ABSTRACT
Background: To know the incidence of significant coronary artery disease in rheumatic valvular heart patients undergoing preoperative valve replacement surgery by coronary angiogram. This very important prognostic indicator after surgery if we miss the cad the morbidity and mortality was high. Aim: To assess the CAD-related RHD in various valve involvement and associated risk factors like systemic hypertension and diabetic mellitus. Materials and methods: In this study, we analyzed 100 patients undergoing preoperative coronary angiogram in our department to know the incidence of significant CAD. This study also detected a correlation between the CAD, various valve involvement, sex, comorbidities like DM, SHT and Dyslipidemia were analyzed and also the incidence of CAD with duration of disease, the age of the patients and associate with post CMC or PTMC. Results: In this study, out of 100 patients undergone preoperative coronary angiogram, 8 had significant CAD. 5 patients were male and 3 were female and involvement of valves LCX was 4, LAD was 2, RCA was 1 and LMCA was 1 (p-value <0.05). In this study, the incidence of CAD was high in patients had comorbidities like DM, SHT, and dyslipidemia. Insignificant CAD group 2 had SHT, 2 had DM, 2 had both DM and SHT remaining 2 had no comorbidities. This study showed 5 patients of Aortic valve disease and 3 patients of Mitral valve disease had significant CAD. Conclusion: From this study, the incidence of CAD in our department is 8% most common in males than females and Aortic valvular RHD patients are mostly affected than other valvular RHD. Incidence increased with Age and associated comorbidities.
ABSTRACT
Introduction: Preeclampsia is one of the commonest complications of pregnancy and is a major course of maternal and fetal mortality and morbidity. In developing countries, it ranks second to anemia as a cause of maternal mortality and morbidity, complicating 7 – 10% of all pregnancies. Cardiac failure with pulmonary edema may occur in hypertensive patients with a normal heart. Aim of the study: The aim of this study was to determine the left ventricular dysfunction in preeclampsia women by measuring the left ventricular systolic and diastolic indices using echocardiography. Materials and methods: This study was a prospective observational study involving 50 patients who had been admitted in the antenatal ward of Govt. Mohan Kumar Mangalam Medical College, Salem over the period of one year from January 2017 to January 2018 (Group – 1). 50 normal normotensive pregnant patients selected at random who came to the OPD of our institute at the same period constituted (Group – 2). 50 normal non pregnant patients selected at random who come to the OPD of our institute at the same period who were from 18 to 35 year of age constituted (Group – 3). Results: The mean age of these study groups 1, 2, and 3 were 23 years, 24 years, 26 years respectively. The mean EF in three groups was 60%, 58.3%, 58.8% respectively. LV systolic and diastolic function indices were compared among the three groups with significance level. There was a statistically significant LV diastolic dysfunction in the preeclampsia group (p-value ˂0.001). Conclusion: In our study, LV systolic function was within normal limits in most of the preeclampsia patient. But statistically significant LV diastolic dysfunction was seen in 17/50 (34%) of the preeclamptic patient (p ˂0.001)