Anemia is very common in patients with cardiovascular diseases. It has been shown that anemia is an independent risk factor for cardiovascular events in general population and in patients of heart failure and acute coronary syndrome (ACS). Various randomized trials have shown prevalence of anemia to be 10 to 43% in patients with ACS. The cardiac remodeling in ACS patients results in left ventricular dilation, which further increases myocardial wall stress. In the presence of anemia, this exacerbates ischemia and enhances myocardial necrosis and fibrosis and ultimately the prognosis. At present, modality of treatment of anemia in ACS patients is less established except blood transfusion. Anemia at admission may have both short- and long-term worse prognosis. Restrictive strategy of blood transfusion, as shown by REALITY trial, may have at least short-term beneficial effect. Due attention should also be given to hospital-acquired anemia (HAA) and anemia developing later, that is, after discharge from hospital. Intravenous iron therapy may be the future therapeutic option, as evidenced by its beneficial effect in treatment of heart failure with anemia.
Coronary Cameral Fistulas (CCFs) are rare arteriovenous malformations, defined as a connection between a coronary artery and a cardiac chamber or any segment of the systemic or pulmonary circulation. These may be congenital or acquired, and show a low incidence in both angiographic studies, and the general population. The presentation of CCFs varies depending upon their size and location. These can be majorly asymptomatic or show symptoms and complications like congestive heart failure, myocardial infarction, and bacterial endocarditis. Although percutaneous closure with embolisation can be done, surgical closure of CCF is a gold standard of treatment. The authors reported a case of a 57-year-old male who presented with exertional chest pain and dyspnea. Coronary angiography revealed the presence of dilated tortuous Left Main Coronary Artery (LMCA), Left Anterior Descending artery (LAD), Left Circumflex artery (LCX) and CCF between LAD to Right Ventricle (RV), Obtuse Marginal (OM) to RV and Posterior Left ventricular Branch (PLB) to RV. No significant obstructive coronary artery disease was present. Coronary artery calcium score was 15. The patient was managed conservatively with antiplatelets, statin, and heparin and responded well to the treatment.
To study the prevalence of Non-Alcoholic Fatty Liver Disease in Coronary Artery Disease patient and the correlation of Coronary Artery Disease severity in patients of Non-Alcoholic Fatty Liver Disease Study included 124 patients of Coronary Artery Disease who underwent detailed clinical and anthropometric examination and routine blood investigations. Ultrasonography of abdomen was done and Non-Alcoholic Fatty Liver Disease grading was done. Coronary angiography was done and angiographic severity was calculated by Gensini score. Non-Alcoholic Fatty Liver Disease was found in 71% of patient. There is a significant difference of Gensini score between patients with and without Non-Alcoholic Fatty Liver Disease. All the stage of Non-Alcoholic Fatty Liver Disease had a significant difference of Gensini score among them with but there was no difference of Gensini score between stage 1 and 2. The presence of Non-Alcoholic Fatty Liver Disease Is associated with a higher Gensini score, however a higher grade of Non-Alcoholic Fatty Liver Disease doesn’t mandate a higher Gensini score.
BACKGROUNDThe prevalence of chronic heart failure (HF) in the general population has been estimated to be around 2-3%.1 Dilated cardiomyopathy (DCM) is the most common cause of HF in young adults.2 The recognition of elevated heart rate as a risk factor for cardiovascular morbidity and mortality and its association with sudden cardiac death has made lowering the heart rate in HF patients one of the most important therapeutic approaches.The aim of the study is to assess the role of ivabradine in idiopathic dilated cardiomyopathy by modulating heart rate, based on functional class, and echocardiographic parameters.
BACKGROUNDWomen constitute about 48% of the total population in India; however due to inadequate perception and attention, CHD also remains a formidable health problem of women in India and it is rightly said that CHD is under diagnosed, undertreated and under researched disease in women for various reasons. Therefore, this study was designed to determine the clinical profile and angiographic characteristics of women with CAD who presented to our hospital, one of the apex referral centre in eastern part of India.
Introduction: Acute Myocardial Infarction (MI) is one of the most common causes of death and disability throughout the world. The most common of all Acute Coronary Syndrome (ACS) in Indian patients is acute ST Elevation Myocardial Infarction (STEMI). Although acute MI more commonly occurs in patients older than 45 years of age, young men and women can also have MI. Aim: To study the risk factors, clinical presentation, angiographic profile and short-term prognosis in patients with STEMI with age <45 years. Materials and Methods: A cross-sectional study was carried out in the Department of Cardiology, SCB Medical College and Hospital, Cuttack, Odisha, India. A total of 198 patients of age ≤45 years with acute STEMI, of both genders diagnosed based on symptoms, Electrocardiogram (ECG), Echocardiogram (Echo) and biomarkers were enrolled from June 2019 to November 2020. Categorical variables were tabulated in frequency with percentage distribution and continuous variables were summarised in mean±SD (Standard Deviation). Results: This study included 198 patients, aged ≤45 years, with STEMI. STEMI was more common in males. The mean age was 38.28 and 42.15 years for males and females, respectively. Smoking (63.5%) was the most common risk factor, followed by dyslipidemia (28.5%). Most of the patients (86.5%) presented with typical chest pain. Killip’s Class I was most common (92.5%) at the time of admission. Anterior Wall Myocardial Infarction (AWMI) was the presentation in the majority (61%). Most patients (47%) had Single Vessel Disease (SVD). One third of the patients had re-canalysed vessels. Type A lesion was commonly seen (61%) and 60% patients underwent coronary angioplasty. Conclusion: In young STEMI patients males were commoner and smoking and dyslipidemia were found to be the common risk factors, smoking being twice more common than dyslipidemia. Typical chest pain of Killip Class I and AWMI were seen in majority. Half of the patients had SVD and one third was found to be re- canalysed. Type A was the commonest lesion and two thirds of the study population could undergo coronary angioplasty.
Aims and Objectives: The present study was aimed in analyzing the clinical presentations, etiological influences, and echocardiographic structures of cases of atrial fibrillation (AF) in SCB MCH, Cuttack. Methods: A cross-sectional research performed on AF cases admitted in SCB MCH, Cuttack, during the period from May 2021 to November 2022. Detailed history, thorough clinical examination and transthoracic echocardiography, has been carried out among study population. Results: Average age of cases was observed as 49.56±17.64 years. Among 100 cases, females were found to be 63% whereas males as 37%. Most of the cases were suffered due to more than one symptoms of severity. About 59% of cases showed rheumatic heart disease (RHD) out of total 100 cases. Among RHD cases, 43% cases were female and the male cases as 16%. Hypertension and coronary artery disease formed the furthermost communal reasons. Mean left atrial (LA) dimension between the study populations was found to be 4.49±0.57 cm. Conclusion: This study concluded that dyspnea seems to be the most common observed symptom; RHD forms the major communal reasons for AF, preceded by hypertension. Mitral valve seems to be involved among all cases of RHD. In major cases, LA enlargement has been reported; therefore, this forms the prognosticator of AF. LA enlargement cases seem to be further susceptible to progress to LA appendage clot.
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