Frequency of atrial fibrillation in mitral stenosis and its correlation with left atrial size

Chronic rheumatic heart disease is much the commonest cause of mitral stenosis. Incidence of rheumatic MS parallels that of acute rheumatic fever. Atrial fibrillation usually develops in the presence of pre-existing ECG evidence of left atrial enlargement and is related to the size of the chamber, the extend of fibrosis of the left atrial myocardium, the duration of the atriomegaly and the age of the patient. Descriptive. Mayo Hospital, Lahore and Punjab Institute of Cardiology, Lahore. Convenient. 129 consecutive cases of predominant mitral stenosis. 112 cases included in the final workup. The frequency of AF in MS in this study was calculated as 25.9%. The correlation between AF and left atrial size was significant [p = 0.000]. This was plotted on the scattergram [Figure No. 1], which shows a steep rise in the frequency of AF beyond a left atrial size of 70 mm. Frequency of AF in patients with MS is 25.9%. The correlation between AF in MS and left atrial size is significant [p = 0.000]

Clinical association of localized intraventricular conduction defect

A prospective study was organized to clarify the clinical association of localized intraventricular conductions [LIVCD]. Fifty patients with symptoms suggesting cardiac origin were studied and subjected to chest X-ray, E.C.G, holter ambulatory monitoring, and treadmill test. The results showed that LIVCD seems to be acquired. Ischemic heart disease constituted the most frequent associated condition [42%]. Hypertension not associated with ischemia constituted the next frequent condition [30%]. Obesity and diabetes mellitus account for [10% and 8%], respectively. No definite association could be found in the remaining 10% of cases, a finding which might be related to other factors e.g. sclerodegenerative affection, myocaraditis, cardiomyopathy. Indeed patients with LIVCD are in need for long-term follow up to monitor the progression of this condition to other types of intraventricular conduction defects

use of arteriolar vasodilator in the management of advanced congestive heart failure

This study reports on therapeutic effect of hydralazine in the management of advanced congestive heart failure [ACHF] in Iraq. One hundred patients, with ACHF [class 4 of NYHA classification] were studied pressure, and the physical fitness for walking were taken as a follow up indicator for beneficial effect. Three months follow up after treatment showed that 50% of patients were stepped up to class 3 of NYHA. Six months follow up showed that 52% were in a good condition, and were satisfy the class 2 of NYHA. One year later 68% of the total patients were survived and they were stepped up, at least, one class of NYHA. Two years follow up showed that 60% of total patients were still surviving with 42% of them satisfy the criteria of class 2 of NYHA. The remaining patients of the total surviving [i.e. 18%] were in class 3 of NYHA. The mortality rate was 10%, 15% and 25% after 6 months, one year, and two years of treatment respectively. Incidence of sudden death was 5% among all patients through the 2 years period of study. As a result of the improvement in clinical states and reduction in mortality, hydralazine would be recommended to be used in the management of congestive heart failure