Chronic anemia in adult patients with cardiovascular diseases, diagnosed clinically and by trans-thoracic-2-dimensional echocardiography: a semi-urban tertiary care teaching hospital study.

Anemia is one of the major health challenges to global development in this century and this Non-Communicable Disease is rapidly rising in both developed and developing countries. Chronic anemia is a risk factor for cardiovascular diseases and affect outcome in patients with heart failure, dilated cardiomyopathy and uncontrolled hypertension. Chronic anemia’s have significant morbidity and mortality in untreated patients. This study was performed to analyze the prevalence of anemia among cardiac patients and to determine the relationship between anemia and socio demographic characteristics. Methods: We enrolled 300 adults’ cardiac patients (≥19 years) during study period. The analysis includes socio demographic data, traditional risk factors for cardiovascular diseases, laboratory test (hemoglobin and creatinine clearance measurement), and non-invasive cardiac investigations. Results: Our analysis suggests prevalence of anemia is very high in CVSD patients & more common among females, older age, diabetics, impaired clearance creatinine, hypertensive and low education level. The highest proportion belonged to valvular heart disease (77.8%), congestive heart failure (74.6%) followed by hypertension (54%), and the lowest is coronary artery disease (46%). Logistic regression reveals that low education, low clearance creatinine level, smoking and diabetes are independently associated with anemia. Conclusion: We conclude that anemia is common among cardiovascular disease patients, and worsens the prognosis of their clinical condition. Intervention policies to minimize anemia risk factors are needed.

Anemia: a non-communicable disease, its prevalence in adult patients of Telangana region of South India; a semi-urban tertiary care teaching hospital study.

Anemia is a one of the major health challenges to global development in this century and this non-communicable disease is rapidly rising in both developed and developing countries. Anemia is wide spread in India but it varies in severity from state to state and zone to zone. Poor diet, lack of sense of hygiene which lead to worm infestations, lack of health consciousness, social taboos and poor economic status all contributes to overwhelming prevalence of anemia. Our analysis suggests prevalence of anemia is very high in adult age group and especially in female patients. Chronic anemia’s have significant morbidity and mortality in untreated patients, because anemia is a sign, not a diagnosis, an evaluation is almost warranted to identify the underlying cause.

Atrial septal aneurysm in adult patients: spectrum of clinical, echocardiographic presentation and to propose a new classification on the basis of trans-thoracic-two-dimensional echocardiography.

An atrial septal aneurysm is a rare but well recognized cardiac abnormality of uncertain clinical relevance. ASA is definitively associated with congenital and acquired heart diseases but also can be presented as an isolated and totally asymptomatic entity. On the basis of our TTE finding we are proposing a new classification of ASA. We have classified ASA in to two major types: (A) Localized, and (B) Generalized. Both major types are further Sub-classified into 5 possible types on the basis of movements of ASA. New classification of ASA is as follows (1) A/B Type 1R: if the bulging is in the RA only (2) A/B Type 2L: if the bulging is in the LA only (3) A / B Type 3RL : if the major excursion bulges to the RA and lesser excursion bulges toward LA (4) A/B Type 4LR: if the maximal excursion of the atrial septal aneurysm is toward the LA with a lesser excursion toward the RA (5) A / B Type 5: if the atrial septal aneurysm movement is bidirectional and equidistant to both atria during the cardiorespiratory cycle. We found higher prevalence (2.24%) of ASA. A/B Type 2L and A/B Type 4LR were most common types. All type of ASA had particular clinical and echocardiographic characteristics. Mobile ASA and ASA with >10 mm excursion are associated with a higher risk of stroke.

Prevalence and pattern of congenital heart diseases in Karimnagar, Andhra Pradesh, India: diagnosed clinically and by trans-thoracic-two-dimensional echocardiography.

Background: To find the prevalence and pattern of congenital heart diseases (CHD) at a Semi-Urban teaching hospital in Karimnagar, Andhra Pradesh, India. Methods: A thorough history, clinical examination and Trans-Thoracic-Two-Dimensional Echocardiography (TTE) was done for all the live birth, children up to 18years of age and patients between 18 to 25 years, who were referred or presented to the Department of Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar (AP), over a period of 5 years from July 2008 through June 2013. Those suspected to having a CHD or referred in our department, were further evaluated with: Clinically, Twelve-Lead-Surface Electrocardiography, Chest Radiography and the diagnosis was confirmed by TTE. Trans-Thoracic-Two-Dimensional Echocardiography, M-Mode, Color flow doppler and Spectral doppler echocardiography was done in all patients in the various views. Results: Total 13,554 patients were examined and underwent TTE. Out of 13,554 patients 116 were identified as having congenital heart diseases, thus giving a prevalence of 8.55 per 1,000 live births. Isolated Ventricular septal defect (28.44%), isolated atrial septal defect (18.10%), Patent ductus arteriosus (10.34%), isolated congenital pulmonary stenosis (6.03%) and tetralogy of Fallot’s (6.03%), were the commonest defects observed and confirmed by TTE. TOF was the main cyanotic CHD (6.03%), with the prevalence of 0.51% per 1,000 live births. VSD, ASD and PDA were more prevalent in males. TOF and Complete A.V. Canal defect was prevalent in females. All small size muscular and perimembranous VSD was closed spontaneously. Spontaneous closure rate of 75.00% in Muscular VSD and 52.17% in perimembranous VSD was observed. Spontaneous closure rate of Ostium secundum type ASD was 53.33%. Conclusions: The prevalence of CHD at a tertiary teaching hospital (CAIMS, Bommakal, Karimnagar, AP, India), is 8.55 per 1,000 live births. VSD, ASD, PDA are the most common acyanotic and TOF was the commonest cyanotic congenital heart defects respectively. Non-Invasive Cardiac diagnostic technique (like TTE) plays major in the diagnosis of CHD. When clinical evidences lead to suspicion of congenital heart defect, an echocardiography should be performed immediately.

Sub aortic fibro muscular ridge with congenital bicuspid aortic valve.

Congenital bicuspid aortic valve stenosis is estimated to occur in 1 to 2% of general population, making it the single most common congenital cardiac anomaly, but in association with fibro muscular sub aortic ridge (fibro muscular collar) is a rare combination of congenital cardiac anomalies. We present here a rare case of sub aortic fibro muscular ridge that is associated with congenital bicuspid aortic valve.