Muhammad R Raza, Irfan Younus Bhatti Rajput, Kashif Zafar, Faiza Altaf, Sobia Aziz
Background: Pandemic caused by Corona virus infection has damaged the population throughout the universe. Cases of COVID-19 increased rapidly in whole world. COVID-19 has been associated with a number of cardiovascular co-morbidities including hypertension, ischemic heart disease, diabetes mellitus, dyslipidemia, atrial fibrillation and cardiac failure. Aims and objective: To determine the frequency of cardiovascular complications in patients with COVID-19. Material and methods: This observational cohort study was conducted in corona ward of DHQ Hospital, Gujrat from 1st January to 31st June 2021. Total 216 patients between 18-70 years of age, admitted who had COVID-19 confirmed by PCR after taking informed consent; patients already suffering from any cardiovascular, respiratory or other life threatening illness were excluded while hypertensive, diabetics and smoker were included in the study. Duration of admission was according to the severity of illness. Detailed history was taken from all patients followed by relevant examination. Investigations like ECG, echocardiographically and troponins were done to diagnose cardiovascular complications. All the patients were treated conservatively. Frequency of cardiovascular complications was noted. The patients who had clinical relief of symptoms, fever free, normal X-Ray chest and at least two consecutive negative PCR results for covid-19 were discharged. p value <0.05 was considered as significant. Results:� Out of two hundred sixteen patients, 30(14%) patients were diabetics and 21(10%) were hypertensive. Myocardial injury in 12% (myocarditis 4%, myocardial infarction 1%, raised troponins without myocarditis and ECG changes in 7% thromboembolism 1%, right ventricle dysfunction 5%, arrhythmias in 9%. Most of the patients had mild symptoms and recovered by conservative management. About 4-5% patients required invasive ventilatory support. Age, gender, diabetes, hypertension and previous cardiovascular co-morbidities increase the frequency of cardiovascular complications. Overall mortality was around 2%. p value was calculated as significant < 0.05. Conclusion: COVID-19 is known for cardiovascular complications in which acute myocardial injury, myocarditis, arrhythmias, thromboembolism, right ventricle dysfunction are common. These complications are more common in those having cardiovascular disease (CVD) or other co-morbidities
{"title":"The frequency of cardiovascular complications in patients suffering from COVID-19","authors":"Muhammad R Raza, Irfan Younus Bhatti Rajput, Kashif Zafar, Faiza Altaf, Sobia Aziz","doi":"10.55958/jcvd.v18i2.91","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.91","url":null,"abstract":"Background: Pandemic caused by Corona virus infection has damaged the population throughout the universe. Cases of COVID-19 increased rapidly in whole world. COVID-19 has been associated with a number of cardiovascular co-morbidities including hypertension, ischemic heart disease, diabetes mellitus, dyslipidemia, atrial fibrillation and cardiac failure. \u0000Aims and objective: To determine the frequency of cardiovascular complications in patients with COVID-19. \u0000Material and methods: This observational cohort study was conducted in corona ward of DHQ Hospital, Gujrat from 1st January to 31st June 2021. Total 216 patients between 18-70 years of age, admitted who had COVID-19 confirmed by PCR after taking informed consent; patients already suffering from any cardiovascular, respiratory or other life threatening illness were excluded while hypertensive, diabetics and smoker were included in the study. Duration of admission was according to the severity of illness. Detailed history was taken from all patients followed by relevant examination. Investigations like ECG, echocardiographically and troponins were done to diagnose cardiovascular complications. All the patients were treated conservatively. Frequency of cardiovascular complications was noted. The patients who had clinical relief of symptoms, fever free, normal X-Ray chest and at least two consecutive negative PCR results for covid-19 were discharged. p value <0.05 was considered as significant. \u0000Results:� Out of two hundred sixteen patients, 30(14%) patients were diabetics and 21(10%) were hypertensive. Myocardial injury in 12% (myocarditis 4%, myocardial infarction 1%, raised troponins without myocarditis and ECG changes in 7% thromboembolism 1%, right ventricle dysfunction 5%, arrhythmias in 9%. Most of the patients had mild symptoms and recovered by conservative management. About 4-5% patients required invasive ventilatory support. Age, gender, diabetes, hypertension and previous cardiovascular co-morbidities increase the frequency of cardiovascular complications. Overall mortality was around 2%. p value was calculated as significant < 0.05. \u0000Conclusion: COVID-19 is known for cardiovascular complications in which acute myocardial injury, myocarditis, arrhythmias, thromboembolism, right ventricle dysfunction are common. These complications are more common in those having cardiovascular disease (CVD) or other co-morbidities","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120985971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maroosh Mumtaz, Fatima Qurratulain Qurratulain, F. Umair, Sadia Nasim Nasim, H. Ali, Kashif Zafar
Background: Contrast induced nephropathy is a well-known entity but it is less known that whether cardiac disease is a risk factor for this complication. Contrast induced nephropathy (CIN) is related with increase mortality and morbidity and the chances of this complication rises in patients who have coronary artery disease (CAD). Objective: The objective of the study is to identify the frequency of contrast induced nephropathy in patients undergoing percutaneous coronary intervention who have normal baseline renal functions. Material and methods: This cross sectional study conducted at angiography department of Punjab Institute of Cardiology, Lahore over a period of 2 years from January 2015 to January 2017. Patients regardless of gender with age of 30 - 65 years, diabetic or non-diabetics were included. Patients with renal disease or serum creatinine > 2 mg/dl at presentation or any other co-morbid medical illness, LV ejection fraction <30% were excluded from study. All the patients underwent coronary angioplasty. Renal function tests were checked 48 hours after procedure. The patients who had their creatinine level raised by 0.5mg/dl after 48hrs were labeled as sufferers of contrast induced nephropathy (CIN). RESULTS Results were compiled after studying the specific variables. Out of 5400 patients who underwent coronary angioplasty, 2988 (55.4%) patients were males & 2412 (44.6%) were females. Out of 5400 patients, 936 (17.33 %) suffered from CIN after PCI. Patients suffered from CIN when following volume of contrast was used: <100ml, 36 (3.84%) patients, 100-200 ml, 288 (30.7%) patients and >200ml, 612 (65.3%) patients. According to the age group following patients suffered from CIN: 30-40 years, 72 (8.6%) patients, 41-55 years, 288 (11.2 %) patients and 56-65 years 576 (28.5%) patients. Out of 2988 male patients, 324 (10.8 %) patients suffered from CIN (p=0.06). Similarly, out of 2412 females 612 (25.3 %) patients had CIN (p=0.05). In 936 patients suffering from CIN, 684(73.1%) patients were diabetic and 252 (26.9%) were non-diabetic. � Conclusion: There is a high frequency of contrast induced nephropathy in elderly and diabetic patients who undergo PCI even if they have normal preexisting renal functions, so this complication can be avoided by the minimum use of contrast during the procedure
{"title":"Contrast induced nephropathy in patients of acute coronary syndrome with normal renal functions undergoing percutaneous coronary intervention","authors":"Maroosh Mumtaz, Fatima Qurratulain Qurratulain, F. Umair, Sadia Nasim Nasim, H. Ali, Kashif Zafar","doi":"10.55958/jcvd.v18i2.101","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.101","url":null,"abstract":"Background: Contrast induced nephropathy is a well-known entity but it is less known that whether cardiac disease is a risk factor for this complication. Contrast induced nephropathy (CIN) is related with increase mortality and morbidity and the chances of this complication rises in patients who have coronary artery disease (CAD). \u0000Objective: The objective of the study is to identify the frequency of contrast induced nephropathy in patients undergoing percutaneous coronary intervention who have normal baseline renal functions. \u0000Material and methods: This cross sectional study conducted at angiography department of Punjab Institute of Cardiology, Lahore over a period of 2 years from January 2015 to January 2017. Patients regardless of gender with age of 30 - 65 years, diabetic or non-diabetics were included. Patients with renal disease or serum creatinine > 2 mg/dl at presentation or any other co-morbid medical illness, LV ejection fraction <30% were excluded from study. All the patients underwent coronary angioplasty. Renal function tests were checked 48 hours after procedure. The patients who had their creatinine level raised by 0.5mg/dl after 48hrs were labeled as sufferers of contrast induced nephropathy (CIN). \u0000RESULTS \u0000Results were compiled after studying the specific variables. Out of 5400 patients who underwent coronary angioplasty, 2988 (55.4%) patients were males & 2412 (44.6%) were females. Out of 5400 patients, 936 (17.33 %) suffered from CIN after PCI. \u0000Patients suffered from CIN when following volume of contrast was used: <100ml, 36 (3.84%) patients, 100-200 ml, 288 (30.7%) patients and >200ml, 612 (65.3%) patients. According to the age group following patients suffered from CIN: 30-40 years, 72 (8.6%) patients, 41-55 years, 288 (11.2 %) patients and 56-65 years 576 (28.5%) patients. Out of 2988 male patients, 324 (10.8 %) patients suffered from CIN (p=0.06). Similarly, out of 2412 females 612 (25.3 %) patients had CIN (p=0.05). In 936 patients suffering from CIN, 684(73.1%) patients were diabetic and 252 (26.9%) were non-diabetic. \u0000� \u0000Conclusion: There is a high frequency of contrast induced nephropathy in elderly and diabetic patients who undergo PCI even if they have normal preexisting renal functions, so this complication can be avoided by the minimum use of contrast during the procedure","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133291356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Ali, Muhammad Amad Abbasi Abbasi, Muhammad Aqeel Aqeel, Habib ur Razaq Razaq, Khurram Shahzad Shahzad
Abstract Elevated plasma lipoprotein (A) concentration is considered as a predisposing risk factor for cardiovascular disease and in-stent restenosis. Lipoprotein (A) is a lipoprotein with an LDL-like particle that contains Apo-lipoprotein B100 and is associated with cardiovascular complications. The most prevalent complication associated with percutaneous coronary intervention is in-stent restenosis.In-stent Restenosis affected 40% of all angioplasties in the pre-stent era, then 28% in the (BMS) era. Furthermore, the introduction of (DES) second generation and drug-coated balloons has further reduced restenosis rates to less than 10%. The aim of this review paper is to investigate the clinical association of Lipoprotein (A) concentration in the occurrence of in-stent restenosis. Our paper possesses some limitations Firstly, it does not explain how lipoprotein concentrations are established. Secondly, the mechanism underlying the lipoprotein (A) lowering effect of current therapy. Keywords: Lipoprotein A, in-stent restenosis, predisposing factor, Diabetes mellitus, Cardio-vascular disease.
{"title":"Association of Lipoprotein A, a Predisposing Risk Factor for In-stent Restenosis","authors":"K. Ali, Muhammad Amad Abbasi Abbasi, Muhammad Aqeel Aqeel, Habib ur Razaq Razaq, Khurram Shahzad Shahzad","doi":"10.55958/jcvd.v18i2.89","DOIUrl":"https://doi.org/10.55958/jcvd.v18i2.89","url":null,"abstract":"Abstract \u0000Elevated plasma lipoprotein (A) concentration is considered as a predisposing risk factor for cardiovascular disease and in-stent restenosis. Lipoprotein (A) is a lipoprotein with an LDL-like particle that contains Apo-lipoprotein B100 and is associated with cardiovascular complications. The most prevalent complication associated with percutaneous coronary intervention is in-stent restenosis.In-stent Restenosis affected 40% of all angioplasties in the pre-stent era, then 28% in the (BMS) era. Furthermore, the introduction of (DES) second generation and drug-coated balloons has further reduced restenosis rates to less than 10%. The aim of this review paper is to investigate the clinical association of Lipoprotein (A) concentration in the occurrence of in-stent restenosis. Our paper possesses some limitations Firstly, it does not explain how lipoprotein concentrations are established. Secondly, the mechanism underlying the lipoprotein (A) lowering effect of current therapy. \u0000Keywords: Lipoprotein A, in-stent restenosis, predisposing factor, Diabetes mellitus, Cardio-vascular disease.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115036726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Serous fluids like pericardial, pleural and ascitic fluids are frequently submitted for pathological evaluation. The differentiation of these fluids into transudates and exudates is the prime aim of the evaluation as this determines the patients’ further management. Light’s criteria, proposed about 50 years ago, utilize various biochemical parameters for this differentiation and are the most widely used criteria. Materials and Methods: This study was carried-out in Pathology department of Punjab Institute of Cardiology, Lahore. 60 serous fluid samples, including pericardial, pleural and ascitic fluids were analyzed routinely and classified into transudates and exudates applying Light’s criteria. The proportion of transudates and exudates were compared amongst different fluids by applying chi-square test, keeping level of significance at p-value <0.05. Cytological examination was reported according to the International System for Reporting Serous Fluid Cytopathology. Results: Most of the fluids, i.e., 44 out of 60 were exudates. This trend was most pronounced for pericardial fluids where 29 out of 31 were exudates. 13 pleural fluids out of 23 were exudative while only 2 out of 6 ascitic fluids were exudative. On cytological examination, 55 fluids were negative for malignant cells, 2 fluids harbored atypical cells and 3 were positive for malignant cells. Careful gross examination of fluids furnished vital information in many cases. Conclusion: Light’s criteria may not be equally applicable across all types of fluids. In our study it had a high sensitivity but low specificity for pericardial exudates. Hence, modification of the criteria may be required to enhance its validity. Careful gross and cytological examination may provide additional invaluable information that could significantly impact management strategies. Keywords: Pleural fluid, pericardial fluid, light’s criteria, transudate, exudate.
{"title":"Evaluation of the applicability of Light’s criteria for differentiation of transudates from exudates across different serous fluids","authors":"A. Imran, Sadaf Farzand","doi":"10.55958/jcvd.v18i1.94","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.94","url":null,"abstract":"Background: Serous fluids like pericardial, pleural and ascitic fluids are frequently submitted for pathological evaluation. The differentiation of these fluids into transudates and exudates is the prime aim of the evaluation as this determines the patients’ further management. Light’s criteria, proposed about 50 years ago, utilize various biochemical parameters for this differentiation and are the most widely used criteria. \u0000Materials and Methods: This study was carried-out in Pathology department of Punjab Institute of Cardiology, Lahore. 60 serous fluid samples, including pericardial, pleural and ascitic fluids were analyzed routinely and classified into transudates and exudates applying Light’s criteria. The proportion of transudates and exudates were compared amongst different fluids by applying chi-square test, keeping level of significance at p-value <0.05. Cytological examination was reported according to the International System for Reporting Serous Fluid Cytopathology. \u0000Results: Most of the fluids, i.e., 44 out of 60 were exudates. This trend was most pronounced for pericardial fluids where 29 out of 31 were exudates. 13 pleural fluids out of 23 were exudative while only 2 out of 6 ascitic fluids were exudative. On cytological examination, 55 fluids were negative for malignant cells, 2 fluids harbored atypical cells and 3 were positive for malignant cells. Careful gross examination of fluids furnished vital information in many cases. \u0000Conclusion: Light’s criteria may not be equally applicable across all types of fluids. In our study it had a high sensitivity but low specificity for pericardial exudates. Hence, modification of the criteria may be required to enhance its validity. Careful gross and cytological examination may provide additional invaluable information that could significantly impact management strategies. \u0000Keywords: Pleural fluid, pericardial fluid, light’s criteria, transudate, exudate.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129627029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Umair, K. Sheikh, Nimra Ashraf, Azhar Saeed Saeed, H. Ali, M. Khalid
Introduction: Obesity raises the risk of cardiovascular disease, the clinical result of acute cardiovascular events may be better in people with a high body mass index (BMI). Aims and Objective: The objective of the study was to compare the frequency of in-hospital mortality in underweight, normal, overweight and obese patients presenting with acute ST elevation myocardial infarction. Material and methods: From September 2017 to February 2018, a descriptive case series was held at the Cardiology Ward of the Punjab Institute of Cardiology in Lahore. A total of 350 patients who met the eligibility requirements were enrolled. Then height and weight were noted and BMI was calculated. The patients were followed-up for 5 days after STEMI. If patient died within hospital stay, then in-hospital mortality was labeled. Results: The mean age of patients was 57.94±13.62 years. There were 177 (50.6%) males and 173 (49.4%) females. 160 (45.7%) patients were diabetic while 190 (54.3%) were non-diabetic. The mean BMI of patients was 25.36±5.66 kg/m2. In-hospital mortality occurred in 11 (22.4%) underweight patients, in 8 (7.1%) patients who had normal BMI, in 11 (10.9%) who were overweight while in 9 (10.2%) who were obese. The significant difference was observed and underweight patients had high in-hospital motility (p<0.05). Conclusion: The frequency of in-hospital mortality was high in underweight patients as compared to normal, overweight or obese patients. Key words: Body mass index, ST elevation myocardial infarction, in-hospital mortality, underweight, normal, overweight, obese
{"title":"Impact Of Body Mass Index On In-Hospital Mortality In Patients Presenting With Acute ST Elevation Myocardial Infarction","authors":"F. Umair, K. Sheikh, Nimra Ashraf, Azhar Saeed Saeed, H. Ali, M. Khalid","doi":"10.55958/jcvd.v18i1.93","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.93","url":null,"abstract":"Introduction: Obesity raises the risk of cardiovascular disease, the clinical result of acute cardiovascular events may be better in people with a high body mass index (BMI). \u0000Aims and Objective: The objective of the study was to compare the frequency of in-hospital mortality in underweight, normal, overweight and obese patients presenting with acute ST elevation myocardial infarction. \u0000Material and methods: From September 2017 to February 2018, a descriptive case series was held at the Cardiology Ward of the Punjab Institute of Cardiology in Lahore. A total of 350 patients who met the eligibility requirements were enrolled. Then height and weight were noted and BMI was calculated. The patients were followed-up for 5 days after STEMI. If patient died within hospital stay, then in-hospital mortality was labeled. \u0000Results: The mean age of patients was 57.94±13.62 years. There were 177 (50.6%) males and 173 (49.4%) females. 160 (45.7%) patients were diabetic while 190 (54.3%) were non-diabetic. The mean BMI of patients was 25.36±5.66 kg/m2. In-hospital mortality occurred in 11 (22.4%) underweight patients, in 8 (7.1%) patients who had normal BMI, in 11 (10.9%) who were overweight while in 9 (10.2%) who were obese. The significant difference was observed and underweight patients had high in-hospital motility (p<0.05). \u0000Conclusion: The frequency of in-hospital mortality was high in underweight patients as compared to normal, overweight or obese patients. \u0000Key words: Body mass index, ST elevation myocardial infarction, in-hospital mortality, underweight, normal, overweight, obese","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116370913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gulshan Ahmad Ahmad, Samar Arfeen Arfeen, S. Khatti, Z. Butt, K. Ali, Saleem Ullah
Background: Acute Coronary Syndrome (ACS) is the term collectively used for referring to clinical manifestations of myocardium ischemia which include unstable angina, myocardial infarction with non-ST-segment elevation and myocardial infarction with ST-segment elevation.1 Myocardial Infarction (STEMI) is characterized by ST elevation presented on the ECG, that is the electrical presentation of the occlusion due to thrombosis in a coronary artery. After the fibrinolytic therapy in STEMI cases, the resolution of ST-segment is analyzed on ECG which serves as easy and cost-effective solution for the assessment of coronary reperfusion. In a study, it is found that 61.5% patients of STEMI showed ST-resolution after streptokinase. Aims and Objective: To determine the frequency of ST-segment resolution after streptokinase in acute STEMI patients. Materials and Methods: This cross-sectional study was carried out from 08-07- 2016 to 07-01-2017.After taking approval from ethical committee and explaining the procedure informed consent was taken. Ninety-two (92) patients were recruited from emergency Department of Tabba Heart Institute Karachi on the basis of inclusion/exclusion criteria via non-probability consecutive sampling technique. ECGs were taken at presentation. ST-elevation was recorded in millimeters in lead with maximum ST-elevation. Injection streptokinase was administered. ECG was performed after 60 minutes of infusion of injection streptokinase. ST resolution in the lead with the maximum ST elevation was noted and was labeled as positive as per operational definition. Results: The range of the age in this study was from 25 to 80 years with mean age of 54.9 ± 4.8 years. Out of 92 patients, 56(60.9%) were male and 36(39.1%) were female. Regarding ECG changes sixty patients (71.7%) were successfully resolved after streptokinase in acute STEMI patients while in twenty-six patients (28.3%) could not resolve. Conclusion: Successfully resolution of ECG changes seen in 71.7% patients after streptokinase in acute STEMI patients while could not be resolved in 28.3% patients. Thus, streptokinase could be preferred therapy for thrombolysis in STEMI. Keywords: ST-elevation myocardial infarction, streptokinase, ST- segment resolution.
{"title":"Frequency of ST-segment resolution after thrombolysisin acute stelevation myocardial infarction patients","authors":"Gulshan Ahmad Ahmad, Samar Arfeen Arfeen, S. Khatti, Z. Butt, K. Ali, Saleem Ullah","doi":"10.55958/jcvd.v18i1.82","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.82","url":null,"abstract":"Background: Acute Coronary Syndrome (ACS) is the term collectively used for referring to clinical manifestations of myocardium ischemia which include unstable angina, myocardial infarction with non-ST-segment elevation and myocardial infarction with ST-segment elevation.1 Myocardial Infarction (STEMI) is characterized by ST elevation presented on the ECG, that is the electrical presentation of the occlusion due to thrombosis in a coronary artery. After the fibrinolytic therapy in STEMI cases, the resolution of ST-segment is analyzed on ECG which serves as easy and cost-effective solution for the assessment of coronary reperfusion. In a study, it is found that 61.5% patients of STEMI showed ST-resolution after streptokinase. \u0000 \u0000Aims and Objective: To determine the frequency of ST-segment resolution after streptokinase in acute STEMI patients. \u0000 \u0000Materials and Methods: This cross-sectional study was carried out from 08-07- 2016 to 07-01-2017.After taking approval from ethical committee and explaining the procedure informed consent was taken. Ninety-two (92) patients were recruited from emergency Department of Tabba Heart Institute Karachi on the basis of inclusion/exclusion criteria via non-probability consecutive sampling technique. ECGs were taken at presentation. ST-elevation was recorded in millimeters in lead with maximum ST-elevation. Injection streptokinase was administered. ECG was performed after 60 minutes of infusion of injection streptokinase. ST resolution in the lead with the maximum ST elevation was noted and was labeled as positive as per operational definition. \u0000 \u0000Results: The range of the age in this study was from 25 to 80 years with mean age of 54.9 ± 4.8 years. Out of 92 patients, 56(60.9%) were male and 36(39.1%) were female. Regarding ECG changes sixty patients (71.7%) were successfully resolved after streptokinase in acute STEMI patients while in twenty-six patients (28.3%) could not resolve. \u0000 \u0000Conclusion: Successfully resolution of ECG changes seen in 71.7% patients after streptokinase in acute STEMI patients while could not be resolved in 28.3% patients. Thus, streptokinase could be preferred therapy for thrombolysis in STEMI. \u0000 \u0000Keywords: ST-elevation myocardial infarction, streptokinase, ST- segment resolution.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122789594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Coronary artery spasm defined as constriction of coronary artery segment either focal or diffuse, may be single or multiple. Which is reversible and cause myocardial ischemia by restricting coronary blood flow and may lead to thrombus formation. We present a case of coronary artery spasm that lead to CABG and was discovered after CABG.
{"title":"Case report: Coronary artery spasm during coronary angiography leading to faulty decision","authors":"F. Umair, H. Ali, Ahmad Noeman","doi":"10.55958/jcvd.v18i1.95","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.95","url":null,"abstract":"Abstract: \u0000Coronary artery spasm defined as constriction of coronary artery segment either focal or diffuse, may be single or multiple. Which is reversible and cause myocardial ischemia by restricting coronary blood flow and may lead to thrombus formation. We present a case of coronary artery spasm that lead to CABG and was discovered after CABG.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115064826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Saleem, Sajjad Ahmad, Z. Sadiq, G. Ahmed, Jawad Ahmed, S. Munir
Background: In some cases of acute inferior wall myocardial infarction, atrioventricular (AV) block is known to be reversible. AV block is associated with certain complications. This study to find the frequency of AV block and related complications in local population. Aims and objective: The objective of the study was to establish the frequency of atrioventricular block in patients presenting with acute coronary syndrome (ACS) and to compare the outcome in patients with or without atrioventricular block Material and methods: Thiscross sectional study was carried-out at the department of Cardiology, Punjab Institute of Cardiology, Lahore over a period of six months.Patients were screened for AV block. During hospital stay, patients were assessed for congestive heart failure, cardiogenic shock, cardiac arrest and mortality. Patients with and without AV block were compared by using chi-square test. Results: In our study, the mean age of patients was 61.00±11.75years. There were 242 (50.4%) males while 238 (49.6%) females. AV block was present in 95 (19.8%) patients while 385 (80.2%) did not develop AV block. Congestive heart failure was present in 50 (52.6%) patients with AV block while in 62 (16.1%)patient without AV block. Cardiogenic shock was present in 27 (28.4%) patients with AV block while in 30 (7.8%) patients without AV block. Cardiac arrest was present in 34 (35.8%) patients with AV block while in 42 (10.9%)patient without AV block. Death occurred in 28 (29.5%) patients with AV block while in 19 (4.9%)patient without AV block. The difference was significant (p<0.05) for all outcomes in both groups. Conclusion The frequency of AV block was although low but the complications were significantly high in patients with AV block. Key words Atrioventricular block, acute coronary syndrome, cardiogenic shock, cardiac arrest, congestive heart failure, death
{"title":"Frequency of atrioventricular block in patients presenting with acute coronary syndrome and to compare the outcome in patients with or without atrioventricular block","authors":"N. Saleem, Sajjad Ahmad, Z. Sadiq, G. Ahmed, Jawad Ahmed, S. Munir","doi":"10.55958/jcvd.v18i1.21","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.21","url":null,"abstract":"Background: \u0000In some cases of acute inferior wall myocardial infarction, atrioventricular (AV) block is known to be reversible. AV block is associated with certain complications. This study to find the frequency of AV block and related complications in local population. \u0000Aims and objective: \u0000The objective of the study was to establish the frequency of atrioventricular block in patients presenting with acute coronary syndrome (ACS) and to compare the outcome in patients with or without atrioventricular block \u0000Material and methods: \u0000Thiscross sectional study was carried-out at the department of Cardiology, Punjab Institute of Cardiology, Lahore over a period of six months.Patients were screened for AV block. During hospital stay, patients were assessed for congestive heart failure, cardiogenic shock, cardiac arrest and mortality. Patients with and without AV block were compared by using chi-square test. \u0000Results: \u0000In our study, the mean age of patients was 61.00±11.75years. There were 242 (50.4%) males while 238 (49.6%) females. AV block was present in 95 (19.8%) patients while 385 (80.2%) did not develop AV block. Congestive heart failure was present in 50 (52.6%) patients with AV block while in 62 (16.1%)patient without AV block. Cardiogenic shock was present in 27 (28.4%) patients with AV block while in 30 (7.8%) patients without AV block. Cardiac arrest was present in 34 (35.8%) patients with AV block while in 42 (10.9%)patient without AV block. Death occurred in 28 (29.5%) patients with AV block while in 19 (4.9%)patient without AV block. The difference was significant (p<0.05) for all outcomes in both groups. \u0000Conclusion \u0000The frequency of AV block was although low but the complications were significantly high in patients with AV block. \u0000Key words \u0000Atrioventricular block, acute coronary syndrome, cardiogenic shock, cardiac arrest, congestive heart failure, death","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116846859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Ashar, Taimur Ahmad, S. Munir, M. Iqbal, Z. Asar, Syed Asif Ali Ali
BACKGROUND: Coronary artery ectasia (CAE) is the aneurysmal dilatation of coronary arteries, which can be local or generalized. It is deliberated as the variant of coronary atherosclerosis. CAE occurs due to several risk factors of cardiovascular diseases. AIMS AND OBJECTIVE: To assess the frequency of various coronary risk factors in patients with acute coronary syndrome having coronary ectasia. MATERIAL AND METHODS: This cross sectional study was carried out at the department of cardiology, Mayo hospital, Lahore over the duration of 6 months from 01-11-2017 to 30-04-2018. Total 135 patients fulfilling the selection criteria were recruited. History of patient regarding coronary risk factors was obtained including DM, smoking, hypertension and hyperlipidemia. RESULTS: The mean age of patients was 59.70±11.29years. There were 75 (55.6%) males and 60 (44.4%) females. The mean BMI of patients was 27.43±4.77kg/m2. In this study, 39 (28.9%) had STEMI, 45 (33.3%) had NSTEMI while 51 (37.8%) had UA. In this study, 93 (68.9%) patients had hypertension, 41 (30.4%) patients had diabetes, 43 (31.9%) patients were smokers and66 (48.9%) patients had hyperlipidemia. CONCLUSION: Frequency of certain risk factors causing coronary artery ectasia in patients having ACS is high in local population. KEY WORDS: Coronary factors, acute coronary syndrome, coronary ectasia, hypertension, diabetes, hyperlipidemia, smoking.
{"title":"Frequency of various coronary risk factors in patients with acute coronary syndrome having coronary ectasia","authors":"Ali Ashar, Taimur Ahmad, S. Munir, M. Iqbal, Z. Asar, Syed Asif Ali Ali","doi":"10.55958/jcvd.v18i1.76","DOIUrl":"https://doi.org/10.55958/jcvd.v18i1.76","url":null,"abstract":"BACKGROUND: Coronary artery ectasia (CAE) is the aneurysmal dilatation of coronary arteries, which can be local or generalized. It is deliberated as the variant of coronary atherosclerosis. CAE occurs due to several risk factors of cardiovascular diseases.\u0000AIMS AND OBJECTIVE: To assess the frequency of various coronary risk factors in patients with acute coronary syndrome having coronary ectasia.\u0000MATERIAL AND METHODS: This cross sectional study was carried out at the department of cardiology, Mayo hospital, Lahore over the duration of 6 months from 01-11-2017 to 30-04-2018. Total 135 patients fulfilling the selection criteria were recruited. History of patient regarding coronary risk factors was obtained including DM, smoking, hypertension and hyperlipidemia.\u0000RESULTS: The mean age of patients was 59.70±11.29years. There were 75 (55.6%) males and 60 (44.4%) females. The mean BMI of patients was 27.43±4.77kg/m2. In this study, 39 (28.9%) had STEMI, 45 (33.3%) had NSTEMI while 51 (37.8%) had UA. In this study, 93 (68.9%) patients had hypertension, 41 (30.4%) patients had diabetes, 43 (31.9%) patients were smokers and66 (48.9%) patients had hyperlipidemia.\u0000CONCLUSION: Frequency of certain risk factors causing coronary artery ectasia in patients having ACS is high in local population.\u0000KEY WORDS: Coronary factors, acute coronary syndrome, coronary ectasia, hypertension, diabetes, hyperlipidemia, smoking.","PeriodicalId":227176,"journal":{"name":"The Journal of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124117825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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