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1.
Article | IMSEAR | ID: sea-209254

ABSTRACT

 Introduction: Ischemic heart disease and its complications are on a rise in premenopausal women unlike previously thought that estrogen provides protective effects from cardiovascular diseases. There are less number of studies for premenopausal women with ST-elevation myocardial infarction and very few took into account the clinical and angiographic pattern. Purpose: In this study, we took into account clinical and angiographic pattern as well as certain risk factor profile. Materials and Methods: Women <50 years admitted in the Intensive Coronary Care Unit of Government Rajaji Hospital, Madurai, with ST-elevation myocardial infarction were taken into the study (43 in number). Their clinical presentation, risk factor profile, biochemical data, electrocardiogram and echo findings, and the angiographic findings were collected. The study was conducted over a period of 1 year. Results: In our study, most of them were diabetics, non-vegetarians were using sunflower oil or palm oil, and almost 100% had dyslipidemia. Most of them had anterior wall myocardial infarction with ejection fraction >40%. Most of them had singlevessel disease. Thirty days mortality was very less. In about five patients, none of the conventional risk factors for coronary artery disease (CAD) were present. Conclusion: Premenopausal women with ST-elevation myocardial infarction are on a rise in the current era, unlike previously thought. The previous studies were of comparative studies between premenopausal and postmenopausal women. Studies about the risk factors among this age group were very less. Although conventional risk factors such as diabetes and dyslipidemia played major role, some of the unusual risk factors and unidentified risk factors were found to contribute to the disease. Further studies are needed to identify the unusual risk factors for CAD present in this age group

2.
Article | IMSEAR | ID: sea-194370

ABSTRACT

Background: Acute myocardial infarction (MI) is a significantly raising problem particularly in India. The various aspects of myocardial infarction such as risk factor profiles, clinical presentations and prognosis differ significantly in south Indian people when compared to others. This study was undertaken to study the association of socio-demographic and life-style factors with acute myocardial infarction in South India.Material: This was a prospective study included 100 patients admitted in ICCU for acute MI in Government Rajaji Hospital Madurai over a period of 1 year. History, ECG, CPK-MB, and 2-D Echo was done to diagnose MI.Results: In this study, 68% patients were males. In this study, 34% patients had diabetes, 42% had hypertension, 58% were smokers. In our study 70% patients had BMI between 25-30kg/m2. In this study, 86% patients had TGL more than 200mg/dl, 28% patients had LDL more than 100 mg/dl and 78% patients had NON-HDL more than 130 mg/dl. In this study, 9 patients had depression. In our study 61% male patients had waist hip ratio more than >1 and in females 69% patients had waist hip ratio more than >0.85. In our study, 22% patients had hemoglobin >16g/dl.Conclusion: Prevention of coronary artery syndrome by modifying the risk factors were crucial. Serum cholesterol, LDL cholesterol, BMI were not significant to predict ACS in our study Waist Hip ratio, Triglyceride, Non-HDL cholesterol, smoking and Depression were significant to predict acute coronary syndrome in this study

3.
Article | IMSEAR | ID: sea-193958

ABSTRACT

Background: Febrile thrombocytopenia due to various etiologies is very common in India. Its clinical manifestations range from asymptomatic infections to severe disease. Cardiac involvement in such systemic illness should be evaluated. Aim of present study is to evaluate cardiac involvement in patients with Febrile thrombocytopenia with platelets count less than 50,000/µL with the help of handheld echocardiography.Methods: Two hundred patients who had fever with thrombocytopenia were enrolled in the study. ECG and echocardiogram were done to all the patients. One-way ANOVA, Chi square test and correlation coefficient from Pearson correlation and P value of < 0.05 was taken as significant.Results: Out of 200 patients there were 146 males and 56 females. The mean age was 24.12yrs in males 28.32yrs in females .Rhythm abnormalities were present in 60 patients and the most common abnormality was sinus tachycardia; 17 patients had ascites and right pleural effusion; 24 patients presented with pericardial effusion and incidental diagnosis of CHD, RHD, and CAD were made; two patients had myocarditis as evidenced by global hypokinesia of left ventricle. All of those cardiac manifestations were common in Dengue Shock Syndrome.Conclusions: Cardiovascular manifestation in Febrile thrombocytopenia is relatively common ranging from pericarditis to myocarditis. Clinician should routinely screen patients with pyrexia with thrombocytopenia for cardiac manifestations. Early diagnosis at bed side may improve the outcome. Management of patients with pre-existing cardiac diseases should be individualized.

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