Restrictive cardiomyopathy is the least common type of primary cardiomyopathies. Electrocardiographic recording is abnormal in 99% of patients with RCM. Biatrial enlargement, obliquely elevated ST segment with notched or biphasic late peaking T waves are considered characteristic ECG finding. Significant ST depression with T inversion mimicking subendocardial ischemia has also been reported in patients with RCM and is even suggested as a predictor of sudden cardiac death. We noted a similar ECG pattern in a 16 yr girl with Idiopathic restrictive cardiomyopathy. Coronaries were normal, stress perfusion imaging did not show any perfusion defect. This diffuse resting ST depression with T inversion in precordial & inferior leads along with ST elevation in aVR was persistent for more than six months.
OBJECTIVE:The goal of this study is to predict the long term LV function in RV apical paced patients.
BACKGROUND:We have used the GLS measured by 2D STE, as a tool to predict the patients who are at high risk of
developing pacing induced LV dysfunction (PIVD) or pacing induced cardiomyopathy (PCMP).
METHOD: A prospective study conducted in the cardiology department of Government Rajaji Hospital, Madurai, including 47 patients of AV
block or sinus node dysfunction with preserved ejection fraction undergoing RV apical pacing. This study population was followed up with serial
trans thoracic 2D echocardiography with GLS by STE for a period of 12 months for the development of PIVD (PCMP).
RESULTS: Of the study population, 42.5% (n=20) developed PIVD at 12 months and these patients had a signicant fall in their GLS values at
one month post pacing. (GLS -16.94% vs -17.60%; p=0.02).
CONCLUSION: GLS, a novel echocardiographic parameter can be used as a tool in predicting the decline in ejection fraction following
pacemaker implantation with potential to predict the development of PIVD. GLS at one month post pacing had a high predictive accuracy for
identifying those who developed PIVD later in the follow up.
Background: Febrile thrombocytopenia due to various etiologies is very common in India. Its clinical manifestations range from asymptomatic infections to severe disease. Cardiac involvement in such systemic illness should be evaluated. Aim of present study is to evaluate cardiac involvement in patients with Febrile thrombocytopenia with platelets count less than 50,000/µL with the help of handheld echocardiography.Methods: Two hundred patients who had fever with thrombocytopenia were enrolled in the study. ECG and echocardiogram were done to all the patients. One-way ANOVA, Chi square test and correlation coefficient from Pearson correlation and P value of < 0.05 was taken as significant.Results: Out of 200 patients there were 146 males and 56 females. The mean age was 24.12yrs in males 28.32yrs in females .Rhythm abnormalities were present in 60 patients and the most common abnormality was sinus tachycardia; 17 patients had ascites and right pleural effusion; 24 patients presented with pericardial effusion and incidental diagnosis of CHD, RHD, and CAD were made; two patients had myocarditis as evidenced by global hypokinesia of left ventricle. All of those cardiac manifestations were common in Dengue Shock Syndrome.Conclusions: Cardiovascular manifestation in Febrile thrombocytopenia is relatively common ranging from pericarditis to myocarditis. Clinician should routinely screen patients with pyrexia with thrombocytopenia for cardiac manifestations. Early diagnosis at bed side may improve the outcome. Management of patients with pre-existing cardiac diseases should be individualized.
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