Insulin resistance, hyperinsulinemia and glucose intolerance in non-diabetic coronary heart disease

Serum insulin level and blood glucose level in the fasting and 2 hours after oral glucose load as well as lipid profile were measured in 25 non-diabetic, normotensive patients with old myocardial infarction and compared with that of 15 healthy control subjects. The results showed a significant increase in fasting serum insulin level, a very highly significant increase in 2-hour serum insulin level and a significant decrease in insulin sensitivity index in patients compared to controls. A nonsignificant increase in fasting plasma glucose and a highly significant increase in 2-hour plasma glucose level were found in patients compared to controls. As regards lipid profile, serum triglycerides, serum total cholesterol and total cholesterol/HDL cholesterol ratio were significantly higher in patients compared to controls. The study showed that insulin resistance and its two major consequences, hyperinsulinemia and glucose intolerance, are major and independent coronary heart disease [CAD] risk factors

Clinical examination and routine investigation versus echocardiographic study in diagnosis of some heart disease in children

The study has been carried out on 55 cardiac patients [31 males and 24 females]. Their ages ranged from one day to 15 years old. The diagnosis was based on history taking, complete phyisical examination, electrocardiographic and radiological examinations. Then, all cases were subjected to echocardiographic examination with its modalities M- mode, two-dimensional and Doppler echocardiography. The patients were divided according to the final diagnosis as following: 27 cases of congenital acyanotic heart disease, 13 cases of congenital cyanotic heart disease and 15 cases of rheumatic heart disease. By using history and complete physical examination, the final diagnosis was reached in 14 cases of congenital acyanotic heart disease, and in 4 cases of congenital cyanotic heart disease, and in 9 cases of rheumatic heart disease. Using ECG over history and physical examination was helpful in diagnosis of an additional one case of endocardial cushion defect. Using radiological examination of the chest and heart over history, physical examination and ECG was helpful in diagnosis of additional 2 cases, which were one case of Fallot's tetralogy and one case of transposition of great arteries. By echocardiography, all the studied cases were diagnosed and the diagnosis was further confirmed by cardiac catheterization in 5 cases

Left ventricular dysfunction in patients with acute myocardial infarction

The aim of this work was to study in left ventricular function in uncomplicated acute myocardial infarction [AMI] by Doppler echocardiography. The study included 30 male patients with uncomplicated AMI [study group] and 30 healthy subjects [control group]. All patients were subjected to clinical examination, ECG, chest X-ray, serum cardiac enzyme profile and full echo-Doppler study. The study showed that both systolic and diastolic BP were significantly increased [P <0.05] in patients with AMI compared with control group but heart rate was not statistically significant [P >0.05] between cases and controls. The diastolic and systolic parameters were significantly impaired in AMI patients compared with control group. Both systolic and diastolic parameters abnormalities in AMI correlated with the site of infarction. They were more significantly impaired in anterior compared with inferior wall MI. It was concluded that Doppler technique is a useful tool in identifying both systolic and diastolic abnormalities. It is a valuable method for initial assessment of severely ill patients with AMI and for serial assessment of a patient response to drug therapy

Study of the comparative effect of verapamil and captopril on exercise tolerance in patients with essential hypertension

The aim of this work is to evaluate the effect of verapamil and captopril on BP changes and cardiovascular responses during exercise in patients with essential hypertension. 30 male patients were included in this study with a mean age of 47 + 4.47 years. All patients have primary uncomplicated hypertension of mild to moderate degree. Patients were subjected to through history taking, clinical examination, ECG, chest X ray and some laboratory investigations. Antihypertensive medication were stopped one week before exercise test which was performed to all patients. Results showed that verapamil had highly significant reduction of all preexercise parameters namely both supine and 2 minutes standing heart rate, systolic and diastolic BP and pulse presure. Captopril showed also highly significant reduction of all preexercise parameters except supine heart rate, there was significant reduction. As regards the effect of both drugs on post exercise parameters. They showed highly significant reduction of maximum heart rate, systolic and diastolic BP, exercise double product and total duration of exercise. They showed significant reduction of pulse pressure. It was concluded that verapamil and captopril are effective in controlling the resting BP and dynamic response to exercise. They are of particular importance when considering treatment of very active athletic hypertensive individuals