The outbreak of coronavirus disease 2019 (COVID-19) is one of the greatest threat and challenge being faced by the entire nations in the current era. Though it primarily affects the respiratory system, like other viral infections, cardiovascular complications such as myocarditis, acute coronary syndrome, exacerbation of heart failure, and arrhythmia are not uncommon in COVID-19. They were reported to be associated with poor outcome. In addition, emerging reports also showed that patients with pre-existing cardiovascular comorbidities are more prone to develop severe form of COVID-19. The factors found to be independently associated with an increased risk of death were the age older than 65 years, coronary artery disease, heart failure, cardiac arrhythmia, chronic obstructive pulmonary disease, and current smoking. Concern has been raised regarding a potential harmful effect of drugs like angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), hydroxychloroquine and azithromycin. Therefore, in this article, we will concisely explore the potential cardiovascular implications of COVID-19 with the help of existing literature.
Background: Osteoporosis and Coronary artery disease are known to share common risk factors, like inflammation, but a direct relationship between the two has not been established. Some of the previous studies showed low BMD (osteoporosis and/orosteopenia) as an independent predictive factor for coronary artery disease in ambulatory patients. However, some reports have failed to demonstrate a direct relationship between low bone mineral density (BMD) and CAD or cardiovascular risk factors. This study was carried out to estimate bone mineral density (BMD) in patients with coronary artery disease (CAD) and also to evaluate the association between bone mineral density and coronary artery disease.Methods: Hospital based prospective observational study, involving 96 consecutive patients who were referred for coronary angiography for the evaluation of established or suspected CAD and also patients who had acute coronary syndrome (ACS) are enrolled in this study. BMD was determined for the lumbar spine (L2-L4) and femoral neck using DXA scan.Results: The total number of subjects was 96. Out of 96, 24 (25%) patients were females and remaining 72 (75%) were males. Coronary angiography was carried out in all patients. 42 patients from the total had coronary angiography proven single vessel disease (SVD), 33 patients had double vessel disease (DVD) and 21 patients had triple vessel disease (TVD). DXA scan was carried out in all patients. T- score of neck of femur region and lumbar spine was calculated. Neither the presence of significant coronary stenoses ≥50% in two or more coronary vessels nor the prevalence of severe coronary stenoses ≥70% differed significantly between patients with normal bone density, osteopenia, or osteoporosis (p<0.05, respectively).Conclusions: The result of this study suggests that in patients undergoing coronary angiography for the evaluation of CAD, the prevalence of low BMD is high; however, there is no statistically significant relationship between osteoporosis, osteopenia and coronary artery disease state.
Spontaneous coronary artery dissection (SCAD), also referred to as SCAD, is an uncommon emergency condition that occurs when a tear forms in a blood vessel in the heart. SCAD has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden cardiac death, particularly among individuals with few conventional atherosclerotic risk factors and young women. It is usually seen in females with pre-existing conditions such as connective tissue disease, systemic lupus erythematosus, and the puerperium. Commonly, the patient presents with acute-onset severe chest pain coupled with autonomic symptoms such as diaphoresis, palpitations, and hypotension. SCAD presenting with ischemic stroke in a male patient is extremely rare. Hereby, we present a case of SCAD in a middle-aged gentleman who strangely presented with ischemic stroke.
Background: Parkinson's disease (PD) is a neurodegenerative disorder, with male preponderance. It is associated with both motor and non-motor symptoms, which affect quality of life in elderly people. Due to paucity of studies on its epidemiology and prevalence, this disease needs assiduity and further exploration.Methods: A hospital based cross-sectional study was conducted in the tertiary care hospital, among 45 patients diagnosed with PD.Results: The mean age of the participants was 61.17±12.30 years, with male to female ratio was 2:1. The average age of onset of PD was 57.4±12.30 years. Tremor was the most common initial symptom (68.88%) followed by rigidity (20%) and bradykinesia. Most of the patients (86.66%) had progressive symptoms, and 69% had unilateral involvement of limbs.Conclusions: The profile of patients with PD in Himachal Pradesh is similar to that from other populations in India and other developing countries. However, the dearth of studies and data pertaining to PD, invigorate the need to explore this neurodegenerative disorder to comprehend its clinic-epidemiological profile in our state.
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