Effect of acute smoking on diastolic function

Smoking is a known risk factor of atherosclerosis, endothelial dysfunction, athermanous plaque rupture, unstable coronary syndrome and sudden cardiac death. The present study comprised 40 randomly selected healthy male hospital staff without a history of hypertension or cardiac or pulmonary disease. Participants were divided into two groups. The first group included 20 professional smokers [at least 5 pack/year till the time of study] and the second group consisted of 20 nonprofessional smokers defined as 0.5 pack/ year or less till the time of study. Participants were instructed not to smoke for 6 hours before the study. Patients underwent echocardiography before smoking. The participants were then asked to smoke a whole cigarette. After smoking, echocardiography was repeated within 7 to 15 minutes. Echocardiographic indices of diastolic function [E wave, A wave, Ea, E/A ratio and deceleration time] were measured before and after smoking. There was no statistically significant difference in the baseline measures in both groups before smoking and also there was no significant difference between measures in the two groups after smoking. The analysis of the pooled data from two groups showed that, smoking resulted in significant increase of heart rate [P<0.001]. A wave, E wave, Ea, E/A ratio and deceleration time changed significantly after smoking [P<0.001, P=0.027, P=0.011, P<0.001 and P<0.001 respectively]. Smoking of only a cigarette in both professional and nonprofessional smokers resulted in the same significant diastolic dysfunction

[One rare case report of congenital heart disease in a 68year old female]

Patent ductusarterioses is a communication between aorta and pulmonary artery.This disease is one of the most common form of congenital heart disease, that usually is diagnosedin the period of neonatal and infancy, and can be treated.Cases of this disease rarely have been diagnosed in the period of adult and elderly. It is rare andreportable for cases of the disease, in which have been diagnosed for the first time in the periodof old age.The patient that is reported here, is a 68 year old female whose disease had just beenidentified. Patient came with the complained of chest pain and palpitation, and continuous murmuron the left side of second intercostal during clinical assessment was noticable.Paraclinical assessment, e.g. chest Xray [CXR], ECG and Echo cadiography, showedpatent ductusarterioses and confirmed by cardiac cathetetrization.We report this 68 old age patient, as an interesting, rare, training case with regard of this matter:that patent ductusarterioses without pulamonary hypertension is rare among elderly people