RV function indices like TAPSE, MPI-TDI and S' velocity are useful in predicting proximal RCA stenosis in first episode of acute IWMI.

CSFT is a simple method to assess the transit time through coronary microcirculation. CSFT was significantly delayed in patients with angina and normal coronaries. TMP and cTIMI frame count were not significantly different between groups.

No abstract

due to severe AR and LV dysfunction. The causes of diastolic MR include: atrioventricular blocks of any degree; after ventricular premature beats, pacemaker and a prolonged PR interval; during atrial tachyarrhythmias with long filling periods; restrictive cardiomyopathy; and in patients with severe AR. 1

No abstract

A 55-year-old man presented with progressive distension of the abdomen, pedal oedema, effort dyspnoea and excessive fatigue. Physical examination showed facial puffiness, distended neck veins with prominent Y descent in jugular venous pressure, ascites, systolic retraction of the chest wall and a loud pericardial knock. Echocardiography showed greatly thickened pericardium ( figure 1A) with features of constrictive pericarditis. Thick pericardium was seen by MRI, with 20 mm thickness lateral to the left ventricle (figure 1B). Cardiac catheterisation disclosed prominent Y descent in right atrial tracing with no respiratory variation of the mean right atrial pressure ( figure 1C). There was elevation and equalisation of right and left ventricular end diastolic pressures, prominent rapid filling wave and ventricular interdependence ( figure 1D). Pericardiectomy was carried out through midline sternotomy, and histopathology showed caseating granuloma consistent with tuberculosis (figure 1E), which is still the leading cause of constrictive pericarditis in developing countries.1 The patient improved well after the surgery and antituberculous treatment.

We report a 42-year-old lady on combined oral contraceptive pills with deep venous thrombosis and mild pulmonary embolism, who developed shock, while being treated with heparin. On auscultation, there was an unexpected loud, superficial, squeaky, triphasic friction rub over the left lower parasternal area. Simultaneous echocardiogram revealed a large serpiginous, freely floating mass in right atrium, prolapsing freely to right ventricular inlet across the tricuspid valve. The endocardial friction rub persisted for about 24 h as long as the thrombus was intracardiac and disappeared when the thrombus disappeared from right heart, occluding the proximal left pulmonary artery. She died due to shock awaiting surgery. We highlight that such a rub in a patient with deep venous thrombosis, though rare, may be an important clue to impending pulmonary embolism.

Current estimates indicate that 8.3% of the adult population, or 71.4 million people, have diabetes in 2011, 61.3 million of whom are in India. The incidence rate for type 1 diabetes in India was frequently used in extrapolation for other countries in the region and therefore plays a pivotal role in the estimates. We evaluated the ventilatory function of type 1 diabetes mellitus and type 2 diabetes mellitus patients. Spirometry and DLCO conducted in patients who have never smoked, with no history of lower respiratory illness and at examination did not have any respiratory symptoms like nasal itching, nasal congestion, running nose, dry throat, hoarseness, epistaxis, sneezing, pain suggestive of sinusitis, cough, expectoration and dyspnea were included. DLCO <80% is statistically similar in two groups with P=0.431. Mean FEV1/FVC (measured %) according to Diabetic duration, diabetic treatment, diabetic complications and DLCO in Type II DM patents was significant. Spirometric values were consistently lower in subjects with Type 1 diabetes mellitus than in Type 2 diabetics. The effect on the FVC was even more pronounced in diabetics who had duration of disease longer than 5 years, and the effect was not explained by the difference in age alone. Subjects with poorer diabetic control have worse spirometric function. Non-enzymatic glycosylation of connective tissue, especially the collagen, may be responsible for reduced lung functions.