ABSTRACT
Background: Electrocardiography [ECG] is simple, quick and economic investigation for diagnosis of acute coronary syndrome. Its applicability in prediction of left main coronary artery/ 3 vessel coronary disease can be of very useful in saving precious time in the critical care of coronary patients
Objective: Electrocardiography changes as a predictor of left main coronary artery / 3 vesselcoronary disease in patients presenting with Non-ST segment elevation acute coronary syndrome
Methodology: This cross sectional study was executed from July 2014 to June 2015 at Isra University hospital Hyderabad taking 114 consecutive patients of age >/=20, of either gender, presenting with symptoms of Non-ST segment elevation MI or that showed ECG changes in lead aVR. Informed written consent for the study was taken from the immediate family members of patients. Approval from ethics review committee of Isra University was taken. Data analysis was done through SPSS. Descriptive statistics [Mean +/-standard deviation for continuous and frequencies and percentages for categorical variables] were expressed
Results: Patients' mean +/-SD age was 56.65 +/-15.44 years [Range: 20-89 years]. Male to female ratio was 3.4:1. More than a half [52%] of these patients had Left main [LM] / 3 vessels disease. About a quarter other [25%] had 2 vessels while [22%] had single vessel disease [P value <0.0001]. Patients having ST elevation in lead aVR, were associated with increased risk of developing LM / three vessels disease [P value <0.0001]
Conclusion: ST elevation in lead aVR and ST depression in leads II, III, and aVF can be practically used for evaluation left main / 3 vessel disease among NSTE-ACS patients
ABSTRACT
Abnormalities in left ventricular relaxation are indicators of left ventricular [LV] diastolic dysfunction. LV diastolic dysfunction may occur in patients with LV hypertrophy in the absence of systolic dysfunction. The purpose of this study is to assess the prevalence of LV diastolic dysfunction in patients with left ventricular hypertrophy in Pakistani population. 200 consecutive patients age 20 years and above and of either sex with left ventricular hypertrophy were included in this study. LV diastolic function was assessed by pulsed wave Doppler studies measuring transmitted E and A-wave velocities, E/A ratio, deceleration time and Isovolumic relaxation time intervals. LV diastolic dysfunction was diagnosed. Out of 200 patients, 106 [53%] were male and 94 [47%] were female. The average age was 53.66 +11.07 years. The average body surface area of male patients was 1.79 + 0.19 and female patients was 1.59 + 0.16 m2. The average LV mass of male patients was 290.09 + 68.29 and of female patients was 242.23 + 54.34 grams. 92 [46%] patients had LV diastolic dysfunction. 58 [61.70%] of female patients and 50 [47.17%] of male patients had LV diastolic dysfunction [P=0.04]. The average age of patients with LVDD was 55.55 + 10.86 years as compared to 50.27 + 10.38 years in patients without LVDD [P=0.001]. The mean body surface area of patients with LVDD was 1.667+0.202 as compared to 1.738+0.199 of patients without LVDD [P=0.014]. Ejection fraction and LV mass were not different statistically in patients with or without LVDD. LVDD is a frequent finding in patients with left ventricular hypertrophy. It is more frequent ir female patients with advancing age and smaller body surface area