Study of coronary artery disease in patients of younger age group less than 40 years of age

Objective: To consider the aetiological factors for causing myocardial infarction in younger age group and to include these perspectives for the diagnosis of coronary artery disease. Study Design: A descriptive study. Place and Duration of Study: Study was carried out at CCU in the Department of Medicine, Avicenna Medical College and Hospital Lahore, from Jun 2012 to May 2013

Material and Methods: All patients within the age group of 26-35 years were admitted in CCU on the basis of multiple clinical symptoms by using approach of regular clinical investigations under the aspect of Ischemic heart disease. Clinical investigations were comprised upon cardiac monitoring, lipid profile, ECG and rate for cardiac enzyme included

Results: A total of 18 patients completed the study with age group of 26-35 years. MI was diagnosed in all patients and maximum number of patients with acute MI varied from age 28-33 years. All patients were heavy smokers with high rate of physical stress. On gross clinical examination it was revealed that majority of the patients included in age of 28-33 years was professionally van drivers

Conclusion: The essence of acute MI was observed and critically analyzed in younger age group of people with certain aetiological factors. This should be essentially important in redefining the criterion on clinical grounds for CAD and this should be recognized at International level. As the studies under clinical grounds with the aspect of CAD being reported at International level so, the amount of parameters in clinical diagnosis has to be considered in regular manners for the cure and prevention of CAD in patients especially of younger age groups less than 40

Assessment of L.V. function by multislice cardiac Ct as compared to 2d_echocardiography

Assessment of left ventricular function and volumes provides valuable information in patients with heart disease. It is also considered a prognostic marker in coronary artery disease. Two- dimensional transthoracic echocardiography is the most widely used method for Left Ventricular function assessment, but this modality is operator dependent and can be impaired by a poor acoustic window. To validate a single tertiary center experience in Multi Detector Computed Tomography for the evaluation of cardiac function in patients undergoing coronary CT angiography. A cross sectional study, conducted at Ibn Albitar center from September 2012 till May 2013. Patients included are those who already underwent 64-slice CT coronary angiography to evaluate known or suspected coronary artery disease, CT coronary angiography is performed using a 64- slice Multi Detector CT-scanner. Transthoracic Echocardiography was done by a single operator served as the reference standard. Eighty patients [66.3% male] were included in the study, the mean age was 53.19 +/- 10.6 years. The mean Left ventricular End Diastolic Volume by Cardiac CT and Echocardiography were 125.31 +/- 41.92, 126.75 +/- 41.894 ml respectively, with excellent correlation [r =0.912; P< 0.001]. Average Left ventricular End Systolic Volume [LVESV] by Cardiac CT and Echocardiography were 58.08 +/- 34.18, 53.74 +/- 33.15 mL respectively

Echocardiography and cardiac catheterization data: as predictors of severity in aortic stenosis

The diagnosis and quantifying severity of aortic stenosis [AS] has undergone substantial refinement, Doppler-echocardiography provides non invasive measures of the transvalvular gradient while cardiac catheterization provides direct measurement of gradient. Study the predictors of severity of aortic stenosis as using Doppler-chocardiography and cardiac catheterization data and the correlation between these data. This is a prospective study of patient with isolated aortic stenosis. Referred to Ibn AL-Nafies Teaching Hospital from October 2007 - October 2008. Echocardiography [echo] and cardiac catheterization[cath] data were recorded and analyzed for the studied group. Sixty -five patients with isolated AS, male: Female ratio was [3.5:1] their age ranges from 18-45 years. The analysis of cardiac echo and catheterization data reveal that each of the following data; left atrium size, left ventricule [LV] wall thickness and LV end diastole pressure were significantly associated with the severity of AS. Doppler estimated Pressure gradient [PG] was underestimate the transvalvular gradient across the aortic valve so should never be used alone as a predictor of severity of AS and should be interpreted together with other echo and cath data as a determinant of AS severity

Pulmonary balloon valvuloplasty in high risk patients

Transcutaneous pulmonary balloon valvuloplasty is the treatment of choice to relieve moderate to severe pulmonary valvular stenosis,the aim of our study is to propose a clinical classification for a group of patients with severe pulmonary valvular stenosis who present with particular signs and symptoms and who carry particular risks and difficulties during cardiac catheterization and pulmonary valvular angioplasty. From Aug 1993 to Sept. 2001,Pulmonary balloon valvuloplasty [PBV] was attempted in 248 patients with pulmonary valvular stenosis [moderate to severe] from early neonatal days and beyond. Among those we selected 47 patients with severe pulmonary valvular stenosis.They were devided into four groups according to their particular clinical manifestations: Group A:Those with pure cyanosis. Group B:Those with Rt sided heart failure without cyanosis Group C:Those with Rt sided failure and cyanosis. Group D:Those with biventricular failure. We recognized specific risks,complications and technical difficulties in those different groups [will be mentioned in details]. Pulmonary balloon angioplasty is still the standard solution to relieve moderate to severe pulmonary valvular stenosis in all ages, but still there is a group of patients who carries technical difficulties,risks and even death with this procedure