Pattern of coronary artery disease with no risk factors under age 35 years

Coronary artery disease [CAD] is no more deemed to be an ailment of the 4[th] or 5[th] decade; rather an earlier age incidence is not infrequently encountered in our population. However, there are a few data regarding CAD in young adults, and much about its underlying pathology still remains undetermined. The objective of this study was to delineate the coronary arterial disease pattern in adults under the age of 35 years, but having no known coronary risk factors. This prospective study was conducted at the Cardiology Departments of all 3 public sector tertiary care hospitals in Peshawar from Jun 2008 to Dec 2009. After having excluded the traditional risk factors for CAD, patients under the age of 35 years with objective evidence of CAD were subjected to percutaneous coronary angiography. Out of a total of 104 patients, 85 [81.73%] patients were men, and 19 [18.27%] were women. The mean age of the whole group was 32.66 +/- 3.237 [22-35] years. Significant CAD [>50% diameter narrowing of at least one major coronary artery] was found in 87 [83.7%] patients while 17 [16.3%] patients had non-atherosclerotic coronary artery disease, including 12 [11.53%] patients having normal coronary arteries, 1 [1%] patient had anomalous origin of right coronary artery [RCA], 1 [1%] patient had coronary arteritis, 2 [1.92%] patients had coronary artery ectasia, and 1 [1%] patient had a myocardial bridge over left anterior descending artery [LAD]. Among the patients with significant CAD, the prevalence rate of one, two and three vessel disease was 54 [51.9%], 22 [21.2%] and 11 [10.6%] respectively. Almost 50% of the lesions occurred in LAD followed by 25% in RCA and 20% in circumflex, while only one patient [1%] had isolated significant CAD of left main coronary artery. Osteal segments were involved in 10%, proximal in 61%, mid in 21% and distal segments in 7% of the lesions. In the younger age group, CAD is mostly a disease of men, single vessel CAD predominates with LAD involvement mostly, predominant osteal to proximal segment involvement of vessels, and a much higher incidence of normal coronaries and non-obstructive CAD is met with

Frequency of Brugada-type ECG pattern [Brugada sign] in an apparently healthy young population

To determine the frequency and demographic features of subjects with Brugada-Type ECG pattern in apparently healthy young population. Cross sectional descriptive study. This study was conducted at School of Nursing Hayatabad Medical Complex, Public Health School, Post Graduate College of Nursing, Qurtaba College, Brain's Post Graduate College and Gandhara Institute of Science and Technology Hayatabad Peshawar from June 2006 to May 2007. A total of one thousand one hundred [1100] subjects, 712 males and 388 females, were included in the study. A prospective analysis of the eleven hundred electrocardiograms [ECG] of healthy young subjects in the above institutions were included in this study. Brugada-Type ECG pattern frequency was 0.8% [nine out of one thousand one hundred healthy subjects]. Five cases [0.45%] were observed between 16 to 20 years of age and four cases [0.36%] were observed in 21 years and above. Out of total of nine cases of Brugada-Type ECG pattern [Brugada Sign], seven were males [0.6%] and two were females [0.2%]. Frequency of Brugada-Type ECG pattern was 0.8% in the apparently healthy young students in Hayatabad Peshawar