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   2014| July-September  | Volume 2 | Issue 3  
    Online since September 5, 2014

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Risk factors for acute myocardial infarction in coastal region of india: A case-control study
Vinay Rao, Prasannalakshmi Rao, Nikita Carvalho
July-September 2014, 2(3):70-75
Background: Various studies have shown that people of Indian origin have an increased risk of ischemic heart disease (IHD) compared with most other ethnic groups. This increased risk has been attributed to multiple risk factors related to lifestyle. Patients and Methods: A total of 100 cases and 100 age and sex-matched controls were taken into this prospective case-control study from Intensive Coronary Care Unit. Prevalence of the following risk factors for myocardial infarction: Age, sex, diet, smoking, alcohol consumption, history of hypertension, history of diabetes mellitus, and lipid profile were studied. Patient data were extracted from the medical records department and by interview. Results: The most important predictor of acute myocardial infarction (AMI) was high low-density lipoprotein (adjusted odds ratio [OR]: 4.124, confidence interval [CI]: 1.44-11.73, P = 0.008) history of hypertension and of overt diabetes mellitus were also independent risk factors (OR: 2, CI: 1.4-3 and OR: 2.29, CI: 1.5-3.5), respectively. Low high-density lipoprotein was found to have no significant association with AMI. Heavy drinkers were found to have a high-risk (OR: 68), while moderate drinkers were found to have protection (OR: 1). Conclusion: Smoking and heavy drinking cessation, treatment of hypertension and reduction in blood glucose, correction of abnormal lipid profile either through use of statins or by dietary modification may be important in preventing IHD in Asian Indians.
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Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south indian population
Rajni Sharma, Shivkumar Bhairappa, SR Prasad, Cholenahally Nanjappa Manjunath
July-September 2014, 2(3):65-69
Aims: The aim was to study the clinical profile, risk factors prevalence, angiographic distribution, and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients of South Indian population. Materials and Methods: A total of 1562 patients of ACS were analyzed for various risk factors, angiographic pattern and severity of coronary heart disease, complications and in hospital mortality at Sri Jayadeva Institute of Cardiovascular Research and Sciences, Bengaluru, Karnataka, India. Results: Mean age of presentation was 54.71 ± 19.90 years. Majority were male 1242 (79.5%) and rest were females. Most patients had ST elevation myocardial infarction (STEMI) 995 (63.7%) followed by unstable angina (UA) 390 (25%) and non-STEMI (NSTEMI) 177 (11.3%). Risk factors; smoking was present in 770 (49.3%), hypertension in 628 (40.2%), diabetes in 578 (37%), and obesity in (29.64%) patients. Angiography was done in 1443 (92.38%) patients. left anterior descending was most commonly involved, left main (LM) coronary artery was least common with near similar frequency of right coronary artery and left circumflex involvement among all three groups of ACS patients. Single-vessel disease was present in 168 (45.28%) UA, 94 (56.29%) NSTEMI and 468 (51.71%) STEMI patients. Double-vessel disease was present in 67 (18.08%) UA, 25 (14.97%) NSTEMI and 172 (19.01%) STEMI patients. Triple vessel disease was present in 28 (7.55%) UA, 16 (9.58%) NSTEMI, 72 (7.95%) STEMI patients. LM disease was present in 12 (3.23%) UA, 2 (1.19%) NSTEMI and 9 (0.99%) STEMI patients. Complications; ventricular septal rupture occurred in 3 (0.2%), free wall rupture in 2 (0.1%), cardiogenic shock in 45 (2.9%), severe mitral regurgitation in 3 (0.2%), complete heart block in 11 (0.7%) patients. Total 124 (7.9%) patients died in hospital after 2.1 ± 1.85 days of admission. Conclusion: STEMI was most common presentation. ACS occurred a decade earlier in comparison to Western population. Smoking was most prevalent risk factor. Diabetic patients had more of multivessel disease. Complications and in hospital mortality was higher in females and elderly population.
  6,845 1,132 13
Prevalence and spectrum of congenital heart diseases in children
Khurshid Ahmed Wanni, Naveed Shahzad, Mohd Ashraf, Kaisar Ahmed, Muzafer Jan, Shafaqat Rasool
July-September 2014, 2(3):76-79
Background: Congenital heart disease (CHD) is one of the major causes of mortality and morbidity in the pediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors. Objective: To find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (J&K). Materials and Methods: A retrospective analysis of case-records data of 767,921 patients (0-18 years) over 3 years and 10 months period was conducted to ascertain the prevalence and spectrum of CHDs. Results: A total of 877 patients out of 767,921, were found having CHDs measuring a prevalence of 1.12/1000. About 777 (88.5%) were the acyanotics, and 100 (11.5%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 241 (31.2%), followed by patent ductus arteriosus in 184 (24.3%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 48 (48.0%) patients. Conclusion: Prevalence of 1.12/1000 among the hospital attending patients could be an underestimation of the actual disease burden in our community, and heightened awareness among the treating physicians about the cardiac diseases could actually reduce the mortality and morbidity associated with these ailments.
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Pericardial effusion in severe iron deficiency anemia
Manoj Lakhotia, Jagdish Singh, Hansraj Pahadia, Harish Kumar, Sanjeev Sanghvi
July-September 2014, 2(3):88-90
Two female patients presenting with shortness of breath on routine activity, were found to have severe iron deficiency anemia and moderate transudative pericardial effusion. With the correction of iron deficiency anemia, pericardial effusion disappeared in both patients. Moderate pericardial effusion occurring with severe anemia has not been described in the literature.
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Unusual presentation of isolated tricuspid valve disease
Anil Sharma, Sunil Dixit, Mohit Sharma, Neeraj Sharma
July-September 2014, 2(3):83-85
Here we present a case 20 year old boy with isolated calcific tricuspid stenosis (TS) and tricuspid regurgitation (TR) underwent TV replacement with bioprosthetic valve. After 3 months patient was presented in our emergency with sudden cyanosis, dyspnea at rest, TS and the large patent foramen ovale with large right to left shunt. Patient was re-operated, bioprothetic valve was explanted and mechanical valve was implanted. Patient developed acquired dysfibrogenemia in early post-op period with valvular dysfunction.
  2,084 192 -
Giant cell arteritis causing annuloaortic ectasia
Shetty Kailkere Padma, Mundayat Gopalakrishnan, K Sajitha, BD Impana
July-September 2014, 2(3):86-87
Giant cell arteritis (GCA) is a rare cause of ascending aortic aneurysm. We present here a 50-year-old patient who was clinically diagnosed with annuloaortic ectasia. She was successfully treated by Bentall's operation. Histopathologically, the findings were of GCA. GCA should be suspected when older women presented with aortic aneurysm and continued surveillance of remaining aorta is necessary.
  2,028 182 -
Solitary intracavitory cardiac metastasis
Subhadeep Banerjee, Tanmoy Pal, Dilip Roy, Aindril Bhowmik
July-September 2014, 2(3):80-82
Metastatic cardiac tumors are more common than the primary ones and they most commonly involve the pericardium or myocardium. Very rarely they may show partial or total intracavitory growth. Ours is one such case of solitary intracavitory cardiac metastasis in a patient with adenocarcinoma of the right lung who presented with hemoptysis and palpitation. Echocardiography and histopathological study clinched the diagnosis.
  2,037 167 -
Preface to third issue of heart india 2014
Alok Kumar Singh
July-September 2014, 2(3):63-64
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