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
OBJECTIVE: To determine the in-hospital outcome of Native Valve Endocarditis patients and associated complications
STUDY DESIGN, PLACE AND DURATION: Hospital based prospective study, Department of Cardiology, Liaquat University Hospital Hyderabad from July 2005 to December 2007
PATIENTS AND METHODS: 56 consecutive patients, who presented with fever, joint pain, dyspnoea, history of Rheumatic fever, previous history of IE, history of I/V drug abusiveness were studied by history, physical examination, 3 blood samples were taken and sent to the laboratory for culture and sensitivity. All patients were evaluated by Doppler echocardiography on day 1, at 14 day, at one month and on 6th week of treatment. Empiric treatment was started on admission and later adjusted according to culture and sensitivity. Descriptive and inferential statistical analysis was performed using SPSS version 16.0
RESULTS: Males out numbered females with ratio 37[66.1%] / 19[33.9%]. Definite vegetation was found in 40/56 [71.4%]; but definite culture positive cases were 30/56 [53.6%]. Complete improvement was seen in 32[57.1%], 08[14.3%] patients died during the course of treatment in hospital, 10[17.9%] were referred for surgery and 06[10.7%] patients developed recurrent episode of infective endocarditis. 13/56[23.2%] patients developed congestive heart failure, recurrent episodes of fever in 8[14.3%] and valvular regurgitation 6[10.7%] cases
CONCLUSION: Our study showed that native valve infective endocarditis is not un common
Early diagnosis and treatment can help in improving morbidity and mortality, overall outcome and can reduce devastating complications associated with infective endocarditis. Patients who require surgical intervention like large vegetations or abscess should be referred for surgery as early as possible to avoid further complications