|Year : 2014 | Volume
| Issue : 4 | Page : 91-92
Preface to Fourth Issue of Heart India 2014
Alok Kumar Singh
Department of Cardiology, Heritage Hospital, Varanasi, Uttar Pradesh, India
|Date of Web Publication||10-Dec-2014|
Dr. Alok Kumar Singh
Department of Cardiology, Heritage Hospital, Varanasi - 221 005, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh AK. Preface to Fourth Issue of Heart India 2014. Heart India 2014;2:91-2
I am delighted to present to you the last issue of Heart India 2014. I would like to take this opportunity to extend our thanks to our valued authors, reviewers and cardiology community for their continuing interest in Heart India, and to every member of the Editorial Board Member for their dedication to this scientific endeavor. In this issue, we are publishing three original research articles and four case reports and one image.
Autonomic function is said to be different between males and females. Uric acid (UA) levels also vary with gender. Kunikullaya et al. in first original article tried to explore if these differences exist among the subjects grouped based on their blood pressure (BP) profiles: Males had significantly higher UA levels. The time domain parasympathetic parameters of heart rate variability (HRV) were higher among females on comparison with males indicating vagal withdrawal among males. The sympathetic parameters in the frequency domain were higher among males. This difference in HRV was observed among all BP profile groups. Authors have concluded males have a higher degree of vagal withdrawal and sympathetic activity.
Hypertension is responsible for significant premature mortality, reduced quality of life and significant costs to the health and social care system and to the economy.  High BP, if left uncontrolled increases the risk of heart attacks, strokes, and kidney failure. Kutnikar et al. in second original article have studied the prevalence of hypertension and assessment of "rule of halves" in Rural Population of Basavanapura Village, Nanjangud Taluk, South India. Of the 447 persons surveyed in Basavanpura Village, BP was recorded among 223 individuals. The overall prevalence of hypertension was found to be 36 (16.1%), of which 22 (61.1%) were diagnosed, 20 (90.90%) treated, and only 14 (70.0%) controlled. Increasing age, sedentary lifestyles, and male sex was identified as the predisposing factors. Authors of this study have concluded that, the prevalence of hypertension in the village is slightly higher (16.14%) than the national prevalence (14%), so there is an urgent need to educate the people to modify the lifestyle and to monitor their BP values regularly.
The diagonal earlobe crease (DELC) has been proposed to be a marker of coronary artery disease (CAD), but this association remains controversial. Montazeri et al. from Iran in third original research article tried to evaluate the frequency of DELC in patients with CAD. Eighty patients with angiographically documented CAD from Borujerd were evaluated for the presence or absence of DELC. The DELC was said to be present if the patient had a deep diagonal crease extending obliquely from the outer ear canal toward the border of the earlobe without discontinuity covering at least two-thirds of the ear lobe length. The frequency of DELC in patients with CAD was high in this study. Authors of this study have suggested that the DELC sign may be a useful physical marker for the screening of CAD patients.
Aortic aneurysm is a rare, but a fatal condition; the incidence is 5.9 new aneurysm/100,000 person-years with median age of 65 years for men and 77 years for women. It becomes still rarer when the cause is idiopathic and is associated with aortic regurgitation. Most of these patients present with aortic regurgitation and on investigation aneurysm are detected. Owing to its rarity and the disguised presentation it is important to be aware of this entity. Srivastava et al. in the first case reporting a case of cystic medial degeneration leading to aortic aneurysm and aortic regurgitation. Surgery is the standard procedure for closure of atrial septal defects (ASDs). Recently, percutaneous trans catheter procedures emerged as therapeutic alternatives for closure of both ASDs and patent foramen ovale. Here, Sharma et al. reporting a case of 21-year-old young female who underwent ASD closure using an Amplatzer device, unfortunately, however the device misplaced to the right atrium during procedure. Percutaneous extraction of the device was failed; patient was taken for immediate surgical intervention in cardiogenic shock. Amplatzer device was removed surgically on cardiopulmonary bypass successfully; patient recovered well.
Left atrium thrombus is seen in patients with rheumatic heart disease, severe mitral stenosis and/or atrial fibrillation, but is usually immobile and located in left atrial appendage. Freely mobile thrombus is rarely seen, and the size may vary from few millimeters to centimeters. The clinical presentation varies from presyncope or syncope in a small well organized thrombus to transient ischemic attacks or stroke in large poorly organized thrombus. Deora et al. reporting a two cases of large mobile thrombus with syncope successfully managed by surgery. Takayasu's arteritis is a large-vessel vasculitis, which is characterized by both stenotic lesions, as well as aneurysmal lesions. Aneurysmal lesions most commonly occur in the aortic root and arch leading to the development of aortic regurgitation. AR is seen in about 24% of cases at the time of presentation. The documentation of high BP in Takayasu arteritis may be difficult because of subclavian and innominate artery stenoses. Fourth case report by Grace et al. highlights the importance of checking all the peripheral pulses and recording the BP in both upper limbs and in the lower limbs in the case of "hypotension."
Severe mitral valve apparatus calcification is frequently seen in patients with advanced age and chronic kidney disease, but it is rare in rheumatic heart disease. Mitral valve calcification in rheumatic heart disease usually involves commissures and leaflet tissue, with extension to the annulus in late stage. Ranjith et al. have reported very useful fluoroscopic image of rheumatic mitral valve calcification, which can be helpful in diagnosing mitral stenosis even on chest X-ray.
| References|| |
Department of Health and Children. Changing Cardiovascular Health: National Cardiovascular Health Strategy 2010-2019. Dublin: Department of Health and Children; 2010. Available from: http://www.dohc.ie/publications/changing_cardiovascular_health.html. [Last accessed on 2013 Feb 11].