1.10209 UHJ 2011; 7(1): 39-41
Introduction:Primary percutaneous coronary intervention (PCI) has become the more preferable reperfusion strategy for the management of acute ST-segment elevation myocardial infarction (STEMI). This dramatic switch from thrombolytic therapy to primary PCI was the result of several studies conducted in the early 1990s that demonstrated the superiority of primary PCI at achievement of higher rate of TIMI 3 flow (more than 80% in primary PCI compared to 50 % in fibrinolytics) and reducing stroke and reinfarction as well as an absolute reduction in mortality by 2%. The likelihood of pre-discharge positive exercise test is also reduced by primary angioplasty. In hospital where facilities for primary angioplasty are available, it should be considered over fibrinolytics. These benefits were achieved despite a median door-to-balloon time (D2BT) of 120 min in many of the studies. [1][2] Case Report: A 52 years old businessman was admitted with the complains of sudden severe central chest pain for two and half hours, which was compressive in nature, radiates to back and left arm, associated with profuse sweating and nausea. He denied any H/O cough, breathlessness or syncope. He was not hypertensive, non diabetic, non smoker and he had no H/O ischemic heart disease in his first degree relatives.On examinatio7 , he was anxious, pulse 92 beats/min, blood pressure 110/70 mmHg, temperature 98 F, respiratory rate was 18 breaths/min, heart sounds were audible and normal without any added sound, lungs were clear in both side. 12 lead Electrocardiogram showed acute ST elevated myocardial infarction in the anterior leads with frequent premature ventricular ectopic beat in couplet pattern . Cardiac markers revealed CK-MB 165 U/ml and Troponin I was 27 U/ml. Bed side echocardiogram anteroseptal wall hypokinesia with LVEF 50%. Immediately with adequate preparation, patient was sent to Cardiac Cath Lab for Coronary angiogram with the view of intervention, Coronary angiography revealed there is a 100% occlusion in proximal part of Left anterior descending Artery (LAD) just after origin of 1 st Diagonal branch. Other vessels were normal. Immediately intracoronary bolus dose of Glycoprotein IIb/IIIa antagonist (Eptifibatide) was given. Then floppy wire was crossed throw the lesion and a drug eluting stent (DES) was directly diploid in this lesion . Successful Primary PCI in Left AnteriorRevascularization completed with good TIMI 3 flow. The total procedure was uneventful. After procedure patient was shifted to CCU. There was no post procedure complication, patient's chest pain was relieved and he was discharged 4 days after primary PCI.
A thirty years old lady presented with uncontrolled hypertension and dizziness during working for last 5 years. She had history of termination of pregnancy due to treatment-resistant hypertension. Even in the post-partum period her blood pressure remains uncontrolled with more than three antihypertensive drugs. Her serum K + level was low and USG of KUB & adrenal glands showed slightly increased right renal cortical echotexture; CT scan of abdomen revealed right Adrenal adenoma. She underwent unilateral adrenalectomy. Now, she has no complaints and her blood pressure is normal without any antihypertensive drugs. There is no target organ damage.
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