Résumé
Background: Thyroid disorders are common in India. Symptoms and signs of thyrotoxicosis are nonspecific. Graves disease is an autoimmune condition and is the most common cause of thyrotoxicosis. Cardiovascular system is frequently affected in thyroid disorders but there is not much data on prevalence of thyrotoxicosis and related cardiovascular morbidities in central India. Objectives of study the clinical profile of patients with thyrotoxicosis and outline the related cardiovascular manifestations in a tertiary care center. Design-over a period of nine months a descriptive cross sectional study was conducted in a tertiary health care center.Methods: A total of 150 patients with thyrotoxicosis were studied. Patients with known diagnosis of thyrotoxicosis and newly diagnosed cases were included. The participants were investigated for thyroid profile, Electrocardiogram, Complete blood count, serum electrolytes and kidney function test.Results: Out of 150 patients of thyrotoxicosis, 87 (58 %) were diagnosed with Graves’s disease. Hypertension was observed in 78 (52 %) of participants. Atrial fibrillation was found in 18 (12%) and sinus tachycardia in 53 (35.33 %) of the participants.Conclusion: Grave’s disease is the commonest cause of thyrotoxicosis. Hypertension, sinus tachycardia and Atrial Fibrillation are the common cardiovascular diseases observed to be associated with thyrotoxicosis.
Résumé
Background: Deep vein thrombosis is a disease of potentially serious consequences and is still often unsuspected. The present study was undertaken to look into etiological factors, management approaches and complications in patients presenting primarily with DVT at a tertiary care centre.Methods: This was a descriptive study profiling 75 confirmed DVT cases admitted at a tertiary care government hospital over two years. Detailed assessment included thorough clinical examination, duplex venous ultrasound and basic investigations, along with special investigations and CT angiography in selected few. Appropriate management was provided, and details recorded. Patients were followed up clinically and by ultrasound after 1 week, 2 weeks and 3 months. The complications, if any were also recorded.Results: The mean age of participants was 39.5±14.4 years, with 28% between 30-39 years. Majority (40%) did not have any obvious predisposing factor and most of them presented with pain and swelling. Most (52%) of the cases had involvement of both proximal and distal veins, 45.33% cases had involvement of only proximal veins whereas only 2.67% had restricted involvement of distal veins. Around 60% of cases have complete clinical resolution and approximately 50% cases have complete ultrasonographic resolution at the end of 3 months.Conclusions: Young adults without any obvious risk factors may develop and present with DVT and hence factors leading to thrombosis in them are recommended to be thoroughly evaluated. Duplex venous ultrasound is reliable non-invasive diagnostic modality and is recommended for diagnosis of DVT in clinically suspected cases.
Résumé
Background: Incidence of Right Ventricular Myocardial Infarction (RVMI) associated with Inferior Wall Myocardial Infarction (IWMI) is reported to be quite high (30%-50%). To diagnose coexisting RVMI is important, since its early recognition and proper treatment reduces overall morbidity and mortality in IWMI. Author assessed the incidence and clinically profiled patients with right ventricular infarction in acute inferior wall myocardial infarction and analysed the effects of RVMI on clinical outcome of IWMI.Methods: A total of 150 patients of IWMI were evaluated in the present hospital based prospective observational study over duration of two years. They were evaluated for coronary risk factors like diabetes mellitus, hypertension, smoking, obesity, alcohol and dyslipidemia. Twelve-lead ECG, cardiac enzyme assay and echocardiography were undertaken in all the participants.Results: Of the total 150 patients, 45 (30%) patients had right ventricular myocardial infarction (RVMI). Complications were significantly lower in patients with isolated IWMI as compared to patients with IWMI and associated RVMI except pulmonary edema (p<0.05). Of the total 22 (14.67%) deaths in the present study, 18 (12%) had associated RVMI and 4 (2.66%) isolated IWMI, the difference being statistically significant.Conclusions: Involvement of right ventricle increases rate of complications as well as the mortality rate in patients with inferior wall myocardial infarction.