BACKGROUNDThe present study deals with the clinical profile of right ventricular infarction as diagnosed by right precordial electrocardiography in patients with acute inferior wall myocardial infarction. Recognition of the syndrome of RVI is important, as it identifies a significant clinical entity which is associated with and is an independent predictor of major complications and in hospital mortality after acute IWMI. The main purpose of this study was to become aware of RVI and its complications like hypotension, arrhythmias and conduction disorders, which not only need appropriate therapy but also requires avoidance of inappropriate therapy, which may reduce right ventricular filling pressure and cardiac output further worsening the condition.Aims and Objective -The study emphasises on the incidence of RVMI in patients of acute inferior wall MI using right precordial ECG, the clinical profile of patients with RVMI in acute IWMI and to study the incidence of complications in patients of acute IWMI. MATERIALS AND METHODSThis is a prospective study carried out on patients admitted with inferior wall MI in our tertiary care hospital from March 2015 to May 2016. At the time of admission, a seventeen lead ECG consisting of twelve conventional leads and additional right precordial leads V3R, V4R, V5R, V6R was taken and subsequent recordings were made for conventional and right precordial leads. RESULTSOut of 90 patients of acute IWMI admitted to ICCU Department of Medicine, 25 patients were diagnosed with RVMI (28%). Patients were continuously monitored during hospital stay and their serial ECGs clinical course and response to treatment were analysed. There was five times increased incidence of mortality in patients of IWMI with RVMI as compared to no RVMI. Complications like cardiogenic shock, various arrhythmia viz. AV block, VT were higher in RVMI group. CONCLUSIONRVMI occurs in a significant number of patients with inferior wall MI. It can be easily diagnosed with considerable accuracy by a simple bedside routine 12-lead ECG along with right-sided ECG leads. Early diagnosis of RVMI can prevent fatal complications like high degree heart blocks, ventricular arrhythmias, cardiogenic shock and high in-hospital mortality. Patients who survive the acute phase have no long-term consequences and complete recovery over a period of weeks to months is the rule in majority. Therefore, right-sided ECG should be taken routinely in all patients of IWMI.
BACKGROUND Persons suffering from Systemic Hypertension are likely to have cardiovascular side effects and this can be evaluated via a Doppler Echocardiography. Hypertension has been shown to be a good prognostic marker in the cardiovascular mortality. This study was done to detect the relationship between Hypertension and Left Ventricular Diastolic Dysfunction to evaluate its role in pathogenesis and its influence amidst other factors such as gender, smoking, hypercholesterolaemia and effect of lifestyle. MATERIALS AND METHODS 153 random patients presenting with or already having been diagnosed with systemic hypertension and not having any renal disease, diabetes mellitus, IHD, cardiomyopathy, valvular heart disease, pericardial disease etc. Consent was taken from all patients. History and examination was done according to a proforma. Blood pressure was taken along with haematological and biochemical examination and ECG was done to rule out secondary hypertension and IHD. All those in the inclusion criteria were taken for Echocardiography and M-mode measurements were taken and EF was calculated. RESULTS 55.6% were having diastolic dysfunction. Majority of them, i.e. 67 (72.8%) of those having diastolic dysfunction were from age group of 51-60 years. Overweight patients, i.e. 52 (33.98%) among which 27 (51.9%) were having diastolic dysfunction. 64 patients (41.8%) were having hypertension since 5-10 years, out of which 39 (60.9%) were having diastolic dysfunction. There are 3 patients above 15 years history of hypertension and all had diastolic dysfunction. CONCLUSION Our study revealed that there is positive co-relation of duration of hypertension with diastolic dysfunction. Other contributory factors found were greater age, male sex, urban population, obesity and smoking which contributed to development of diastolic dysfunction.
Background: Diastolic dysfunction in young adults is associated with increased morbidity and mortality. The identification of risk markers associated with diastolic dysfunction could allow for targeted primary prevention efforts. Aims and Objectives: The aim of the study was to study whether dyslipidemia is associated with diastolic dysfunction independent of systemic hypertension in young patients under 40 years of age. Materials and Methods: This was a cross-sectional analytical study done from April 2021 to March 2022 in SSMC and SGMH Rewa (M.P.), 214 normotensive cases under 40 years of age were taken as cases by simple random sampling. Sample size calculated by standard formula with confidence level of 95% and margin of error was <5%. Lipid profiles (S. Triglyceride [TG], S. Cholesterol, and S. low-density lipoprotein [LDL]) of all the patients were checked. 2D echocardiogram of patients was done to check for diastolic dysfunction. All data were compiled and compared with the previous studies. Results: We found that the prevalence of diastolic abnormalities in adults under 40 years of age was 21.9%. It was found that there was significant correlation between dyslipidemia and presence of diastolic dysfunction in patients. Patients with higher than normal levels of S. TG, S. Cholesterols, and S. LDL were found to have more prevalence of diastolic dysfunction then patients with normal levels of S. TG, S. Cholesterols, and S. LDL. Higher grades of diastolic dysfunction were found in patients with dyslipidemia as compared to patients without dyslipidemia. High levels of TG and LDL and even Borderline high levels of LDL can be good predictors of diastolic dysfunction. Conclusion: Dyslipidemia is associated with diastolic dysfunction in young patients even without systemic hypertension.
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