Ventricular tachycardia; prevalence and prognosis

Frequent or complex patterns of ventricular ectopic activity, whether occurring during routine activity or induced by exercise, are often a marker for serious heart disease and a harbinger of sudden death. The detection of such arrhythmias is thus an important responsibility of the physician. To find the prevalence, associated characteristics and prognostic significance of exercise induced non-sustained VT in a representative population. Nishtar Hospital, Multan. 1000 patients. Two years. Descriptive, analytical study. Convenient probability sampling done. Ten subjects, 7 men and 3 women, with exercise induced VT were identified, representing 1.1% of those tested; only 1 was young than 65 years. All episodes of VT were asymptomatic and non-sustained. In 9 of 10 subjects, VT developed at or near peak exercise. The longest run of VT was 6 beats; multiple runs of VT were present in 4 subjects. Two subjects had exercise induced ST segment depression, but subsequent exercise thallium scintigraphic results were negative in each. Compared with a group of age and sex matched control subjects. those with asymptomatic, non-sustained VT displayed no difference in exercise duration, maximal heart rate, or the prevalence of coronary risk factors or exercise induced ischemia as measured by electrocardiography and thallium scintigrahy. Over a mean follow period of 2 years, no subject has developed symptoms of heart disease or experienced syncope or sudden death. Thus, exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not portend increased cardiovascular morbidity or mortality rates over a 2 year period of observation. Exercise induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not show increased cardiovascular morbidity or mortality rates over a 2 year period of observation

Variant angina; comparison of patients with and without fixed severe coronary artery disease

The syndrome of variant angina occurs in patients with a wide spectrum of coronary artery obstructions, ranging from normal coronary arteries to severe 3-vessel coronary artery disease [CAD]. Treatment of these patients is, in large part, determined by the extent and severity of the underlying fixed coronary obstructions. To determine the clinical features of variant angina with and without fixed severe coronary artery disease. Nishtar Hospital, Multan. Two years. Descriptive, comparative analytical study. Sample size 108 patients. Sampling technique: Convenient probability sampling done. 43 patients with variant angina who had less than 50% fixed coronary luminal diameter narrowing [group-I] were compared with 65 patients with variant angina who had 70% or greater diameter narrowing [group-II]. Statistically significant differences were found in 3 clinical features between group-I and group-II i.e. [1] a more than 3 months history of angina at rest before diagnosis [80% vs 23%, P <0.001]; [2] an abnormal electrocardiogram at rest [19 vs 48%, P <0.01]. [3] an abnormal stress test [26% [8 of 30] vs 84% [15 of 18], P <0.01. However, these features were not clinically reliable in separating patients with variant angina with and without fixed severe obstructions because of overlap between the two groups. No difference was found between the 2 groups in age, sex, predominant symptoms at the time of catheterization, history of exertional angina, syncope with angina, prolonged angina, previous artery disease. Coronary arteriography should be performed to define the underlying coronary anatomy and to determine optimal therapy in patients with variant angina

Risk factors of coronary heart disease at tertiary care hospital

Coronary heart disease [CHD] is the single most common cause of death in the developed world. The incidence rate, risk factors prevalence and mortality vary widely among the countries. To identify risk factors associated with clinical evidence of CHD. This retrospective study was carried out in Cardiology ward, Nishtar Hospital, Multan during the period from January 2004 to January 2005. A total number of 100 patients were included in the study, attending OPD and emergency. Out of these, 60 were male and 40 were females. Age range was 40-80 years. Out of 100 patients 45 [45%] were smoker and 55 [55%] were non-smoker. Diabetes mellitus was also a contributed risk factor for CHD, 75 [75%] patients were diabetic as shown in. hypertension was found in 65 [65%] of cases. Higher age, being male, heredity, family history of CHD, hyperlipidemia, and hypertension were associated with CHD

Incidence of ischemic heart disease in patients with type-II dependent diabetes mellitus

Hyperlipidemia appears to be a risk factor for atherogenesis. Diabetic patients have increased platelet adhesiveness and response to aggregating agents. These changes are also likely to favour atherogenesis. Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and ad higher incidence of myocardial infarction than the general population. To find out the incidence of IHD in patients with NIDDM and too evaluate the pattern of clinical presentation of IHD in diabetic patients like with typical/atypical symptoms, evidence of silent ischemia and myocardial infarction. This study was carried out in Nishtar Hospital, Multan from June 2004 to July 2005. A total of 100 patients were included in the study. Study design is non-probable purposes. The 100 patients selected for study were between 30-80 years old. Majority of them belonged to 30-45 years of age. Mean age was 48.7 +/- 11.2 years. History of disease duration was also noted and 100 patients included had disease from 1 month to 30 years. Out of 100 patients, 70 [70%] were male and 30 [30%] were female. Among these 17 had evidence of IHD. Typical symptoms of IHD were found in 6 patients. Majority of them had more than one symptom and in one patient, dyspnea was the only symptom. Moreover 5 patients [29.5%] of those who had IHD had dyspnea apart from other atypical symptoms. The incidence of IHD is higher in diabetic patients as compared to non-diabetics