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   2016| October-December  | Volume 4 | Issue 4  
    Online since December 20, 2016

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Coronary artery disease in young adults: Angiographic study-A single-center experience
G Suresh, K Subramanyam, Srinivasa Kudva, Rama Prakasha Saya
October-December 2016, 4(4):132-135
Background and Objectives: Premature coronary artery disease (PCAD) seems to increase, particularly in developing countries. There are fewer data regarding myocardial infarction in young adults, with varying risk factors and patterns of coronary involvement. This study was done to present the coronary angiographic characteristics of CAD in young patients aged <40 years. Materials and Methods: In this cross-sectional record-based study, patients aged <40 years who were evaluated angiographically for chronic stable angina or acute coronary syndrome were included. Single vessel disease (SVD), double vessel disease (DVD), and triple vessel disease (TVD) were noted down. Onset of CAD before 40 years of age was considered as PCAD. Results: A total of 4526 cases underwent coronary angiogram between January 2008 and December 2014; 154 (3.40%) were <40 years of age with a mean (standard deviation) age of 36.51 (±3.654) years. In <40 years age group, nearly third-fourth of the cases (112, 72.73%) had critical CAD; among them, 98 (87.5%) were male and 14 (12.5%) were female. About two-third of the cases (74, 66.07%) had SVD, followed by DVD (25, 22.32%) and TVD (13, 11.61%). Conclusions: Incidence of critical CAD in young adults is quite high. Young patients with CAD are mainly males, and SVD is more common. Emphasis should be given on diagnosis and management of risk factors in this vulnerable group.
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Effectiveness of planned teaching program on knowledge regarding early sign and symptoms of myocardial infarction among hypertensive patients
Mandeep Kaur, Parampal Kaur Cheema
October-December 2016, 4(4):123-128
Introduction: Hypertension is a major public health problem and an established major risk factor for developing myocardial infarction (MI). However, majority of the population with hypertension does not have sufficient knowledge regarding early sign and symptoms of MI as the sign and symptoms appear in a confusing way hence causes delay in seeking treatment. Aim of the Study: Assess the effectiveness of planned teaching program (PTP) on knowledge regarding early sign and symptoms of MI among hypertensive patients. Materials and Methods: A quasi-experimental research approach with nonrandomized control group design was used. Through purposive sampling, sixty patients were selected (thirty in each experimental and control groups). Data were collected with interview method by using self-structured knowledge questionnaire. Pretest was taken, and PTP was administered to experimental group only. After 7 days, posttest was taken from both groups. Collected data were analyzed using descriptive and inferential statistics. Results: In experimental group, mean pretest knowledge score was 13.87 and posttest mean knowledge score was 23.57. In control group, mean pretest knowledge score was 13.97 and posttest mean knowledge score 13.83. As per t-test, difference between mean posttest knowledge score (23.57, 13.83) of both groups was found statistically significant (t = 15.767 ***, P< 0.001). Conclusion: PTP significantly improved the knowledge of patients. This emphasized that providing education to patients at risk for MI can greatly reduce the morbidity and mortality associated with it.
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Coronary artery ectasia, an enigma in cardiology: A case report with review of literature
Tony Ete, Gaurav Kavi, Animesh Mishra, Pravin Kumar Jha, Amit Malviya, Rinchin Dorjee Megeji
October-December 2016, 4(4):149-152
Coronary artery ectasia (CAE) is the diffuse affection of artery which is defined as a dilation 1.5 fold the diameter of the normal adjacent segments of the same artery. Usually, it affects male, and the cause is multifactorial. It is considered as a variant of atherosclerosis. CAE is associated with connective tissue diseases such as Takayasu arteritis and polyarteritis nodosa. It may be primary or secondary to the presence of other diseases. Hence, the presence of CAE supports search to look for the presence of aneurysms involving other major vessels. Involvement of artery in CAE may be focal or diffuse. Prevalence of CAE varies between 0.3% and 5.3% in different studies. Clinically, it may present with features of angina and myocardial infarction. Coronary angiography is the mainstay of diagnosing CAE. Other measures to diagnose are computerized tomography coronary angiography and magnetic resonance angiography. CAE can be managed both medically through anticoagulants, antiplatelet therapy, and invasive interventional procedures such as percutaneous transluminal coronary angioplasty and coronary artery bypass grafting, if indicated.
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Celiac artery thrombosis and superior mesenteric artery stenosis
Mohit Sharma, Ghanshyam Kumawat
October-December 2016, 4(4):136-138
Acute thrombosis of the celiac artery trunk or elsewhere in mesenteric blood supply is a rare cause of acute abdominal pain. Celiac artery thrombosis carries high mortality and morbidity rates if the diagnosis and treatment are delayed. It is frequently associated with other cardiovascular events. The most common etiology is atherosclerosis. The main goal of the treatment is to revascularize and start the diminished or stopped mesenteric blood flow and to avoid end-organ ischemia. Thrombolysis with urokinase followed by anticoagulation with heparin in an emergency situation can save the life of the patient before surgical intervention.
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Frank's sign and coronary artery disease in Indian population
Amit Kumar
October-December 2016, 4(4):129-131
Background: The diagonal earlobe crease (DELC) has been linked to coronary artery disease (CAD). There are limited data, regarding it, in Indian patients with CAD. The present study was done to evaluate the prevalence of DELC in Indian patients with CAD. Methods: This cross-sectional study recruited 255 CAD patients who underwent coronary angiography at our center. After taking data of traditional CAD risk factors, patients were evaluated for the presence or absence of DELC. Results: The prevalence of DELC in Indian patients with CAD was 41.2%. CAD patients, in whom DELC was present, had significantly higher prevalence of smoking and hypertension (P = 0.03 and P< 0.0001, respectively). The prevalence of diabetes mellitus, dyslipidemia, and family history of premature CAD was not significantly different in CAD patients with or without DELC. There was also a higher prevalence of significant CAD and multivessel involvement (P = 0.02 and P = 0.0002, respectively) among CAD patients having DELC. Conclusion: DELC was observed in nearly 41.2% of Indian patients with CAD. The presence of DELC may be a marker of high-risk CAD patient.
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Preface to fourth issue of Heart India 2016
Alok Kumar Singh
October-December 2016, 4(4):121-122
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Experience of stenting in the left main coronary artery using optical coherence tomography: Acase-series
Sridhar Kasturi, Shivakumar Bandimida
October-December 2016, 4(4):143-146
Over the past decade, optical coherence tomography (OCT) imaging, with its high spatial resolution, has emerged as useful tool for planning percutaneous coronary intervention (PCI) and optimizing stent deployment, particularly in patients with complex lesions. However, there are limited reports of OCT-guided stent implantation in patients with left main coronary artery (LMCA) disease. Here, we present three cases of frequency-domain OCT-guided stenting in complex LMCA lesions, performed at our institute. The procedures were successful in all three cases. We opine that OCT-guided PCI could be a good alternative to coronary artery bypass grafting in patients with LMCA stenosis.
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A rare cause of paroxysmal atrial fibrillation: Mass in the left atrium
Biji Soman, Muneer Abdul Rahaman
October-December 2016, 4(4):139-142
A 57-year-old female with no known comorbidities presented to us with complaints of exertional dyspnea New York Heart Association Class II and occasional gray out. Clinical examination was unremarkable. Outpatient 12-lead electrocardiogram showed atrial fibrillation (AF) with fast ventricular rate. Transthoracic echocardiogram revealed a mass in the left atrium. The patient was advised to undergo surgical excision of the mass. The patient underwent the surgery. Her rhythm reverted back to sinus rhythm. Histopathology revealed the mass to be petrified cardiac myxoma. This case is unique because patients with atrial myxoma presenting with AF are rare, and petrified cardiac myxoma is a rare histological variety.
  1,261 120 -
Popliteal artery thrombosis caused by osteochondroma: Arare presentation
Kader Muneer, Kailash Kumar Goyal, Himanshu Gupta, Chakanalil Govindan Sajeev
October-December 2016, 4(4):153-155
Popliteal entrapment syndrome should be considered as a cause of lower limb vascular insufficiency in young adults. It is often caused by musculotendinous structures and bony abnormalities are rarely implicated. Early diagnosis and prompt surgical treatment are the key factors for a better prognosis. This report describes a rare case of popliteal artery thrombosis cause by an osteochondroma treated by surgical resection with good results.
  1,208 114 -
A curious case of anomalous pulmonary venous drainage in a double holed atrial septum
Kader Muneer, Shreetal Rajan Nair, CG Sajeev
October-December 2016, 4(4):147-148
A 5-year-old child who was incidentally detected to have a systolic murmur was found to have a sinus venosus atrial septal defect(ASD) abutting the orifice of the inferior vena cava associated with partial anomalous pulmonary venous drainage in addition to an ostium secundum-ASD. The fundamental embryological error is a failure of the sinoatrial orifice to shift rightward.
  1,207 94 -
Acute dilatation of right ventricle following aortic valve replacement
Vivek Chowdhry, Biswal Suvakanta, BB Mohanty
October-December 2016, 4(4):156-157
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Journal Watch
Alok Kumar Singh
October-December 2016, 4(4):158-159
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