Study of cardiac function in adults with dengue

Background: Medical literature has reports of isolated cases of atrioventricular conduction disorders, supraventricular arrhythmias, and myocarditis in dengue fever (DF).There is a paucity of data available in the published literature on the cardiac manifestations of DF from India. The aim of the present study was to assess the cardiac manifestations of DF. Methods: The140 patients aged ?18 years with DF confirmed with a serology-dengue non-structural protein 1 antigen-positivewere included for this prospective observational study. Three serial ECGs were taken on day one, day three and day seven or day of discharge. All the patients were evaluated using 2D echo on day one, day seven or day of discharge. The primary outcome measures were to find the incidence and type of echocardiographic abnormalities and electrocardiographic changes in dengue.Results: The incidence of cardiac abnormalities on ECG and 2D echo was 30 (21.4%), and 5 (7.0%) respectively. On ECG, 14 (10%) 9 (6.4%) 3 (2.1%) 3 (2.1%) and 1 (0.7%) patients had sinus bradycardia, sinus tachycardia, non-specific ST-T changes, right bundle branch block and atrio-ventricular block respectively. On 2D echo, 7 (5.0%), 5 (3.6%) and 1 (0.7%) patient had systolic dysfunction, ejection fraction (<45.0%) and diastolic dysfunctionrespectively. Conclusions: The incidence of cardiac abnormalities on ECG and 2D ECHO in dengue patients was considerable. ECG and 2 D echo should be undertaken in patients with DF.

An Observational Study Of Cardiac Involvement In Copd Patients And It’s Correlation With Severity Of The Disease

Introduction: The association of type 2 diabetes mellitus and thyroid dysfunction is well known. Thyroid dysfunction especially subclinical hypothyroidism has been reported to be a risk factor for sight threateningdiabetic retinopathy. Therefore, it is of importance to investigate the determinants of clinical and subclinicalhypothyroidism in patients with diabetic retinopathy. This study was aimed to investigate the effect of hypothyroidism on diabetic retinopathy and the determinants of hypothyroidism.Aims: To study the association of hypothyroidism and diabetic retinopathy and its effect on severity of retinopathy in type 2 diabetes and investigate the determinants of hypothyroidism in patients with diabetic retinopathy.Subjects and methods: A cross sectional study conducted on one hundred patients of type 2 diabetes withdiabetic retinopathy. They were evaluated for status of diabetes control, thyroid function, lipid profile andretinopathy grade. Those found to have clinical and subclinical hypothyroidism were analyzed for variousclinical and biochemical parameters for possible determinants of thyroid dysfunction.Results: There were seventy-four euthyroid patients and eighteen with subclinical hypothyroidism and five withclinical hypothyroidism. Patients with subclinical hypothyroidism had severe form of retinopathy (61.11%versus 32.43%). The odds of having a subclinical hypothyroidism in patients with severe form of diabeticretinopathy was found to be significant (OR 3.23; p=.048 CI=1.10-9.88). High HBA1c was an independent determinant of abnormal thyroid function.Conclusions: About one fourth of type II diabetes patients with retinopathy have thyroid dysfunction. Thesepatients are also likely to have severe form of the retinopathy especially those having subclinical hypothyroidism. Thus, we recommend thyroid function test should be done in all patients with type II diabetes mellitus withretinopathy. Those identified as having subclinical hypothyroidism should be closely followed so as, to detectand prevent vision threatening complications

A Study of Cardiac Dysfunction in Patients of Hypothyroidism

Introduction: Thyroid disorders are probably the mostcommon endocrinal disorders affecting the populationworldwide. Hypothyroidism is associated with obesity,dyslipidemia and increased atherosclerotic cardiovasculardisease. Hypothyroidism are associated with increasedcardiovascular morbidity and mortality. The present study wasplanned to study the cardiac dysfunction in hypothyroidismcases by using non-invasive method ECG and 2 D ECHO.Material and methods: A total of 100 patients withhypothyroidism were enrolled in the study.They were clinicallyevaluated and underwent relevant investigations,includingthyroid profile, ECG and 2D ECHO for cardiac abnormalities.Results: Mean age of patients was 40.45±13.03 years.Majority of patients were females (71%). There were only29% males. Male to female ratio of study population was0.41:1. Among 100 patients,on ECG abnormal findings wereseen in 57% cases. Bradycardia alone was the most commonECG abnormality affecting 27% of patients. 25% patientsshowed low voltage complexs. A total of 5% patients showedboth bradycardia and low voltage complex. On 2D ECHO,62% patients had normal findings. Abnormal findings wereseen in 38%. Among abnormal findings, the most commonwas mild pericardial effusion (18%) followed by LVDDGrade 1 (16%), LVDD Grade 1 with mild pericardial effusion(2%) and LVDD Grade 2 respectively.Conclusion: Cardiac dysfunction was found in hypothyroidpatients.

Clinical study of 2D Echo cardiography findings in stroke- ischemic patients

Background: The Echocardiography is the mainstay investigation tool used in stroke patients. Stroke has acquired third place as leading cause of death with ischemic stroke being very common among all the types of the stroke.Objective of the study was to evaluate 2D Echo cardiography findings in the stroke (ischemic) patients.Methods: Hospital based cross sectional study was carried out among the confirmed 50 patients of ischemic stroke. Routine investigations has been done to all the patients included in the study, specific investigations like 2D echo and CT brain (Plain), Doppler study of carotids and fasting lipid profile has been done.Results: Majority of the study subjects belonged to the age group of 60-69 years i.e. 36% followed by the age group of 50-59 years. The most common risk factor for this ischemic stroke found out in the present study was hypertension in 66% of the cases. The prevalence of ischemic stroke was 70% in the males and 30% in the females. Out of 50 cases, 43 cases i.e. 86% were having abnormal lipid profile. Bilateral carotid atherosclerosis (64%) is more common than the unilateral carotid atherosclerosis (36%) on color Doppler study. Mitral annular calcification was the most common finding in 2D ECHO study in 52% of the cases.Conclusions: Males are more affected than females. Hypertension and smoking are two major and predominant risk factors for stroke. Elderly age group is commonly affected. Bilateral carotid atherosclerosis is common finding on color Doppler study and Mitral annular calcification the most common finding in 2D ECHO study.

Study of fetal 2D echo in pregnant women with diabetes and gestational diabetes mellitus

Background: Diagnosis of diabetes in pregnancy is an important public health issue. Present study was done to study incidence of abnormal foetal 2D echocardiography in women with diabetes and gestational diabetes mellitus and to know their obstetric outcome.Methods: It is a prospective, observational study, which includes 80 patients. It was conducted at our tertiary care centre after the approval by ethics committee, and the results were analysed.Results: Out of 80 patients included, 77% women had GDM and rest 23% had DM. In this study, all patients had fetal 2D echocardiography done. 3 patients had report suggestive of congenital heart disease in the fetus. 1 of them was suggestive of TAPVC, 1 was suggestive of enlarged right atrium, 1 report was suggestive of VSD. Two of the abnormal fetal 2D echocardiography diagnosis of TAPVC and VSD was confirmed by neonatal 2D echo. One baby with Normal antenatal 2D echo had ASD on post-natal evaluation. The baby with antenataly enlarged right atrium had no cardiac anomaly on post-natal evaluation.Conclusions: Incidence of DM/GDM is increasing. As baby is likely to have congenital anomalies, out of which cardiac anomalies are most common, fetal echocardiography is a well-established, accurate, and safe method for diagnosing congenital heart disease. All the babies with abnormal fetal echocardiography need post-natal confirmation.

Age-wise Variations in the Dimensions of Left atrium and left ventricle in 100 apparently healthy individuals

Introduction: The study on the measurements of the chambers of the heart is very important, which gives details of anatomy, physiology and also pathological conditions of the heart. This knowledge also helps in diagnosis, treatment and follow-up of cardiovascular diseases. Materials & methods: The present study was conducted on 100 apparently normal people attending Out-patient and In-patient sections in Cardiology Department at Osmania General Hospital and CARE hospitals, Hyderabad from October 2012 to September 2013. Results & conclusion: In the present study it was found that the dimensions of left atrium and left ventricle increased with increase in age, which falls in line with previous studies performed on the same criteria.

Clinical profile of patients of acute pulmonary thromboembolism

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.

A Study Of Etiology, Clinical Profile And Complications Of Patients With Atrial Fibrillation

BACKGROUND: Atrial fiillation (AF) is the most common cardiac arrhythmia, occurring in 1–2% of the general population. AF confers a 5–fold risk of stroke. Much earlier detection of the arrhythmia might allow the timely introduction of therapies to protect the patient, not only from the consequences of the arrhythmia, but also from progression of AF from an easily treated condition to an utterly refractory problem. AIM OF STUDY: Analysis of etiological features, clinical features and Complications of atrial fiillation. METHODOLOGY: 100 cases of atrial fiillation both male and female were included in the study. The diagnosis was made on clinical grounds and then confirmed by ECG and Echo cardiogram. RESULTS: In this study of atrial fiillation, the occurrence of AF is maximum in age group 61 and above. Out of 100 cases 43 cases were male, 57 cases were female, and 60 cases were rheumatic heart disease. CONCLUSION: In this study common aetiology of AF was RHD 60% followed by Hypertensive heart disease and Ischemic heart disease each carries 10%. The most common symptomatic presentations were dyspnea and palpitation followed by chest pain and dizziness. The commonest complication noted was heart failure.

The Effect of Aging on the Left Ventricular Mass

The fundamental alterations in the cardiovascular system that occur consequent to aging are of great pratical importnace to clinicians. Senescent cardic muscle has many features of prolonged tension development, impaired relaxation and diminished response to receptor-mediated inotropic interactions. We estimated left ventricular mass by 2-D echo area-length method using a high quality planimeter. Age-related increments in left ventricular mass demostrated, but left ventricular enddiastolic cavity volumes were unaffected by age. The increase in left ventricular mass observed with aging is typical of pressuer-overload hypertrophy and its stimulus may be increased afterload from senescent changes.