ABSTRACT
To determine the frequency of clot in left atrium [LA] in patients suffering from tight mitral stenosis [MS] with atrial fibrillation. A cross-sectional descriptive type study at two centers was performed. A total of 50 adult patients with tight MS and AF were included. A 12 leads electrocardiography was performed once for each patients to look for AF after transthoracic echocardiography [TTE] and clinical examination features revealed tight MS. Patients with AF were selected and TTE was done to detect clot in LA. Tran esophageal echocardiography [TEE] was performed whenever clot could not be detected with TTE. Among 50 patients studied. There were 20 males and 30 females, TTE was done of all patients and LA clot were detected in 10 patients [20% of total] and TEE were performed in remaining 40 patients [80% of total] and additional 12 patients [24% of total] with clot in LA were detected. Therefore total of 44% of patients had LA clot. Among them 4% had clot in LA body and 40% had in LA appendage. LA dimension was found to be relevant [P value = 0.004] with the presence of clot in patients of severe MS with AF. LA spontaneous echo contrast [LASEC] was found in all patients. LA clot was present in 44% patients with tight MS and AF. Larger LA diameters is a strong predictor- of presence of LA clot in severe MS with AF
ABSTRACT
To determine the association between an abnormal ankle brachial index [ABI] and the presence of significant coronary artery disease [CAD] on coronary angiography. Cross-sectional, observational study. The study was carried out at Sheikh Zayed Hospital, Lahore, from July to October 2007. A series of 41 patients undergoing coronary angiography in Sheikh Zayed Hospital were selected and their ABI were calculated before the diagnostic coronary angiography. ABI calculations and coronary angiography reporting were done by separate individuals and data was analysed using SPSS 12.0. All patients undergoing diagnostic coronary angiography were included in the study except for those having peripheral arterial disease documented by lower extremity revascularization, lower extremity ulceration and lower extremity amputation. Proportion were compared using chi-square test with significance at p <0.05. Out of the 41 patients 31 male [76%] and 10 female [24%], 3 patients [7.31%] had ABI <0.9 and all 3 had triple vessel disease. Ten patients [24%] had ABI 0.91-0.99 and 2 [20%] of them had single vessel disease. Two [20%] had double vessel disease and 6 [60%] had triple vessel disease. Twenty four patients [58%] had ABI of 1.00-1.28 and 8 [33%] of these had single vessel disease, 3 [12%] had double vessel disease and 13 [55%] had triple vessel disease, while 4 patients had normal coronaries. A total of 22 patients were found to have triple vessel disease and only 3 [13.6%] of these 22 patients had an ABI <0.9 which is statistically not significant [p=0.07]. This study was not able to establish a direct association between ABI and significant CAD as only 3 patients out of 22 with triple vessel disease had an ABI <0.9. However, an approximately log linear relationship was noted between ABI and CAD risk which means that not only the average CAD risk increased exponentially at values < 1.0 but also that the CAD risk continued to decline as ABI values increased above 1.0
Subject(s)
Humans , Male , Female , Coronary Artery Disease , Coronary Angiography , Risk AssessmentABSTRACT
A number of researchers have used different electrocardiographical criteria to predict the culprit vessel in acute inferior wall myocardial infarction [MI] cases. Therefore, the determination of infarct related artery in AMI is extremely important with regard to prediction of potential complications, furthermore, predicting the probable site of occlusion within RCA is worthwhile because proximal occlusions are likely to cause greater myocardial damage and an early invasive strategy may be planned in such cases. Our study aimed at evaluating the ECG criteria to predict the proximity of lesion in the right coronary artery [RCA] in acute inferior wall MI cases. The Objectives were to predict the presence of a proximal lesion in right coronary artery by severity of ST segment elevation in inferior ECG leads. This cross-sectional study carried out at the department of cardiology and cardiac catheterization at Jinnah Hospital, Lahore from April 2008 to September 2008. A total of 60 patients who suffered from inferior wall MI were included in the study who underwent coronary angiography in the first week. The ECGs of these patients were then compared with the angiographic findings to correlate the proximity of culprit lesion in RCA with the degree of ST segment elevation in inferior limb leads. Out of 60 patients, 29 [48.4%] had the culprit lesion in proximal, 23 [38.5%] in mid and 8 [13.4%] in distal RCA. Patients with proximal RCA disease showed a mean ST segment elevation of 12.55 +/- 1.38 mm, with mid RCA disease 8.39 +/- 0.89 mm and with distal RCA disease 6.0 +/- 0.54 mm. This study demonstrated that the severity of ST segment elevation was correlated with proximity of RCA lesion