Evaluation of chest pain

Exercise Threadmill Test and Echocardiography was done in 50 patients presenting with chest pain. 55 percent of males and 39 percent of females had positive tests. The description of chest pain had some significance in males but not in females. Resting ECG abnormalities were of predictable value in male but not in female. Left ventricular dysfunction with exercise is sensitive parameter for dectecting coronary artery disease.

Tricuspid involvement in chronic rheumatic heart disease

Out of 977 cases of chronic rheumatic heart disease examined echocardiographically, the incidence of involvement of the tricuspid value was found to be surprisingly high, reaching about 10 percent when both TI and TS were considered. Thus echocardiography is considered mandatory when analysing or studying any patient with chronic rheumatic heart disease.

Ruptured sinus of valsalva : A case report with description of echocardiographic features

A patient with right sinus of valsalva aneurysm which had ruptured into the right ventricle is described. The diagnosis was confirmed at cardiac catheterization and angiography. Echocardiographic findings are discussed and these are compared with those given by others. Detection of a continuous murmur over the precordium during clinical examination alerts one to the diagnosis of patient ductus arteriosus. However, one should also consider aorto-pulmonary window, ruptured sinus of valsalva and coronary arteriovenous fistula among other rarer conditions in the differential diagnosis, Rupture of the sinus of Valsalva is usually thought to present with sudden onset of symptoms 1,2 and the patient may have sudden chest pain, syncope, rapidly progressive cardiac failure or even sudden death. We describe a patient with ruptured sinus of Valsalva who was completely asymptomatic at the time of diagnosis and whose abnormality was first suspected during a routine check-up.

Jones criteria as applied to Burmese subjects

Rheumatic fever is half as commom as chronic rheumatic heart disease. The latter forms about 20 per cent of all reportable heart disease in Burma. Both rheumatic fever and rheumatic heart disease form about 32 per cent of all organic heart disease seen for the first time at the Cardiac Clinic Rangoon. The prevalence rate for rheumatic fever in school children in the Greater Rangoon was 0.9 per cent in 1970 and 1971. 100 cases each of rheumatic fever and chronic rheumatic heart disease with elevated E.S.R from the Cardiac Unit Rangoon Hospital were analysed. Against Jones' major and minor criteria. Whereas high E.S.R. fever carditis and arthralgia were common, frank arthri tis, pericardial rubs and fulminating rheumatic fever were rare. Subcutaneous nodules, erythema margina tum and prolonged PR intervals were even rarer as compared to those reported originally by Jones. Chorea was extremelv rare. The presence of positive throat swab for heta hemolytics treptococci and of epistaxis in the rheumntics was significantlv higher than in the non-rheumatics. Other criteria like abdominal and precordial pains myalgia and rexia easv fatigability, leucocvtosis, 4SO titre, C-reaetive protein and other laboratory tests were too unreliable or unavailable.

Corelation of cardiac antibody titre and histopathological features of the left auricular biopsy in patients with mitral stenossis (1981)

20 patients who underwent mitral valvotomy were submitted to left atrial biopsy and correlation with serum cardiac autoantibody estimation. There was to a high degree, correlation between the histological evidence of active rheumatic carditis and the levels of cardiac antibody. There was less correlation between the ESR readings and the levels of cardiac antibody. In patients where cardiac biopsy could not be taken, it would be appropriate to estimate serum cardiac antibody titre to detect latent rheumatic activity in the heart tissue.

A study of cardiac arrest due to coronary arterial disease

Experience gained at the CCU / RGH from 1971 to 1983 is- analysed regarding the cause of cardiac arrest and the steps possib1e and feasible for improving the mortality rate are being discussed.

Juvenile mitral stenosis

Out of 3648 mitral valvotomies, 558 patients were under the age of 18 lie 15 per cent and were classified as "juveniles". Like and dissimilar features as compared to the adult counter-parts, in this group of juveniles, are discussed.

Recent trends. Management of pre-hospital cardiac arrest

A short account on the etiology, diagnosis, treatment and complications of treatment, of cardiac arrest is given. Cardio-pulmonary resuscitation should be started within 3 minutes of cardiac arrest, in order to prevent brain damage.

A case of hypertrophic obstructive cardiomyopathy. (Case report)

Hypertrophic Obstructive Cardiomyopathy is not a commonly recognized condition in Burma, but such cases are present and a case of Hypertrophic Obstructive Cardiomyopathy in a 25 years old Burmese female is reported. Clinical presentations were effort dyspnoea, palpitation and angina of ten years standing. She died of cardiac arrest and autopsy findings showed Asymmetrical Septal Hypertrophy. Clinico-pathological aspect of Hypertrophic Obstructive Cardiomyopathy is discussed.

An analysis of mitral stenosis in Burmese patients

Based on data derived from 1,055 rheumatic cardiac cases from the Cardiac Clinic and from 506 mitral stenosis patients operated at the Cardiac Unit, Rangoon General Hospital, pure mitral stenosis (MS) in sinus rhythm occurred in only 33 per cent. Association of atrial fibrillation occurred in 35 per cent, of jet mitral incompetence (mi) in 15 per cent, of aortic incompetence (ai) in 13 per cent, of tricuspid incompetence (TI) in 12 per cent, of inaudible mi in 7 per cent, on pulmonary incompetence (PI) in 6 per cent, of both PI and TI in 2 per cent and of jet mi/ai in 2 per cent.Of the 506 mitral valvotomies, there were II with mixed aortic stenosis (as) and incompetence, 4 with/pure aortic stenosis, 4 with Lutembacher's syndrome, 3 with jet mi and mixed aortic stenosis and incompetence, 2 with jet milas, 2 with organic TI and 2 with tricuspid stenosis. Juvenile MS (under 16 years of age) occurred in about 6 per cent. Silent MS occured in 8 instances.