Background and Aims: Atrial fibrillation (AF) is the most common sustained arrhythmia. This study aims to evaluate its prevalence in patients attending emergency department of tertiary care cardiac centre.Methods: It was a prospective observational study of 1012 consecutive patients who attended emergency department of Shahid Gangalal National Heart Centre from September 2014 to November 2014. Electrocardiogram, demographic features, diagnosis and clinical presentations were reviewed.Results: Among the 1012 patients, 553 (54.6%) were male and 459(45.4%) were female. Mean age was 52.13} 17 years. A total of 140 patients (13.8%) patients had AF. The mean age of patients with AF was 55 years. The prevalence of AF was higher in female than male (19.2% Vs 9.4%). Among the Rheumatic heart disease patients, seventy percentages of them had AF. Dyspnea was the commonest symptom of patients with AF followed by palpitation.Conclusion: The prevalence of AF in our study is higher than in western world mainly because of endemic rheumatic heart disease.Nepalese Heart Journal 2016; 13(1): 1-4

BackgroundDoor-to-balloon (DTB) time of 90 min during primary angioplasty is considered as the benchmark duration. Shorter DTB time is preferable, and longer duration can have poor clinical outcomes.MethodsA cross-sectional observational study of three months in Shahid Gangalal National Heart Center was conducted in which all patients undergoing primary angioplasty were included. The DTB time was calculated, and the different determining factors were studied.ResultsSeventy-nine patients undergoing primary percutaneous intervention were studied. The median DTB time was 79 minutes (Interquartile range [IQR] 59–115 min). Forty-six (58.2%) patients had a DTB time of less than 90 min. DTB time varied significantly with direct visit vs transfer (p = 0.029) and office time visit (9 am–5 pm) vs off time (5 pm–9 am) (p = 0.012). DTB time did not differ between any infarct-related vessels (p = 0.471), number of vessels involved (p = 0.638), and the added procedures (defibrillation, thrombosuction, and temporary pacemaker insertion) (p = 0.682) during angioplasty. No significant differences were recorded according to age (p = 0.330), gender (p = 0.254), hypertension (p = 0.073), diabetes (p = 0.487), heart failure (p = 0.316), and baseline left ventricular ejection fraction (LVEF) (p = 0.819).ConclusionThe median DTB time in primary angioplasty was less than 90 minutes. The significant determining factors were timing of hospital visit (office vs off time) and type of visit (direct vs transfer). There can be improvement in factors determining DTB time to lower it further.

Coronary artery disease (CAD), predominately manifest in older individuals, is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. When the afflicted individual is under the age of 40, the tragic consequences for family, friends, and occupation are particularly catastrophic and unexpected. Fortunately, the incidence of myocardial infarction (MI) and symptomatic CAD in young adults is low; most studies show that only about 3% of all CAD cases occur in this age range. Premature CAD is defined as cardiac events occurring before the age of 45 in men and 55 in women. In its severe form it is defined as CAD occurring below the age of 40 years. Prematurity and severity suggests that the disease starts at an early age and has a malignant course. In this study, we aim to investigate the major risk factor (smoking, Hypertension, Diabetes and dyslipidemia ) as defined by ACC-AHA pattern in ACS patient 40years or below admitted in Shahid Gangalal National Heart Centre (SGNHC) from April 2008 to April 2009. There were all together 54 ACS patients, male 44(81%) and female 10(19%). HTN is the risk factor which was more commonly diagnosed and treated, while Dyslipidemia, DM and IFG were not usually diagnosed in young patient before they were diagnosed CAD. Dyslipidemia was the most common comprising 83.3% followed by HTN 70%, smoking 70%, abnormal blood glucose level 50%, DM in 22.2% while IFG in 27.7 %. High total cholesterol (48%) is the common form of dyslipidemia followed by high LDL (44.4%), low HDL in 31.4%. When non modifiable risk factor family history is excluded, 85% of the patients have two or more risk factors of CAD. When smoking along with family history is excluded 94.5% of the patients have 1 or more risks factors for CAD.

Background and Aims-

The CTSS -25G/A polymorphism was not related with CHD in our Chinese population sample.