Angiographically documented coronary artery disease in asymptomatic middle aged men suspected of silent ischaemic heart disease

One hundred and fourteen asymptomatic middle aged men, with a positive stress test, underwent coronary angiography at Armed Forces Institute of Cardiology/National Institute of Heart Diseases [AFIC/NIHD], Rawalpindi. Of these, 66 [58%] were found to have significant disease [>50% luminal narrowing in at least one of the major epicardial arteries] while 48 [42%] had normal coronary arteries. Of the former, 27[41%] had 1-vessel CAD, 18[27%] had 2-vessel CAD and 21 [32%] had 3-vessel CAD. There were significantly more hypertensives, hyperlipidaemics and diabetics in CAD group, while other risk factors were the same. The overall risk factor prevalence was low. The major reasons for performing coronary angiography were a positive stress test done as part of routine annual medical checkup and resting ECG changes of enough significance to warrant further investigations. It is concluded that the presence of significant coronary artery disease can be silent in a large number of asymptomatic middle aged men, especially those who have conventional risk factors

Blood lead levels and anemia in lead exposed workers

The effects of lead on haematological parameters were studied in 51 occupationally exposed individuals comprising of 27 lead furnace workers, 24 lead pellet handlers and 20 healthy age and service matched controls. Blood lead levels were estimated by atomic absorption spectrometer AAS-180-80 and haematological parameters by Technicon H.1[TM] system. The lead furnace workers had highest blood lead levels [median 71.20 ug/dl, range 21.2-171.10 ug/dl] and low Hb [median 106 g/l, range 73-144 g/l] as compared to healthy subjects [median lead levels 29.80 ug/dl, rang 10.20-54.10 ug/dl and Hb median 135 g/l, range 101-153 g/l]. The workers handling pellets had moderately increased blood lead levels [median 45.50 ug/dl, range 8.50-130.6 ug/l] and low Hb [median 114 g/l, range 74.158 g/l]. The furnace exposed workers had higher blood lead levels and low Hb compared to the lead pellet handlers. TRBC, Hct, MCV, MCH and MCHC did not reveal any significant difference in all groups. It is concluded that chronic lead exposure causes normocytic normochromic anaemia and shows a dose response relationship between lead levels and severity of anemia