Apical hypertrophic cardiomyopathy in Pakistan: electrocardiographic, echocardiographic and myocardial scintigraphic features

Apical hypertrophic cardiomyopathy is a recently recognized entity, with typical electrocardiographic, echocardiographic and myocardial scintigraphic features. Thallium imaging is more sensitive than echocardiography, but electrocardiogram appears to be an important clue to its diagnosis which shows changes in the mid precordial leads in most of the patients

Rate dependent bundle branch block

Eight cases of intermittent bundle branch block showing rate dependence are presented. Six cases were tachycardia dependent, one bradycardia dependent and one case showed both Right Bundle Branch Block and Left Bundle Branch Block at different rates. Tachycardia - dependent bundle branch block was explained on the basis of cycle-length recovery time relation and revealed a critical rate for normal intraventricular conduction. Bradycardia - dependent bundle branch block was best explained on the basis of enhanced phase-4 depolarisation of the bundle branch block system. Ischemic heart disease and Hypertension appeared to be the most important aetiological factors. The appearance of intermittent bundle branch block in younger age groups could be a marker of ischaemic heart disease developing in the later part of life

Prevalence of heart disease in school children of Islamabad

A survey of all the schools in Islamabad [Pakistan] was conducted to assess the prevalence rate of rheumatic and congenital heart disease. A total number of 15, 100 boys and girls between the age of 5-15 years were examined. By standardised and well accepted criteria 4. 77 per thousand were found to have heart disease. 1. 52 per thousand had rheumatic heart disease and 3.25 per thousand had congenital heart disease. Of the rheumatic heart disease group mitral valve was involved in 77%. Aortic in 7.5% and both the valves in 15.5%. All the female children in the group had mitral valve disease. 77% children belonged to the families with monthly income of less than Rs. 625/-. Only 30.7% gave positive history of rheumatic fever. Of the congenital heart disease group V.S.D. was the commonest lesion. Benign systolic murmurs were present in 20% of the children. The general health, average height and weight of children with heart disease were found to be below the normal. The prevalence rate rheumatic heart disease in this study appeared low as compared to the reports from some other developing countries and from other over-crowded cities of Pakistan. This is considered to be due to better living conditions in Islamabad