multi slice computed tomography coronary angiographic study of coronary artery disease in soldiers with chest pain

The study is sought to highlight the role and results of MSCT angiography in scenario of acute chest pain to determine or exclude significant coronary artery disease in patients who do not have high risk features for significant coronary disease. Descriptive study. Computed topography department, Armed Forces Institute of Cardiology, National Institute of Heart Diseases Rawalpindi from September 2013 to December 2013. A total of 150 patients [soldiers] who were referred to this hospital with chest pain and who did not have high risk features were evaluated by multi slice computed coronary angiography. One hundred and fifty patients who reported to this hospital with chest pain were evaluated by multi slice computed tomography [MSCT] angiography. Their age ranged from 20 to 53 years. Cases studied were those having low probability of coronary artery disease. Patients having high probability of coronary disease, acute coronary syndrome or definite coronary artery disease were excluded from this study and were evaluated by conventional coronary angiography, 114 [76%] patients showed normal coronary arteries. 6 [4%] had subcritical coronary disease, 5 [3.33%] had only minor irregularity in coronary arteries, 4 [2.66%] had significant coronary artery disease that necessitated coronary angiogram. 16 [10.66%] cases had muscle bridge in left anterior descending artery. One [0.66%] patient had patent graft after coronary artery bypass graft surgery. Three [2%] patient's had patent stents in coronary arteries. While 1[0.66%] patient had aberrant origin of coronary artery. There were no side effects observed during study. Patients presenting with chest pain with low risk features can be studied conveniently with MSCT angiography. Prevalence of significant coronary artery disease is low. MSCT angiography is a very useful, convenient and safe tool to screen low risk patients to rule out presence of significant coronary artery disease

Procedural outcome of primary PCI inst-segment elevation myocardial infarction at Afic and Nihd Rawalpindi - Pakistan

To determine the procedural outcome of primary percutaneous coronary interventions [PCI] in ST segment elevation myocardial infarction. A quasi-experimental study. Armed Forces Institute of Cardiology and National Institute of Heart Diseases, a tertiary care cardiac institute from November 2011 to September 2013. Total 228 patients who underwent primary percutaneous intervention [primary PCI] were included in this study. A pre designed performa was prospectively filled which included demographic and procedural variables. Procedural success and in hospital mortality were recorded. The mean age was 59 +/- 10.88 years. There were 205 [89.9%] males, 80 [35.1%] patients were found to be diabetic, 47 [20.6%] hypertensive, and 90 [39.5%] patients were smokers. Family history of ischemic heart disease was positive in 51 [22.4] patients. Anterior, inferior and lateral myocardial infarction were present in 137 [60.1%], 90 [39.5%] and 1 [0.4%] patients respectively. The Median time from the onset of symptoms to the arrival in the hospital was 122.5 +/- 142.57 and median door to balloon time was 60 +/- 22.88 min. Left anterior descending [LAD] was the commonest infarct related artery accounting for culprit artery in 138 [60.5%] followed by right coronary artery [RCA] and left circumflex artery [LCX] in 72 [31.6%] and 18 [7.9%] cases respectively. Procedural success was achieved in 222 [97.4%] patients. Six [2.6%] patients died in the hospital. High success rate with low mortality rates can be achieved in our set up. However more studies and long term follow up is required to validate our results

Peripheral arteriovenous malformations

Arteriovenous malformation [AVM] is an anomaly characterized by abnormal vascular communications between arteries and veins in the different organs of the body. It may be congenital or acquired. Microsurgical resection, endovascular embolization and radiosurgery [irradiation] are the three effective modes of treatment currently available. However, no objective criteria have been established for which mode[s] of treatment should be selected for individual patients with AVMs