Pacemaker lead in lung, a rare case.

Pacemaker lead perforation is a rare complication of pacemaker device implantation. We report a case where a ventricular lead perforated through right ventricle, pericardium and went into left lung parenchyma without the development of pericardial effusion, cardiac tamponade, pleural effusion, pneumo or hemo thorax. Patient presented with complaints solely related to failure of pacing rather than disastrous or life threating complications. Echocardiography didn't reveal any evidence of perforation and it was detected on fluoroscopy and computed tomography helped in making the diagnosis. Patient was treated with second procedure where second device placed on other side without manipulating previous device or lead.

Echocardiographic Pattern of Congenital Heart Diseases in Adolescent and Adult population of Western Rajasthan.

BACKGROUND: Nearly one third of all major congenital anomalies are due to congenital heart disease (CHD). Globally the prevalence of CHD in adults varies from 0.66 to 40.0 per 1000 study population. In India the prevalence of CHD is 1.09 to 543 per 1000 study population. CHD is a major global health burden because of increased mortality and morbidity associated with it. Early diagnosis and management can be helpful in improving survival rates, quality of life and prognosis in patients suffering from CHD. AIMS AND OBJECTIVES: The aim of this study was to assess the echocardiographic profile of CHD in Western Rajasthan, India in population above 12 years of age. METHODS: This retrospective study was carried out at department of Cardiology and Pediatrics of Dr. S. N. Medical College and attached group of hospitals in Jodhpur, Rajasthan, India. The presence of CHD among all patients above 12 years of age who underwent transthoracic echocardiography over a period of around 4 years from July 2014 to April 2018 was analyzed. RESULTS: A total of 256 patients above 12 years of age were identified as having CHD out of the 33,228 patients who underwent echocardiography during the study period, thus giving a prevalence of 7.7 per 1000 study population. Amongst the total diagnosed CHD cases, 137 (53.52%) patients were male with male to female ratio of 1.15:1. CHDs were diagnosed more commonly between 13 to 24 years of age (54.69%). The commonest type of CHD in the present study was atrial septal defect (27.34%) whereas the most common cyanotic CHD was tetralogy of Fallot (10.94%). CONCLUSION: Prevalence of CHD in study cohort of age more than 12 years in Western Rajasthan, India was 7.7 per 1000 study population. Profile of CHDs in the present study was similar to that in published literature. We propose to do larger and targeted studies in this age group because many CHDs will become inoperable or even if operated will leave some or other cardiac dysfunction beyond adolescence.

Ruptured Sinus of Valsalva Aneurysm with Subaortic Membrane causing Severe Left Ventricular Outflow Tract Obstruction.

ABSTRACT: Rupture sinus of Valsalva aneurysm (SVA) is an uncommonly encountered condition. It can present with wide range of manifestations from an asymptomatic murmur to cardiogenic shock. The case discussed in this report had a rare combination of ruptured SVA with subaortic membrane. Corrective cardiac surgery was advised, but due to financial constraints, the patient was not willing for surgery.

Percutaneous Transcatheter Treatment of Lutembacher Syndrome.

Lutembacher syndrome is a rare cardiac abnormality characterized by a combination of congenital atrial septal defect (ASD) and acquired rheumatic mitral stenosis (MS). Here we report a case of 18-year-old male with Lutembacher syndrome successfully treated percutaneously with transcatheter Accura balloon valvuloplasty and Amplatzer septal occluder device closure.

Clinical, demographic, risk factor and angiographic profile of coronary slow flow phenomenon: A single centre experience.

BACKGROUND: The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. Although it is well-known to interventional cardiologists for approximately four decades, the etiopathogenesis still remains unclear. AIMS AND OBJECTIVES: In this study, we aimed to determine the clinical, demographic, risk factor and angiographic profile of patients with CSFP. METHODS: Clinical, demographic, risk factor and angiographic profile were recorded in all consecutive patients who had undergone coronary angiography between September 2016 and March 2017 and showed features of CSFP and a control group who showed normal coronary flow (NCF). The CSFP was diagnosed on the basis of the corrected thrombolysis in myocardial infarction frame count. RESULTS: CSFP was significantly more prevalent in male patients. Among the traditional risk factors, there was significantly more prevalence of hypertension (31.25% versus 6.67%, p < 0.001), dyslipidemia (40% versus 7.5%, p < 0.001) and history of tobacco use (47.5% versus 10.0%, p < 0.001) in CSFP patients as compared to NCF patients. On multivariable regression analysis hypertension, dyslipidemia, history of smoking and tobacco chewing were found to have independent association with CSFP. Acute coronary syndrome (ACS) was the most common mode of presentation in CSFP patients. CONCLUSION: CSFP was relatively common among patients who presented with ACS. Hypertension, dyslipidemia, smoking and tobacco chewing can be considered independent risk factors for this phenomenon. Therefore, CSFP should be considered as a pathological entity and not an entirely benign condition.

Biventricular thrombi complicating acute myocardial infarction.

A rare case of biventricular thrombi complicating acute myocardial infarction detected during echocardiography is described.