ABSTRACT
Atrial infarction is a very rare diagnosis. Though available literature suggests, the condition per se may have been not so rare. Over the past few decades, atrial infarction have been reported several times, even some case series have been reported, but there is no consensus on the diagnosis of this condition, and its true importance also has not been understood completely. Previous works have shown that this condition is associated with several serious complications; hence recognition of this condition in early period is important, which is at the same time not so easy due to subtlety of the known features and less availability of information. We report a case of 70 year old Muslim, Bengali, male suffering from acute coronary syndrome, in whom, right atrial infarction was recognized by electrographic features, which is very rarely diagnosed with confidence in ante-mortem patients. Since, in Bangladesh, post-mortem autopsy to find out causes behind cardiac death is not done routinely and in the light of possibility of serious life-threatening complications, ante-mortem diagnosis of atrial infarction is necessary. So, Cardiologists should be aware of this uncommon condition.
ABSTRACT
Background: Ischemic Heart Disease which encompasses Acute Coronary Syndrome and Chronic Stable Angina is the most common cause of worldwide mortality and morbidity. Carotid intima media thickness (CIMT) is a non-invasive ultrasonographic technique to image the carotid arteries which measures the thickness of the intima and media of these vessels. It is a marker of atherosclerotic process. Flow mediated dilatation (FMD) is a marker of endothelial function of arteries. Ischemic heart disease can be predicted long before its actual occurrence by observing these two phenomenons. Methods: This cross sectional study done in the Department of Cardiology, Dhaka Medical College Hospital during the period of Oct 2010- Sept 2011.We enrolled 102 patients admitted with IHD by purposive sampling. We assessed FMD of brachial artery, CIMT by vascular duplex. Coronary artery disease severity was assessed by vessel score, stenosis score and extent score from angiography. Results:The mean (±SD) age of the patients was 50.9(±11.3) years. The male- female ratio was 5:1. CIMT has significant negative correlation with FMD (r=-.407, p=<.001). Flow mediated dilatation of brachial artery has weak but significant negative co-relation with vessel score(r=-.609, p=<.001), stenosis score(r=- .493, p=<.001) and extent score (r=-.477, p=<.001). However, carotid intima media thickness has weak but positive correlation with vessel score (r=.447, p=<.001), stenosis score (r=.417, p=<.001) and extent score(r=.412, p=<.001). Conclusion: The present study concludes CIMT has significant negative correlation with flow mediated dilatation of brachial artery. FMD has weak but significant negative co-relation and CIMT has weak but positive correlation with vessel score, stenosis score and extent score of coronary arteries.