Sanjaya Humagain, Surya Raj Pathak, Rajendra Prasad Koju
Background and Aims: Cardiovascular Disease is the leading cause of death. Prevention of cardiovascular disease is the major aim of treatment of anyone who has risk. Dyslipidemia lies in the center of cardiovascular disease risk. Not only there is difference in pattern of dyslipidemia and response to statins in different ethnic groups, there is difference in mortality due to cardiovascular disease in different race and ethnic group. Atorvastatin and Rosuvastatin are the first line statins. This study is carried out to see how our population responds to these statins in terms of change in lipid profile.
Methods: It is a real world observational study. Dyslipidemia patients requiring statins were given either Atorvastatin 10 mg or Rosuvastatin 5 mg according to physician’s discretion. Demographic profile and baseline lipid was recorded. Lipid profile was again recorded after 3 to 4 months of treatment.
Result: Out of 343 enrolled only 304 data was analyzed. Total cholesterol decreased by 21.9 % (p = 0.002) in Atorvastatin group and by 22.9 % (p= 0.002) in Rosuvastatin group. Low Density Lipoprotein (LDL) decreased by 22.3 % (p = 0.004) in Atorvastatin group and 21.5% (p=0.005) in Rosuvastatin group. There was no significant difference between two groups.
Conclusion: Both Atorvastatin 10 mg and Rosuvastatin 5 mg can reduce the lipids significantly in our population. There is no difference in using Atorvastatin 10 mg or Rosuvastatin 5 mg. However, reduction was only mild to moderate with the given doses.
{"title":"Efficacy of Different Statins Among Newly Diagnosed Dyslipidemic Patients in Dhulikhel Hospital","authors":"Sanjaya Humagain, Surya Raj Pathak, Rajendra Prasad Koju","doi":"10.3126/njh.v20i1.55004","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55004","url":null,"abstract":"Background and Aims: Cardiovascular Disease is the leading cause of death. Prevention of cardiovascular disease is the major aim of treatment of anyone who has risk. Dyslipidemia lies in the center of cardiovascular disease risk. Not only there is difference in pattern of dyslipidemia and response to statins in different ethnic groups, there is difference in mortality due to cardiovascular disease in different race and ethnic group. Atorvastatin and Rosuvastatin are the first line statins. This study is carried out to see how our population responds to these statins in terms of change in lipid profile.
 Methods: It is a real world observational study. Dyslipidemia patients requiring statins were given either Atorvastatin 10 mg or Rosuvastatin 5 mg according to physician’s discretion. Demographic profile and baseline lipid was recorded. Lipid profile was again recorded after 3 to 4 months of treatment.
 Result: Out of 343 enrolled only 304 data was analyzed. Total cholesterol decreased by 21.9 % (p = 0.002) in Atorvastatin group and by 22.9 % (p= 0.002) in Rosuvastatin group. Low Density Lipoprotein (LDL) decreased by 22.3 % (p = 0.004) in Atorvastatin group and 21.5% (p=0.005) in Rosuvastatin group. There was no significant difference between two groups.
 Conclusion: Both Atorvastatin 10 mg and Rosuvastatin 5 mg can reduce the lipids significantly in our population. There is no difference in using Atorvastatin 10 mg or Rosuvastatin 5 mg. However, reduction was only mild to moderate with the given doses.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051143","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}
Amit Kumar Singh, Murari Thakur, Ruby Singh, Jitendra Mandal
Fetal arrythmia is reported to affect 1-2% of pregnancies. Besides digoxin not many drugs have been tried in treating such cases. After confirming 1:1 conduction between atrium and ventricle, no structural heart disease of fetus and normal echocardiography and ECG of mother, verapamil was given in the treatment of fetal supraventricular tachycardia. The drug crossed placenta to revert fetus SVT to sinus rhythm without harming mother. The treatment helped fetus against possible complications.
{"title":"Verapamil for treatment of Fetal Supraventricular Tachycardia","authors":"Amit Kumar Singh, Murari Thakur, Ruby Singh, Jitendra Mandal","doi":"10.3126/njh.v20i1.55042","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55042","url":null,"abstract":"Fetal arrythmia is reported to affect 1-2% of pregnancies. Besides digoxin not many drugs have been tried in treating such cases. After confirming 1:1 conduction between atrium and ventricle, no structural heart disease of fetus and normal echocardiography and ECG of mother, verapamil was given in the treatment of fetal supraventricular tachycardia. The drug crossed placenta to revert fetus SVT to sinus rhythm without harming mother. The treatment helped fetus against possible complications.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051142","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 and Aims: Rheumatic heart disease is still one of the most common heart lesion in developing countries. The maternal and fetal hazards increase with the severity of Mitral stenosis. This study was aimed to determine the fetomaternal outcome in women with mitral stenosis during pregnancy. Methods: This was descriptive cross-sectional study which included all pregnant patients with isolated rheumatic mitral valve stenosis. Major adverse outcomes studied were cardiac failure, thromboembolic event, admission in cardiac care or intensive care unit, atrial fibrillation, endocarditis, pulmonary hypertension and cardiac death. Results: Out of 3194 pregnant women, 31 had mitral stenosis. Their mean age was 27 years, mean mitral valve area 1.43cm2 and majority were primigravida (61.29%). Among them, symptomatic cardiac failure was present in 6.66%, 30% and 66.66% of mild, moderate and severe mitral stenosis respectively. The chances of cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies was high in all patients without having percutaneous trans-luminal mitral commissurotomy than those who underwent the procedure for moderate to severe mitral stenosis during pregnancy. Conclusion: There were high chances of adverse fetomaternal outcome in pregnant women with mitral stenosis. Cardiac failure was found to be increased with the severity of mitral stenosis. PTMC during pregnancy resulted in decreased cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies.
{"title":"Evaluation of Pregnancy Outcome in Women with Rheumatic Mitral Valve Stenosis","authors":"Poonam Koirala, Asmita Ghimire, Neebha Ojha, Ishita Koirala","doi":"10.3126/njh.v20i1.55002","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55002","url":null,"abstract":"Background and Aims: Rheumatic heart disease is still one of the most common heart lesion in developing countries. The maternal and fetal hazards increase with the severity of Mitral stenosis. This study was aimed to determine the fetomaternal outcome in women with mitral stenosis during pregnancy. Methods: This was descriptive cross-sectional study which included all pregnant patients with isolated rheumatic mitral valve stenosis. Major adverse outcomes studied were cardiac failure, thromboembolic event, admission in cardiac care or intensive care unit, atrial fibrillation, endocarditis, pulmonary hypertension and cardiac death. Results: Out of 3194 pregnant women, 31 had mitral stenosis. Their mean age was 27 years, mean mitral valve area 1.43cm2 and majority were primigravida (61.29%). Among them, symptomatic cardiac failure was present in 6.66%, 30% and 66.66% of mild, moderate and severe mitral stenosis respectively. The chances of cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies was high in all patients without having percutaneous trans-luminal mitral commissurotomy than those who underwent the procedure for moderate to severe mitral stenosis during pregnancy. Conclusion: There were high chances of adverse fetomaternal outcome in pregnant women with mitral stenosis. Cardiac failure was found to be increased with the severity of mitral stenosis. PTMC during pregnancy resulted in decreased cardiac failure, atrial fibrillation, preterm delivery and small for gestational age babies.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051329","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}
Acute myocardial infarction results due to acute disruption of coronary blood flow, commonly presented with chest pain. Electrocardiogram showing ST-segment elevation in consecutive leads is a classical ST-elevation myocardial infarction; however, atypical ST-segment elevation also can occur. We report an elderly lady who presented to the island health centre with intractable central chest pain. Electrocardiogram showed ST-segment elevation in V1 and aVR; whereas ST-depression in V4-6. With primary management, she was referred to a regional hospital. Repeat electrocardiogram showed ST-segment elevation in V1, aVR, and III; whereas ST-depression in V4-6, aVL, and I. Therefore, considering Aslanger's pattern of ECG change myocardial infarction, she was referred to the cardiac centre where coronary angiography revealed severe diffuse triple vessel disease. Primary PCI was performed on the right coronary artery initially as it is the primary culprit vessel with stenosis of other vessels. Therefore, staged angioplasty was performed on the left coronary system. Uncommon and atypical electrocardiographic presentations may be encountered in daily practice, associated with severe multiple-vessel diseases. So, it can be challenging for a cardiologist as well during interventions.
{"title":"Diagnostic and therapeutic dilemma due to new pattern electrocardiographic change in myocardial infarction: a case report from a remote island","authors":"Ramesh Rana, Mohamed Shaneez Najme, None Gunaseelan, Jubida Gulshan Ara, Narottam Shrestha, Bijaya KC","doi":"10.3126/njh.v20i1.55043","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55043","url":null,"abstract":"Acute myocardial infarction results due to acute disruption of coronary blood flow, commonly presented with chest pain. Electrocardiogram showing ST-segment elevation in consecutive leads is a classical ST-elevation myocardial infarction; however, atypical ST-segment elevation also can occur. We report an elderly lady who presented to the island health centre with intractable central chest pain. Electrocardiogram showed ST-segment elevation in V1 and aVR; whereas ST-depression in V4-6. With primary management, she was referred to a regional hospital. Repeat electrocardiogram showed ST-segment elevation in V1, aVR, and III; whereas ST-depression in V4-6, aVL, and I. Therefore, considering Aslanger's pattern of ECG change myocardial infarction, she was referred to the cardiac centre where coronary angiography revealed severe diffuse triple vessel disease. Primary PCI was performed on the right coronary artery initially as it is the primary culprit vessel with stenosis of other vessels. Therefore, staged angioplasty was performed on the left coronary system. Uncommon and atypical electrocardiographic presentations may be encountered in daily practice, associated with severe multiple-vessel diseases. So, it can be challenging for a cardiologist as well during interventions.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051144","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 and Aims: Patient’s satisfaction with the healthcare services is important because evidence suggests that satisfied patients are more adherent to treatment guidelines and have better clinical outcomes. We aim to assess the patients’ satisfaction with healthcare services in a tertiary cardiac centre of Nepal.
Methods: We conducted a descriptive cross sectional study to collect the data by convenience sampling method from 365 patients who attended the out-patient Department of Shahid Gangalal National Heart Centre from December 2021 to March 2022. In this study a validated tool was used after translation into Nepali language. A semi structured face to face interview schedule was used to collect data from the patients, which was then filled in Kobo Toolbox; the web based questionnaires and were analyzed.
Results: Overall satisfaction rate of the patients with the health care services provided by a tertiary cardiac center was 91.25%. In this study, 89.86% were satisfied with physical facilities, 91.24% with registration and pharmacy services, 93.36% with physicians and nurses’ services and 90.56% with other services.
Conclusion: In this study, most of the participants were highly satisfied with the services provided by the hospital. However, the feedback from this study can be used for the improvement of the health care services which could be beneficial for the hospital as well as cardiac patients with overall benefit in cardiovascular outcome.
{"title":"Patient’s Satisfaction with Healthcare Services in Out Patient Department of a Tertiary Cardiac Centre in Nepal","authors":"Suraksha Dhungana, Dipanker Prajapati, Sunita Khadka, Prati Badan Dangol, Murari Dhungana, Nita Devi Dangol, Deoki Saru, Roji Shakya, Kopila Luitel, Shanta Singh Thakuri, Chandra Mani Adhikari","doi":"10.3126/njh.v20i1.55000","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55000","url":null,"abstract":"Background and Aims: Patient’s satisfaction with the healthcare services is important because evidence suggests that satisfied patients are more adherent to treatment guidelines and have better clinical outcomes. We aim to assess the patients’ satisfaction with healthcare services in a tertiary cardiac centre of Nepal.
 Methods: We conducted a descriptive cross sectional study to collect the data by convenience sampling method from 365 patients who attended the out-patient Department of Shahid Gangalal National Heart Centre from December 2021 to March 2022. In this study a validated tool was used after translation into Nepali language. A semi structured face to face interview schedule was used to collect data from the patients, which was then filled in Kobo Toolbox; the web based questionnaires and were analyzed.
 Results: Overall satisfaction rate of the patients with the health care services provided by a tertiary cardiac center was 91.25%. In this study, 89.86% were satisfied with physical facilities, 91.24% with registration and pharmacy services, 93.36% with physicians and nurses’ services and 90.56% with other services.
 Conclusion: In this study, most of the participants were highly satisfied with the services provided by the hospital. However, the feedback from this study can be used for the improvement of the health care services which could be beneficial for the hospital as well as cardiac patients with overall benefit in cardiovascular outcome.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051331","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 and Aims: Worldwide, cardiovascular diseases lead to the death of around 17.9 million annually in which 85% of those deaths is due to heart attack and stroke. However, most cardiovascular diseases are preventable with modification of behavioural risk factors. Hence, this study was conducted to find out cardiovascular health practice among adults in urban city of Kathmandu.
Methods: A cross-sectional study design was used where data was collected through an in-person interview technique among randomly selected 236 adults residing in Budhanilkantha Municipality of Kathmandu District. Semi-structured interview schedule based on WHO Stepwise approach and literature review was used to collect data. Data was analysed using descriptive statistics (frequency, percentage, median, Interquartile Range) and inferences were drawn with an application of the chi-square test.
Results: Among 236 samples, the majority (81.8%) of the adults had good practice of cardiovascular health. However, few adults (22%) consumed WHO recommended fruits and vegetables and only a quarter of them (36.4%) monitored blood cholesterol. Among them (24.1%) were current alcohol users and (25.4%) were current smokers. More than half (52.1%) were physically active. The practice of cardiovascular health was significantly associated with marital status (p<0.001) of the adults.
Conclusion: Although, most of the adults adopted the practice to maintain cardiovascular health, their adherence to monitoring blood cholesterol, adequate intake of the recommended number of fruits and vegetables, and physical activity is low. Hence, awareness programs focusing these facets would be helpful.
{"title":"Cardiovascular Health Practice among Adults in a Municipality in Kathmandu District, Nepal","authors":"Samiksha Subedee, Muna Sharma","doi":"10.3126/njh.v20i1.55001","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55001","url":null,"abstract":"Background and Aims: Worldwide, cardiovascular diseases lead to the death of around 17.9 million annually in which 85% of those deaths is due to heart attack and stroke. However, most cardiovascular diseases are preventable with modification of behavioural risk factors. Hence, this study was conducted to find out cardiovascular health practice among adults in urban city of Kathmandu.
 Methods: A cross-sectional study design was used where data was collected through an in-person interview technique among randomly selected 236 adults residing in Budhanilkantha Municipality of Kathmandu District. Semi-structured interview schedule based on WHO Stepwise approach and literature review was used to collect data. Data was analysed using descriptive statistics (frequency, percentage, median, Interquartile Range) and inferences were drawn with an application of the chi-square test.
 Results: Among 236 samples, the majority (81.8%) of the adults had good practice of cardiovascular health. However, few adults (22%) consumed WHO recommended fruits and vegetables and only a quarter of them (36.4%) monitored blood cholesterol. Among them (24.1%) were current alcohol users and (25.4%) were current smokers. More than half (52.1%) were physically active. The practice of cardiovascular health was significantly associated with marital status (p<0.001) of the adults.
 Conclusion: Although, most of the adults adopted the practice to maintain cardiovascular health, their adherence to monitoring blood cholesterol, adequate intake of the recommended number of fruits and vegetables, and physical activity is low. Hence, awareness programs focusing these facets would be helpful.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051328","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}
Madhab Bista, Ram Kumar Mehta, Surya B. Parajuli, Prashant Shah
Background and Aims: Anemia is a frequently encountered comorbid illness in heart failure and is associated with poor clinical outcomes. There are limited studies done in Nepal to evaluate its prevalence among patients diagnosed with heart failure. Hence, this study was aimed to find out the prevalence of anemia and associated factors among patients with heart failure at Birat Medical College Teaching Hospital.
Methods: A hospital based cross sectional study was conducted from 1st July 2022 to 30 February 2023 among consecutively selected 100 patients at Birat Medical College Teaching Hospital. Socio-demography, clinical features and laboratory parameters to evaluate anemia were obtained. Ethical clearance was taken from the Institutional Review Committee of institute. Collected data was entered in Microsoft Excel and analyzed by Statistical Package for Social Sciences version 23. Frequency, mean, percentage were calculated and chi square test at 0.05% level of significance was used to find the association.
Results: The prevalence of anemia was 65%. Out of 100 patients, majority had iron deficiency anemia (40%), followed by anemia of chronic disease (10%). Thirty three percent had iron deficiency without anemia. Female patients 36(75%) and patients with chronic obstructive pulmonary disease (COPD) 15(93.8%) had significantly higher prevalence of anemia (p value <0.05).
Conclusions: Nearly two third of heart failure patients had anemia among which iron deficiency anemia was the commonest. Female and patients with COPD had higher prevalence of anemia.
背景和目的:贫血是心力衰竭的常见合并症，与较差的临床预后相关。在尼泊尔进行了有限的研究，以评估其在诊断为心力衰竭的患者中的流行程度。因此，本研究旨在了解Birat医学院附属医院心力衰竭患者贫血的患病率及相关因素。
方法:于2022年7月1日至2023年2月30日在比拉特医学院教学医院连续选择100例患者进行横断面研究。获得评估贫血的社会人口学、临床特征和实验室参数。伦理许可已获得研究所机构审查委员会的批准。收集到的数据在Microsoft Excel中输入，并使用Statistical Package for Social Sciences version 23进行分析。计算频率、平均值和百分比，并采用0.05%显著性水平的卡方检验发现相关性。
结果:贫血的发生率为65%。在100名患者中，大多数患有缺铁性贫血(40%)，其次是慢性病贫血(10%)。33%的人缺铁但没有贫血。女性患者36例(75%)和慢性阻塞性肺疾病(COPD)患者15例(93.8%)的贫血患病率显著高于女性患者(p值<0.05)。结论:近三分之二的心力衰竭患者伴有贫血，其中以缺铁性贫血最为常见。女性和COPD患者的贫血患病率较高。
{"title":"Prevalence of anemia and associated factors among patients with heart failure at Birat Medical College Teaching Hospital","authors":"Madhab Bista, Ram Kumar Mehta, Surya B. Parajuli, Prashant Shah","doi":"10.3126/njh.v20i1.55193","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55193","url":null,"abstract":"Background and Aims: Anemia is a frequently encountered comorbid illness in heart failure and is associated with poor clinical outcomes. There are limited studies done in Nepal to evaluate its prevalence among patients diagnosed with heart failure. Hence, this study was aimed to find out the prevalence of anemia and associated factors among patients with heart failure at Birat Medical College Teaching Hospital.
 Methods: A hospital based cross sectional study was conducted from 1st July 2022 to 30 February 2023 among consecutively selected 100 patients at Birat Medical College Teaching Hospital. Socio-demography, clinical features and laboratory parameters to evaluate anemia were obtained. Ethical clearance was taken from the Institutional Review Committee of institute. Collected data was entered in Microsoft Excel and analyzed by Statistical Package for Social Sciences version 23. Frequency, mean, percentage were calculated and chi square test at 0.05% level of significance was used to find the association.
 Results: The prevalence of anemia was 65%. Out of 100 patients, majority had iron deficiency anemia (40%), followed by anemia of chronic disease (10%). Thirty three percent had iron deficiency without anemia. Female patients 36(75%) and patients with chronic obstructive pulmonary disease (COPD) 15(93.8%) had significantly higher prevalence of anemia (p value <0.05).
 Conclusions: Nearly two third of heart failure patients had anemia among which iron deficiency anemia was the commonest. Female and patients with COPD had higher prevalence of anemia.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051330","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 and Aims: Percutaneous coronary interventions have been provided in various hospitals of Nepal for more than two decades. Hence, we aimed to study the percutaneous coronary intervention revascularization status in patients with coronary artery disease at a tertiary center of eastern Nepal.
Methods: A cross sectional study was conducted at Birat Medical College Teaching Hospital from 1st Aug to 30th Feb 2023. Ninety seven coronary artery disease patients (Unstable angina, Non ST elevated Myocardial Infarction ST elevated Myocardial Infarction and Stable Angina) requiring percutaneous coronary interventions were enrolled. Patient socio-demography and findings of percutaneous coronary intervention were recorded, entered in Microsoft Excel and analyzed by SPSS 23.
Results: Majority 30(31.3%) had unstable angina. Left main coronary artery was normal in all patients. Severe stenosis was found in 58(59.7%) of left anterior descending artery, 32(32.9%) of right coronary artery and 29(29.8%) of left circumflex artery. Total occlusion was found in 10(10.3%) of left anterior descending artery, 8(8.2%) of right coronary artery and 6(6.2%) of left circumflex artery. Majority 68(70.1%) of patients had elective percutaneous coronary intervention.
Conclusion: The most common mode of presentation of coronary artery disease was unstable angina and majority have severe stenosis. The preferred intervention was elective percutaneous coronary intervention.
{"title":"Modes of Presentation and Patterns of Coronary Artery Disease in Patients Undergoing Percutaneous Intervention at Birat Medical College Teaching Hospital","authors":"Prashant Shah, Madhab Bista, Heera KC","doi":"10.3126/njh.v20i1.54992","DOIUrl":"https://doi.org/10.3126/njh.v20i1.54992","url":null,"abstract":"Background and Aims: Percutaneous coronary interventions have been provided in various hospitals of Nepal for more than two decades. Hence, we aimed to study the percutaneous coronary intervention revascularization status in patients with coronary artery disease at a tertiary center of eastern Nepal.
 Methods: A cross sectional study was conducted at Birat Medical College Teaching Hospital from 1st Aug to 30th Feb 2023. Ninety seven coronary artery disease patients (Unstable angina, Non ST elevated Myocardial Infarction ST elevated Myocardial Infarction and Stable Angina) requiring percutaneous coronary interventions were enrolled. Patient socio-demography and findings of percutaneous coronary intervention were recorded, entered in Microsoft Excel and analyzed by SPSS 23.
 Results: Majority 30(31.3%) had unstable angina. Left main coronary artery was normal in all patients. Severe stenosis was found in 58(59.7%) of left anterior descending artery, 32(32.9%) of right coronary artery and 29(29.8%) of left circumflex artery. Total occlusion was found in 10(10.3%) of left anterior descending artery, 8(8.2%) of right coronary artery and 6(6.2%) of left circumflex artery. Majority 68(70.1%) of patients had elective percutaneous coronary intervention.
 Conclusion: The most common mode of presentation of coronary artery disease was unstable angina and majority have severe stenosis. The preferred intervention was elective percutaneous coronary intervention.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051137","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}
Congenital junctional ectopic tachycardia (JET) is a rare tachyarrhythmia found in young infants and is often difficult to treat. JET is characterized by incessant tachycardia which causes ventricular dysfunction, heart failure and high mortality. Ivabradine is one of the newer antiarrhythmic drugs with special indications in decreasing heart rate in adults with chronic heart failure. It has shown promising role in congenital JET. However, there are no guidelines recommending ivabradine as a first-line agent for congenital JET. We report an infant with congenital JET who was successfully treated with ivabradine.
{"title":"Congenital Junctional Ectopic Tachycardia in a 6-month-old boy treated with Ivabradine: A Case Report","authors":"Dinesh Upreti, Samir Shakya, Ratna Mani Gajurel, Hemant Shrestha, Sanjeev Thapa, Manju Sharma","doi":"10.3126/njh.v20i1.55039","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55039","url":null,"abstract":"Congenital junctional ectopic tachycardia (JET) is a rare tachyarrhythmia found in young infants and is often difficult to treat. JET is characterized by incessant tachycardia which causes ventricular dysfunction, heart failure and high mortality. Ivabradine is one of the newer antiarrhythmic drugs with special indications in decreasing heart rate in adults with chronic heart failure. It has shown promising role in congenital JET. However, there are no guidelines recommending ivabradine as a first-line agent for congenital JET. We report an infant with congenital JET who was successfully treated with ivabradine.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"268 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051148","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}
We report a case of bi-atrial thrombi traversing the atrioventricular valves in a 72-year-old female with multiple thromboembolic phenomena. Right atrial thrombus can be seen in patients who are immobilized for long period of time and those with deep vein thrombosis and pulmonary embolism. And the left atrial thrombus may present in a case of atrial fibrillation but not common in patients with sinus rhythm. This patient is unique having thrombus in both the atria. She initially presented with ischemic stroke. Echocardiography revealed bi-atrial clots. Later, she developed pulmonary embolism followed by acute right upper limb ischemia. The patient refused all invasive treatments and was managed with anticoagulants only. The patient responded well to therapy with complete thrombus resolution without any significant complications.
{"title":"Bi-atrial Thrombi in a Structurally and Functionally Normal Heart; Ticking Time Bomb","authors":"Rajib Rajbhandari, Jageshwar Prasad Shah, Sarbagya Manandhar, Arya Pradhan, Rebika Dangol","doi":"10.3126/njh.v20i1.55051","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55051","url":null,"abstract":"We report a case of bi-atrial thrombi traversing the atrioventricular valves in a 72-year-old female with multiple thromboembolic phenomena. Right atrial thrombus can be seen in patients who are immobilized for long period of time and those with deep vein thrombosis and pulmonary embolism. And the left atrial thrombus may present in a case of atrial fibrillation but not common in patients with sinus rhythm. This patient is unique having thrombus in both the atria. She initially presented with ischemic stroke. Echocardiography revealed bi-atrial clots. Later, she developed pulmonary embolism followed by acute right upper limb ischemia. The patient refused all invasive treatments and was managed with anticoagulants only. The patient responded well to therapy with complete thrombus resolution without any significant complications.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051139","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：