Pub Date : 2023-04-18DOI: 10.1177/26324636231158460
S. Vooturi, Potharaju Anil, Yazala Monica
Cardiovascular disease is a leading cause of mortality across the globe. More than one-third of these deaths are due to coronary artery disease (CAD). Importantly, 80% of CAD and atherosclerosis-related morbidity and mortality can be prevented by modifying behaviors like physical inactivity. However, exercise is often “under-prescribed” to CAD patients; among those referred, only 40% actually participate. Improved understanding of benefits and recent advances in cardiac rehabilitation by patients and physicians may help improve referral and compliance to exercise training in these patients. In the current review, we discuss how increasing physical activity over the long-term leads to improvement in coronary blood flow and consequently reduces morbidity and mortality in patients with CAD.
{"title":"Effects of Exercise Training and Physical Activity in Patients with Coronary Artery Disease","authors":"S. Vooturi, Potharaju Anil, Yazala Monica","doi":"10.1177/26324636231158460","DOIUrl":"https://doi.org/10.1177/26324636231158460","url":null,"abstract":"Cardiovascular disease is a leading cause of mortality across the globe. More than one-third of these deaths are due to coronary artery disease (CAD). Importantly, 80% of CAD and atherosclerosis-related morbidity and mortality can be prevented by modifying behaviors like physical inactivity. However, exercise is often “under-prescribed” to CAD patients; among those referred, only 40% actually participate. Improved understanding of benefits and recent advances in cardiac rehabilitation by patients and physicians may help improve referral and compliance to exercise training in these patients. In the current review, we discuss how increasing physical activity over the long-term leads to improvement in coronary blood flow and consequently reduces morbidity and mortality in patients with CAD.","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129456710","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}
Pub Date : 2023-04-14DOI: 10.1177/26324636231163762
Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Srinath Kundu, Debasish Das
We report a case of deceleration-induced cardiac injury in a truck driver following traffic accident.Sonography revealed large pericardial effusion with tamponade. Surgical exploration showed large tear at SVC-RA junction which was repaired.Mechanism of such tear at that site is discussed.
{"title":"A Rare Case of Deceleration Induced Longitudinal Tear in Superior Vena Cava–Right Atrium Junction Presenting as Cardiac Tamponade","authors":"Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Srinath Kundu, Debasish Das","doi":"10.1177/26324636231163762","DOIUrl":"https://doi.org/10.1177/26324636231163762","url":null,"abstract":"We report a case of deceleration-induced cardiac injury in a truck driver following traffic accident.Sonography revealed large pericardial effusion with tamponade. Surgical exploration showed large tear at SVC-RA junction which was repaired.Mechanism of such tear at that site is discussed.","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132459726","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}
Pub Date : 2023-03-23DOI: 10.1177/26324636231158467
Megha Pushkarna
It is becoming increasingly apparent that although anxiety and depression are separate concerns, there is considerable overlap of clinical symptoms and pathophysiological processes. Research shows that comorbidities, anxiety, and depression are most common than either disorder alone. Coronary heart disease and mental illness are among the leading causes of morbidity and mortality worldwide. Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience challenging and demanding situations when their partner becomes critically ill. In the present research, spouses showed normal anxiety levels, but when assessed separately, women’s anxiety scores were significantly higher compared to men. There was no significant difference between male and female spouses’ depression scores. Correlation analysis showed a positive relationship between anxiety and depression scores explaining that with rise in anxiety scores, there was an increase in depression scores in female spouses. Spouses who were unemployed felt overwhelmed with not being financially competent to manage expenses incurred for surgery and pre- and postoperative care. Lastly, a lack of social support led to anxiety in nuclear families.
{"title":"Anxiety and Depression in Spouses of Cardiac Patients","authors":"Megha Pushkarna","doi":"10.1177/26324636231158467","DOIUrl":"https://doi.org/10.1177/26324636231158467","url":null,"abstract":"It is becoming increasingly apparent that although anxiety and depression are separate concerns, there is considerable overlap of clinical symptoms and pathophysiological processes. Research shows that comorbidities, anxiety, and depression are most common than either disorder alone. Coronary heart disease and mental illness are among the leading causes of morbidity and mortality worldwide. Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience challenging and demanding situations when their partner becomes critically ill. In the present research, spouses showed normal anxiety levels, but when assessed separately, women’s anxiety scores were significantly higher compared to men. There was no significant difference between male and female spouses’ depression scores. Correlation analysis showed a positive relationship between anxiety and depression scores explaining that with rise in anxiety scores, there was an increase in depression scores in female spouses. Spouses who were unemployed felt overwhelmed with not being financially competent to manage expenses incurred for surgery and pre- and postoperative care. Lastly, a lack of social support led to anxiety in nuclear families.","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131971268","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}
Pub Date : 2023-03-22DOI: 10.1177/26324636231162241
Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Debasish Das
{"title":"A Rare Case of Cor Triatriatum Dexter With Severe Rheumatic Mitral Stenosis With Severe Organic Tricuspid Valve Regurgitation Masquerading as Acute Pulmonary Embolism in a Young","authors":"Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Debasish Das","doi":"10.1177/26324636231162241","DOIUrl":"https://doi.org/10.1177/26324636231162241","url":null,"abstract":"","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128514269","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}
Pub Date : 2023-03-01DOI: 10.1177/26324636231157538
B. Rao
{"title":"Passing on the Editorial Baton","authors":"B. Rao","doi":"10.1177/26324636231157538","DOIUrl":"https://doi.org/10.1177/26324636231157538","url":null,"abstract":"","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122005288","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}
Pub Date : 2023-03-01DOI: 10.1177/26324636231157469
P. Patel, Rupesh Shrivastava, Raghuveer Patel, Pradeep Warghane
Some individuals develop a rare form of coronary heart disease called coronary artery ectasia (CAE). It is characterized by a dilation of more than one-third of the length of a coronary artery and a diameter that is 1.5 times that of the adjacent normal coronary artery. In the absence of significant coronary constriction, angina pectoris, positive stress tests, and acute coronary syndromes may all be indications of CAE. A distal embolization, vasospasm, or vascular rupture may cause thrombus formation in an ectatic artery. Antiplatelets, such as aspirin, are the cornerstone of treatment for people with CAE. Anticoagulants are used to prevent thrombus formation based on the presence of concurrent obstructive coronary artery disease and the patient’s risk of bleeding. As atherosclerosis is the most common cause of CAE, all patients are advised to take statins for primary prevention. Due to their anti-inflammatory properties, angiotensin-converting enzyme inhibitors may be prescribed to individuals with hypertension. If hypertension and coronary vasospasm occur simultaneously, beta-blockers and calcium channel blockers may be beneficial. Because they may aggravate symptoms, nitrates are normally not suggested. Other CAE treatment methods include the prevention of thromboembolic complications and percutaneous or surgical revascularization. CAE prognosis is determined on the severity of the associated coronary artery.
{"title":"Coronary Artery Ectasia","authors":"P. Patel, Rupesh Shrivastava, Raghuveer Patel, Pradeep Warghane","doi":"10.1177/26324636231157469","DOIUrl":"https://doi.org/10.1177/26324636231157469","url":null,"abstract":"Some individuals develop a rare form of coronary heart disease called coronary artery ectasia (CAE). It is characterized by a dilation of more than one-third of the length of a coronary artery and a diameter that is 1.5 times that of the adjacent normal coronary artery. In the absence of significant coronary constriction, angina pectoris, positive stress tests, and acute coronary syndromes may all be indications of CAE. A distal embolization, vasospasm, or vascular rupture may cause thrombus formation in an ectatic artery. Antiplatelets, such as aspirin, are the cornerstone of treatment for people with CAE. Anticoagulants are used to prevent thrombus formation based on the presence of concurrent obstructive coronary artery disease and the patient’s risk of bleeding. As atherosclerosis is the most common cause of CAE, all patients are advised to take statins for primary prevention. Due to their anti-inflammatory properties, angiotensin-converting enzyme inhibitors may be prescribed to individuals with hypertension. If hypertension and coronary vasospasm occur simultaneously, beta-blockers and calcium channel blockers may be beneficial. Because they may aggravate symptoms, nitrates are normally not suggested. Other CAE treatment methods include the prevention of thromboembolic complications and percutaneous or surgical revascularization. CAE prognosis is determined on the severity of the associated coronary artery.","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131810030","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}
Pub Date : 2023-01-20DOI: 10.1177/26324636221149466
Nishad Chitnis
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inhibitors are effective in patients with a higher left ventricular ejection fraction remains less certain. Methods: We randomly assigned 6,263 patients with heart failure and a left ventricular ejection fraction of more than 40% to receive dapagliflozin (at a dose of 10 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of worsening heart failure (which was
{"title":"New Developments in Cardiology with Implications in Clinical Practice","authors":"Nishad Chitnis","doi":"10.1177/26324636221149466","DOIUrl":"https://doi.org/10.1177/26324636221149466","url":null,"abstract":"Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or less. Whether SGLT2 inhibitors are effective in patients with a higher left ventricular ejection fraction remains less certain. Methods: We randomly assigned 6,263 patients with heart failure and a left ventricular ejection fraction of more than 40% to receive dapagliflozin (at a dose of 10 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of worsening heart failure (which was","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131658139","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}
Pub Date : 2023-01-18DOI: 10.1177/26324636221149522
M. Bansal
Cardiovascular disease (CVD) is the leading cause of mortality in India, and its prevalence continues to rise unabatedly.1,2 The rising prevalence of CVD in India necessitates urgent and effective steps to halt this epidemic. At the population level, it is required to educate people about the menace of CVD, emphasize upon them the need and the benefits of prevention, and teach them the ways to prevent CVD. At the individual level, strategies are needed to identify those at risk for developing CVD and then institute aggressive risk reduction strategies in them. Fundamental to both the approaches is a thorough understanding of the risk factors causing CVD in India. The mechanisms underlying CVD among Indians have been a matter of considerable debate. Indians (and in general South Asians) not only have a higher incidence of CVD, but they also tend to develop the disease at a younger age and have more severe and extensive disease.3–5 Greater genetic propensity has been postulated to be one of the important reasons underlying this excess CVD risk among Indians. This assumption is supported by the consistently higher CVD morbidity and mortality seen among the migrant South Asians residing in the UK or US, as compared to the respective native populations.6−8 In contrast, the famous INTERHEART study showed that even among South Asians, almost 90% of the acute myocardial infarctions could be explained by the nine conventional and non-conventional risk factors, namely, abnormal lipids, smoking, hypertension, diabetes mellitus (DM), abdominal obesity, psychosocial factors, lack of regular physical activity, consumption of alcohol, and lower intake of fruits and vegetables.5 It was further shown that the South Asians tended to develop these harmful factors at a younger age, and this led to the higher incidence and earlier onset of myocardial infarctions in them.9 The INTERHEART study thus relegated genetic factors to only a minor contributor toward excess CVD risk among South Asians. In a way, it is a reassuring finding since it allows us an opportunity to intervene through appropriate preventive strategies. The risk factor profile among South Asians and Indians has certain characteristic features. Visceral adiposity is
{"title":"Risk Factors for Acute Coronary Syndrome in Indians: A Reappraisal","authors":"M. Bansal","doi":"10.1177/26324636221149522","DOIUrl":"https://doi.org/10.1177/26324636221149522","url":null,"abstract":"Cardiovascular disease (CVD) is the leading cause of mortality in India, and its prevalence continues to rise unabatedly.1,2 The rising prevalence of CVD in India necessitates urgent and effective steps to halt this epidemic. At the population level, it is required to educate people about the menace of CVD, emphasize upon them the need and the benefits of prevention, and teach them the ways to prevent CVD. At the individual level, strategies are needed to identify those at risk for developing CVD and then institute aggressive risk reduction strategies in them. Fundamental to both the approaches is a thorough understanding of the risk factors causing CVD in India. The mechanisms underlying CVD among Indians have been a matter of considerable debate. Indians (and in general South Asians) not only have a higher incidence of CVD, but they also tend to develop the disease at a younger age and have more severe and extensive disease.3–5 Greater genetic propensity has been postulated to be one of the important reasons underlying this excess CVD risk among Indians. This assumption is supported by the consistently higher CVD morbidity and mortality seen among the migrant South Asians residing in the UK or US, as compared to the respective native populations.6−8 In contrast, the famous INTERHEART study showed that even among South Asians, almost 90% of the acute myocardial infarctions could be explained by the nine conventional and non-conventional risk factors, namely, abnormal lipids, smoking, hypertension, diabetes mellitus (DM), abdominal obesity, psychosocial factors, lack of regular physical activity, consumption of alcohol, and lower intake of fruits and vegetables.5 It was further shown that the South Asians tended to develop these harmful factors at a younger age, and this led to the higher incidence and earlier onset of myocardial infarctions in them.9 The INTERHEART study thus relegated genetic factors to only a minor contributor toward excess CVD risk among South Asians. In a way, it is a reassuring finding since it allows us an opportunity to intervene through appropriate preventive strategies. The risk factor profile among South Asians and Indians has certain characteristic features. Visceral adiposity is","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127753920","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}
Pub Date : 2023-01-18DOI: 10.1177/26324636221148906
K. Narayanan, M. Sreekar, Mohammed Arif
A stepwise analytic approach is needed to decipher tachyarrhythmia electrocardiograms. It is also important to be able to promptly recognize certain characteristic patterns described in some classical arrhythmias. Knowledge of these unique electrocardiogram morphologies and the underlying reasons for them help in quick diagnosis and appropriate management.
{"title":"Broad QRS Tachycardia: Recognizing Characteristic Patterns","authors":"K. Narayanan, M. Sreekar, Mohammed Arif","doi":"10.1177/26324636221148906","DOIUrl":"https://doi.org/10.1177/26324636221148906","url":null,"abstract":"A stepwise analytic approach is needed to decipher tachyarrhythmia electrocardiograms. It is also important to be able to promptly recognize certain characteristic patterns described in some classical arrhythmias. Knowledge of these unique electrocardiogram morphologies and the underlying reasons for them help in quick diagnosis and appropriate management.","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125047425","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}
Pub Date : 2023-01-16DOI: 10.1177/26324636221148915
Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Debasish Das
{"title":"Reconstruction of Radiotherapy-induced Perforation of Anterior Wall of Right External Iliac Artery in a Desmin Positive Pleomorphic Leiomyosarcoma with Ringed PTFE Graft","authors":"Satyapriya Mohanty, Pranjeet Deb, A. Banerjee, Abhinav Kumar, S. Singh, Debasish Das","doi":"10.1177/26324636221148915","DOIUrl":"https://doi.org/10.1177/26324636221148915","url":null,"abstract":"","PeriodicalId":429933,"journal":{"name":"Indian Journal of Clinical Cardiology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131052919","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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