An Observational Study Showing Incidence of Heart Disease in the Male Population from North India.

Background: Structural Heart Disease (SHD) is a preventable cause of mortality. As age advances the morbidity rates due to SHD increases. SHD is more common in rural areas and lower socio-economic status because of poor hygiene and poor nutrition. The aim of this study was to find the incidence of heart disease in a male north Indian population. Method: A team consisting of three doctors examined all the candidates presenting over a period of one and a half years for enrollment at a particular Centre. The age group of this population was between 18 years to 22 years. All candidates underwent medical examination. Candidates having suspicion of SHD were referred to the physician/cardiologist. All those persons whose disability was within permissible limits were taken as fit and the others were taken as unfit. Results: Total 4223 candidates reported in the above period. 334 candidates who had disabilities were lost to follow-up and excluded, leaving a total of 3889 candidates. After specialist review, 1471 candidates were found unfit for various causes, out of which 283 were for cardiac murmurs. Many candidates were found to be suffering from multiples disabilities. Conclusion: Our study found an incidence rate of 72.7 per thousand which is much higher than that of other studies. The possible reasons for this could be that the persons are primarily from rural background and low socioeconomic strata which have a comparatively incidence of SHDs. Also contributing to the higher incidence may be the fact of stricter application of physical standards for enrollment in the army.

An appraisal of infants with murmurs referred to a cardiac clinic.

Objective: Appraisal of infants with murmurs referred to a cardiac clinic. Method: Retrospective analysis of all infants with newly heard murmurs referred from April 2007 to October 2009 to cardiac clinics run by a paediatrician with special expertise in cardiology in the City Hospital and Sandwell General Hospital in the West Midland, UK.. Results: During the study period, 246 infants were referred for murmurs. Of the referrals 55% were following postnatal checks and 45% from paediatric clinics and general practitioners. All infants had clinical examinations, saturation checks and electrocardiograms. Echocardiograms were done when needed. In 88 (36%) infants no murmurs were heard during assessment and no follow-up was needed. In 158 (64%) infants murmurs were heard during assessment. Fifty four (34%) infants with innocent murmurs and normal echocardiograms were discharged from the clinic. All 13 (8%) infants with patent foramen ovale (PFO) showed closure of PFO on subsequent follow up. Cardiac defects (excluding PFO) were found on echocardiogram in 91 (58%) infants. Of the 91 infants 24 (26%) with significant cardiac defects were referred to the nearest tertiary cardiac centre for further management. Conclusions: The prevalence of murmurs detected at routine neonatal examination was 0.7%. Fifty eight percent of infants with murmurs had cardiac defects 26% of which were significant.

An Adult Case of Internal Mammary Arterio-Venous Fistula

A left internal mammary artery to vein fistula was found incidentally in a 32-year-old woman with a continuous murmur. There was no significant history of trauma and no cardiac symptoms. A percutaneous embolization with vascular plug and coil was performed.