Among various cardiac manifestations of hypothyroidism, pericardial effusion is not an uncommon finding. But effusion leading to Tamponade is a rare complication owing to its slow collection due to increased capillary permeability. Most of the times patient can be managed conservatively but in case of hemodynamic compromise tapping of fluid will give immediate relief of symptoms. To discuss various pathophysiological issues and management options of pericardial effusion with Tamponade in hypothyroidism. Six cases of hypothyroidism with pericardial effusion and Tamponade were studied. Their demographic features and treatment issues were assessed. Five out of six cases underwent pericardiocentesis. One case was manged conservatively. All the cases were stable on follow up. Prompt diagnosis with early pericardiocentesis with thyroid supplementation will have better prognosis.
{"title":"“All that Glitters like Gold is Not Good.” Pericardial Effusion with Cardiac Tamponade in Hypothyroidism","authors":"I. Tammiraju, Meghana Bhupathi","doi":"10.25259/ijcdw_3_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_3_2023","url":null,"abstract":"Among various cardiac manifestations of hypothyroidism, pericardial effusion is not an uncommon finding. But effusion leading to Tamponade is a rare complication owing to its slow collection due to increased capillary permeability. Most of the times patient can be managed conservatively but in case of hemodynamic compromise tapping of fluid will give immediate relief of symptoms. To discuss various pathophysiological issues and management options of pericardial effusion with Tamponade in hypothyroidism. Six cases of hypothyroidism with pericardial effusion and Tamponade were studied. Their demographic features and treatment issues were assessed. Five out of six cases underwent pericardiocentesis. One case was manged conservatively. All the cases were stable on follow up. Prompt diagnosis with early pericardiocentesis with thyroid supplementation will have better prognosis.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88277852","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}
Dennis Johannes van de Watering, B. J. L. van den Branden, J. Spaan, M. Meuwissen
In this case report, we present a case of a 38-year-old woman with no cardiac history and no risk factors who was admitted to the hospital with a spontaneous coronary artery dissection (SCAD) after pregnancy. Twelve years later, she suffered a recurrent SCAD during her menopause. SCAD is a rare occurrence of acute coronary syndromes and recurrence is even more rare. SCAD seems to occur predominantly in females and seems to be related to hormone levels. At first presentation, the patient was 38 years old and 4 weeks postpartum. She presented with chest pain. Electrocardiogram (ECG) showed loss of r-amplitude but no ST-segment deviation. Troponins were elevated and showed significant rise and fall. She was treated with dual anti-platelet strategy and underwent coronary angiography (CAG) which showed a type 1 dissection of the distal circumflex artery. The lesion was treated conservatively. Second presentation was 12 years later, in which she again presented with chest pain this time during menopause. ECG showed marginal changes and the troponins were again elevated. She underwent CAG again which showed a new SCAD (Type 2 B) in the second marginal obtuse artery. The old SCAD lesion was healed. Renal angiography was preformed which showed an renal bead pattern typical for fibromuscular dysplasia. Again, she was treated conservatively. This case is the first case report of a patient suffering from a recurrent SCAD in a different coronary artery, both events probably related to hormonal changes, that is, postpartum and during menopause. This may emphasize careful examination of chest pain in menopause patients with a history of earlier SCAD.
{"title":"Spontaneous Coronary Artery Dissection Postpartum and Recurrence during Menopause: Hormonal Involvement in Acute Coronary Syndromes","authors":"Dennis Johannes van de Watering, B. J. L. van den Branden, J. Spaan, M. Meuwissen","doi":"10.25259/ijcdw_20_2022","DOIUrl":"https://doi.org/10.25259/ijcdw_20_2022","url":null,"abstract":"In this case report, we present a case of a 38-year-old woman with no cardiac history and no risk factors who was admitted to the hospital with a spontaneous coronary artery dissection (SCAD) after pregnancy. Twelve years later, she suffered a recurrent SCAD during her menopause. SCAD is a rare occurrence of acute coronary syndromes and recurrence is even more rare. SCAD seems to occur predominantly in females and seems to be related to hormone levels. At first presentation, the patient was 38 years old and 4 weeks postpartum. She presented with chest pain. Electrocardiogram (ECG) showed loss of r-amplitude but no ST-segment deviation. Troponins were elevated and showed significant rise and fall. She was treated with dual anti-platelet strategy and underwent coronary angiography (CAG) which showed a type 1 dissection of the distal circumflex artery. The lesion was treated conservatively. Second presentation was 12 years later, in which she again presented with chest pain this time during menopause. ECG showed marginal changes and the troponins were again elevated. She underwent CAG again which showed a new SCAD (Type 2 B) in the second marginal obtuse artery. The old SCAD lesion was healed. Renal angiography was preformed which showed an renal bead pattern typical for fibromuscular dysplasia. Again, she was treated conservatively. This case is the first case report of a patient suffering from a recurrent SCAD in a different coronary artery, both events probably related to hormonal changes, that is, postpartum and during menopause. This may emphasize careful examination of chest pain in menopause patients with a history of earlier SCAD.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72873414","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}
The left main coronary artery disease (CAD) is a complex subset of CAD with constantly evolving guidelines in management and treatment. Indications for revascularization and the strategies of revascularization (Percutaneous intervention versus bypass surgery) are the subject of many trials and metanalysis. If percutaneous intervention is planned, meticulous planning and imaging to guide intervention are mandated. Step-wise layered provisional strategy is the treatment of choice with a systematic two-stent strategy reserved for complex bifurcation.
{"title":"Interventions for the Left Main Coronary Artery Disease","authors":"Sujatha Vipperla, Fathima Aaysha Cader","doi":"10.25259/ijcdw_26_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_26_2023","url":null,"abstract":"The left main coronary artery disease (CAD) is a complex subset of CAD with constantly evolving guidelines in management and treatment. Indications for revascularization and the strategies of revascularization (Percutaneous intervention versus bypass surgery) are the subject of many trials and metanalysis. If percutaneous intervention is planned, meticulous planning and imaging to guide intervention are mandated. Step-wise layered provisional strategy is the treatment of choice with a systematic two-stent strategy reserved for complex bifurcation.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136095513","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}
This study aims to provide major insight in 24-h ambulatory blood pressure monitoring (ABPM), which will describe the 24 h (Circadian rhythm) blood pressure (BP) profile by measuring its impact on the sleep quality. For the study, 25 men and 25 women were recruited. Sleep quality was assessed by the Pittsburgh Sleep Index. Using wrist actigraphy, sleep-quality was assessed during seven working non-ABPM days (starting point) and the three following 24-h ABPM days. During the day, the average AMP was 139.2 10.9/83.4 8.6 mm Hg, while at night, it was 118.9 12.9/68.5 9.7 mm Hg. There were 40 dipper and 10 non-dipper, respectively, on the standard of a systolic BP dip of <10%. Time had no bearing on total sleep time or sleep efficiency between ABPM days and non-ABPM days, indicating that ABPM has no negative effects on sleep quality. Both male and female having untreated hypertension were found to have disrupted sleep quality. Importantly, it is now evident that the ABPM has a negative impact on sleep quality for either dippers or non-dippers.
本研究旨在为24小时动态血压监测(ABPM)提供重要见解，该监测将通过测量其对睡眠质量的影响来描述24小时(昼夜节律)血压(BP)概况。在这项研究中，25名男性和25名女性被招募。睡眠质量由匹兹堡睡眠指数评估。使用手腕活动记录仪，在非ABPM工作的7天(起点)和随后的3天(24小时ABPM)中评估睡眠质量。白天平均AMP为139.2 10.9/83.4 8.6 mm Hg，夜间平均AMP为118.9 12.9/68.5 9.7 mm Hg，以收缩压降<10%为标准，共40例，非共10例。在ABPM日和非ABPM日之间，时间对总睡眠时间和睡眠效率没有影响，这表明ABPM对睡眠质量没有负面影响。研究发现，患有未经治疗的高血压的男性和女性的睡眠质量都会受到影响。重要的是，现在很明显，ABPM对饮用者和非饮用者的睡眠质量都有负面影响。
{"title":"Ambulatory Blood Pressure Monitoring and Sleep Quality in Hypertensive Men and Women","authors":"G. Fatima","doi":"10.25259/ijcdw_18_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_18_2023","url":null,"abstract":"\u0000\u0000This study aims to provide major insight in 24-h ambulatory blood pressure monitoring (ABPM), which will describe the 24 h (Circadian rhythm) blood pressure (BP) profile by measuring its impact on the sleep quality.\u0000\u0000\u0000\u0000For the study, 25 men and 25 women were recruited. Sleep quality was assessed by the Pittsburgh Sleep Index. Using wrist actigraphy, sleep-quality was assessed during seven working non-ABPM days (starting point) and the three following 24-h ABPM days.\u0000\u0000\u0000\u0000During the day, the average AMP was 139.2 10.9/83.4 8.6 mm Hg, while at night, it was 118.9 12.9/68.5 9.7 mm Hg. There were 40 dipper and 10 non-dipper, respectively, on the standard of a systolic BP dip of <10%. Time had no bearing on total sleep time or sleep efficiency between ABPM days and non-ABPM days, indicating that ABPM has no negative effects on sleep quality.\u0000\u0000\u0000\u0000Both male and female having untreated hypertension were found to have disrupted sleep quality. Importantly, it is now evident that the ABPM has a negative impact on sleep quality for either dippers or non-dippers.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89583554","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}
In patients presenting with Unstable Angina the correlation of clinical risk predictors and clinical risk scores with angiographic extent of Coronary Artery Disease (CAD) is less well understood. The objective is to assess the correlation of various clinical risk scores for unstable angina and individual clinical risk factors with the extent and severity of coronary artery disease as assessed by coronary angiography. The present study was a single centre, hospital based, observational, cross-sectional, descriptive study conducted at a tertiary care teaching and research institute in South India. One hundred and fifty patients presenting with chest pain consistent with unstable angina were assessed for existence of independent clinical predictors and calculations were done for their 5 clinical risk scores. Coronary angiography was performed in all the patients leading to the generation of Modified Gensini score and its correlation with the various clinical risk scores was done. Presence of dyslipidemia and diabetes were stronger predictors of Modified Gensini score. TIMI, GRACE& HEART risk scores had moderate correlation with angiographic severity while FRISC and PURSUIT scoring systems had a weak correlation. Presence of dyslipidemia and diabetes significantly affect the extent of CAD. Thus their presence in patients presenting with unstable angina assign them to the high risk category. Angiographic extent of CAD was strongly correlated with TIMI, GRACE and HEART risk scores, thus emphasizing on their use in risk stratification and in identifying the category of patients likely to make the most out of an early invasive strategy.
{"title":"Correlation of Clinical Risk Scores for Unstable Angina with the Angiographic Extent and Severity of Coronary Artery Disease","authors":"Shailesh Bhatia","doi":"10.25259/ijcdw_12_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_12_2023","url":null,"abstract":"\u0000\u0000In patients presenting with Unstable Angina the correlation of clinical risk predictors and clinical risk scores with angiographic extent of Coronary Artery Disease (CAD) is less well understood. The objective is to assess the correlation of various clinical risk scores for unstable angina and individual clinical risk factors with the extent and severity of coronary artery disease as assessed by coronary angiography.\u0000\u0000\u0000\u0000The present study was a single centre, hospital based, observational, cross-sectional, descriptive study conducted at a tertiary care teaching and research institute in South India. One hundred and fifty patients presenting with chest pain consistent with unstable angina were assessed for existence of independent clinical predictors and calculations were done for their 5 clinical risk scores. Coronary angiography was performed in all the patients leading to the generation of Modified Gensini score and its correlation with the various clinical risk scores was done.\u0000\u0000\u0000\u0000Presence of dyslipidemia and diabetes were stronger predictors of Modified Gensini score. TIMI, GRACE& HEART risk scores had moderate correlation with angiographic severity while FRISC and PURSUIT scoring systems had a weak correlation.\u0000\u0000\u0000\u0000Presence of dyslipidemia and diabetes significantly affect the extent of CAD. Thus their presence in patients presenting with unstable angina assign them to the high risk category. Angiographic extent of CAD was strongly correlated with TIMI, GRACE and HEART risk scores, thus emphasizing on their use in risk stratification and in identifying the category of patients likely to make the most out of an early invasive strategy.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78211068","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}
Raised blood lactate levels are strongly associated with mortality in patients with cardiogenic shock. Recent practices of the early identification and initiation of mechanical circulatory support have improved outcomes in cardiogenic shock, but therapeutic targets to guide real-time clinical decision making are lacking. Recent evidence suggests that the degree and rate at which blood lactate levels decrease after the initiation of treatment is important in patient prognosis. With this background, lactate clearance has been suggested as a potential treatment target due to its independent association with morality. Lactate levels were measured at baseline and at 6, 12, and 24 h. Patients were grouped into survivors and non-survivors based on in-hospital mortality. Patients who had normal lactate (<2.0 mmoL/L) at baseline were excluded from the study. Statistical analysis done using appropriate tests. Absolute lactate levels were compared between groups at baseline and 6, 12, and 24 h. Lactate clearance was calculated at 6, 12, and 24 h among survivors and non-survivors. In total, 90 patients were enrolled, and 65 (72.2%) of them survived to hospital discharge. Absolute blood lactate levels were 4.71 ± 1.36 mmoL/lit in survivors and 6.17 ± 2.88 mmoL/lit in non-survivors at baseline (P = 0.007). The mean lactate clearance at 6 h was 12.22 ± 85.96% in survivors and 12.98 ± 30.97% in non-survivors (P = 0.3). At 24 h, the mean lactate clearance was 54.63 ± 22.34% and 26.34 ± 19.3% in survivors and non-survivors, respectively (P < 0.01). Survivors had significantly greater lactate clearance at 12 and 24 h compared with non-survivors, suggesting that lactate clearance is an important prognostic marker in cardiogenic shock. These results further support the validity of lactate clearance as an appropriate surrogate for mortality and as a potential therapeutic target in clinical practice. Especially in centers lacking invasive hemodynamic monitoring.
{"title":"Lactate Clearance – A surrogate for Mortality in Cardiogenic Shock","authors":"Abhinay Reddy Nandikonda, V. Lakshmi","doi":"10.25259/ijcdw_8_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_8_2023","url":null,"abstract":"\u0000\u0000Raised blood lactate levels are strongly associated with mortality in patients with cardiogenic shock. Recent practices of the early identification and initiation of mechanical circulatory support have improved outcomes in cardiogenic shock, but therapeutic targets to guide real-time clinical decision making are lacking. Recent evidence suggests that the degree and rate at which blood lactate levels decrease after the initiation of treatment is important in patient prognosis. With this background, lactate clearance has been suggested as a potential treatment target due to its independent association with morality.\u0000\u0000\u0000\u0000Lactate levels were measured at baseline and at 6, 12, and 24 h. Patients were grouped into survivors and non-survivors based on in-hospital mortality. Patients who had normal lactate (<2.0 mmoL/L) at baseline were excluded from the study. Statistical analysis done using appropriate tests.\u0000\u0000\u0000\u0000Absolute lactate levels were compared between groups at baseline and 6, 12, and 24 h. Lactate clearance was calculated at 6, 12, and 24 h among survivors and non-survivors. In total, 90 patients were enrolled, and 65 (72.2%) of them survived to hospital discharge. Absolute blood lactate levels were 4.71 ± 1.36 mmoL/lit in survivors and 6.17 ± 2.88 mmoL/lit in non-survivors at baseline (P = 0.007). The mean lactate clearance at 6 h was 12.22 ± 85.96% in survivors and 12.98 ± 30.97% in non-survivors (P = 0.3). At 24 h, the mean lactate clearance was 54.63 ± 22.34% and 26.34 ± 19.3% in survivors and non-survivors, respectively (P < 0.01).\u0000\u0000\u0000\u0000Survivors had significantly greater lactate clearance at 12 and 24 h compared with non-survivors, suggesting that lactate clearance is an important prognostic marker in cardiogenic shock. These results further support the validity of lactate clearance as an appropriate surrogate for mortality and as a potential therapeutic target in clinical practice. Especially in centers lacking invasive hemodynamic monitoring.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78473713","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}
Coronary thrombus is an integral part of unstable atherosclerotic plaque causing acute coronary syndrome. The thrombus results from a either a disrupted atherosclerotic plaque or plaque erosion. A vulnerable plaque initiates the formation of a thrombus which consists of platelets, red blood cells, vasoconstrictors, and procoagulant bound by fibrin fibers. intracoronary thrombi (ICT) can be red or white. Angiography is the gold standard for diagnosis of coronary thrombus. Thrombus burden inversely impacts myocardial perfusion, with high thrombus burden resulting in sub optimal primary percutaneous coronary intervention (PCI) results and poor outcome. Management of ICT is a therapeutic challenge and involves a combination of pharmacological and mechanical therapies. Low thrombus burden is dealt with standard pharmacotherapy, balloon angioplasty, and stenting with occasional need to use aspiration catheter. High thrombus burden requires a targeted thrombus strategy.
{"title":"Latest Concepts in Diagnosis and Management of Coronary Thrombus","authors":"Lalita Nemani","doi":"10.25259/ijcdw_1_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_1_2023","url":null,"abstract":"Coronary thrombus is an integral part of unstable atherosclerotic plaque causing acute coronary syndrome. The thrombus results from a either a disrupted atherosclerotic plaque or plaque erosion. A vulnerable plaque initiates the formation of a thrombus which consists of platelets, red blood cells, vasoconstrictors, and procoagulant bound by fibrin fibers. intracoronary thrombi (ICT) can be red or white. Angiography is the gold standard for diagnosis of coronary thrombus. Thrombus burden inversely impacts myocardial perfusion, with high thrombus burden resulting in sub optimal primary percutaneous coronary intervention (PCI) results and poor outcome. Management of ICT is a therapeutic challenge and involves a combination of pharmacological and mechanical therapies. Low thrombus burden is dealt with standard pharmacotherapy, balloon angioplasty, and stenting with occasional need to use aspiration catheter. High thrombus burden requires a targeted thrombus strategy.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88369782","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}
Preeclampsia is one of the most common hypertensive disorders in pregnancy accounting for >50,000 maternal deaths, and over 500,000 fetal deaths worldwide. The incidence of preeclampsia is estimated to be 7 times higher in developing countries like India. Women with preeclampsia are several folds more likely to contract cardiovascular diseases such as ischemic heart disease, stroke, and thromboembolism later in life. This study aims to record the prevalence of preeclampsia, examine the incidence of various associated risk factors and document, and analyze the effects preeclampsia has on the mother and fetus. A cross-sectional study was conducted. Five hundred pregnant women were randomly selected based on availability of medical records. Prevalence of preeclampsia was identified in them and the preeclamptic population was further studied for various risk factors and epidemiological factors. The impact on mother and fetus was also studied. The data obtained from the medical records were entered into MS excel and variables were expressed as frequency and proportions. Analysis was done on SPSS 26.0 and major data were subjected to Chi-square test for determining significance. Out of a total of 500 pregnant women, 31 developed preeclampsia; hence, the prevalence of preeclampsia was found to be 6.2%. Of the 31 preeclamptic women, majority belonged to the 20–29 age group (51.6%), 19 (61.2%) had a pre-pregnancy body mass index >23, thus being classified as overweight or obese. Thirteen of these 19 (41.9%) were obese class 1, while 5 (16.1%) were obese class 2. Only two patients were multiparous, while nulliparous and primiparous women accounted for 48.38 and 45.16% of preeclamptic women. Twenty of the 31 women had preeclampsia with severe features and this was found to be significantly associated with delivering a baby having lower birth weight (P < 0.05). A significant 45.1% (14 of the 31 women) had to undergo preterm delivery and 48.38% of the preeclamptic women terminated pregnancy by a lower segment cesarean section. Two of the women were also diagnosed with elevated liver enzymes and low platelets syndrome. With respect to the fetal outcomes, 48.4% of infants had low birth weight. Intrauterine fetal death, fetal growth restriction, and cleft lip and palate were also documented in few neonates. Preeclampsia has a high morbidity and mortality rate as well as an increased risk for future cardiovascular diseases. Hence, risk factors which are in an individual’s self-control such as weight must be modified to prevent unfavorable complications. Pregnant women at risk of preeclampsia should be identified and high-quality antenatal care should be given to minimize the complications of preeclampsia both for the mother and the fetus. More research avenues must be explored on this subject so that enhanced treatment and management options can emerge.
{"title":"Preeclampsia: Prevalence, Risk Factors, and Impact on Mother and Fetus","authors":"Vaibhav Shandilya, Neiketa Sinha, S. Rani","doi":"10.25259/ijcdw_32_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_32_2023","url":null,"abstract":"\u0000\u0000Preeclampsia is one of the most common hypertensive disorders in pregnancy accounting for >50,000 maternal deaths, and over 500,000 fetal deaths worldwide. The incidence of preeclampsia is estimated to be 7 times higher in developing countries like India. Women with preeclampsia are several folds more likely to contract cardiovascular diseases such as ischemic heart disease, stroke, and thromboembolism later in life. This study aims to record the prevalence of preeclampsia, examine the incidence of various associated risk factors and document, and analyze the effects preeclampsia has on the mother and fetus.\u0000\u0000\u0000\u0000A cross-sectional study was conducted. Five hundred pregnant women were randomly selected based on availability of medical records. Prevalence of preeclampsia was identified in them and the preeclamptic population was further studied for various risk factors and epidemiological factors. The impact on mother and fetus was also studied. The data obtained from the medical records were entered into MS excel and variables were expressed as frequency and proportions. Analysis was done on SPSS 26.0 and major data were subjected to Chi-square test for determining significance.\u0000\u0000\u0000\u0000Out of a total of 500 pregnant women, 31 developed preeclampsia; hence, the prevalence of preeclampsia was found to be 6.2%. Of the 31 preeclamptic women, majority belonged to the 20–29 age group (51.6%), 19 (61.2%) had a pre-pregnancy body mass index >23, thus being classified as overweight or obese. Thirteen of these 19 (41.9%) were obese class 1, while 5 (16.1%) were obese class 2. Only two patients were multiparous, while nulliparous and primiparous women accounted for 48.38 and 45.16% of preeclamptic women. Twenty of the 31 women had preeclampsia with severe features and this was found to be significantly associated with delivering a baby having lower birth weight (P < 0.05). A significant 45.1% (14 of the 31 women) had to undergo preterm delivery and 48.38% of the preeclamptic women terminated pregnancy by a lower segment cesarean section. Two of the women were also diagnosed with elevated liver enzymes and low platelets syndrome. With respect to the fetal outcomes, 48.4% of infants had low birth weight. Intrauterine fetal death, fetal growth restriction, and cleft lip and palate were also documented in few neonates.\u0000\u0000\u0000\u0000Preeclampsia has a high morbidity and mortality rate as well as an increased risk for future cardiovascular diseases. Hence, risk factors which are in an individual’s self-control such as weight must be modified to prevent unfavorable complications. Pregnant women at risk of preeclampsia should be identified and high-quality antenatal care should be given to minimize the complications of preeclampsia both for the mother and the fetus. More research avenues must be explored on this subject so that enhanced treatment and management options can emerge.\u0000","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80848330","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}
Left internal mammary artery (LIMA) grafts are the preferred arterial grafts as they are more durable. LIMA grafts can develop stenosis most commonly at the distal anastomotic site and less frequently involve the ostium or body of LIMA. They may occur in the immediate post-operative period due to technical faults or occur several years later. LIMA graft interventions are more challenging because of its long and tortuous course and frequently tend to develop spasm and dissection. It might be the only method of revascularization in some patients and needs to be undertaken on and off. LIMA grafts have been used for retrograde revascularization of chronic total occlusion of native coronary arteries.
{"title":"Interventions in Left Internal Mammary Artery","authors":"A. Mahilmaran","doi":"10.25259/ijcdw_21_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_21_2023","url":null,"abstract":"Left internal mammary artery (LIMA) grafts are the preferred arterial grafts as they are more durable. LIMA grafts can develop stenosis most commonly at the distal anastomotic site and less frequently involve the ostium or body of LIMA. They may occur in the immediate post-operative period due to technical faults or occur several years later. LIMA graft interventions are more challenging because of its long and tortuous course and frequently tend to develop spasm and dissection. It might be the only method of revascularization in some patients and needs to be undertaken on and off. LIMA grafts have been used for retrograde revascularization of chronic total occlusion of native coronary arteries.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77085102","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}
{"title":"Continuous Ambulatory Wireless Cardiac Monitoring: A Screening Tool for Cardiac Rhythm Disorders","authors":"H. Pandve","doi":"10.25259/ijcdw_19_2023","DOIUrl":"https://doi.org/10.25259/ijcdw_19_2023","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74081647","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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