Cardiology and Angiology: An International Journal

Rare Case of Sars COV2 Virus (COVID 19) Associated Intra Myocardial Hematoma and Role of Diagnostic Imaging

Naresh Sen, Sonal Tanwar — Mon, 25 Apr 2022 00:00:00 +0000

SARS Cov2 infection is a pandemic declared by WHO in early month of 2020 as corona virus disease (COVID 19) which was diagnosed first in Wuhan, China in December 2019. During first wave of COVID 19 we faced with severe acute respiratory insufficiency and respiratory failure with common symptoms of high-grade fever, shortness of breath and loss of sensations but later on we accessed the different symptoms to related with multi systems of human body. Cardiac emergencies or cardiovascular morbidities with mortality were accessed across the globe during COVID 19 pandemic era. Data revealed that SARS Cov2 affected on heart by both direct or indirect pathway which leads to acute myocarditis, myocardial injury/infarct, heart failure, thrombosis and arrhythmias. Here we are presenting a rare case as hematoma in myocardium called as intramyocardial dissecting hematoma. Non-invasive diagnostic tools to prevent mortality in cardiology field and avoid further complication.

Impact of Atrial Fibrillation on in-Hospital and Short-Term Outcomes of Patients with Acute Coronary Syndrome

Ahmed Mahmoud Elsoudy, Mohamed Bayoumi Nassar, Mohamed Naseem, Seham Fahmy Badr — Wed, 27 Apr 2022 00:00:00 +0000

Background: Atrial fibrillation (AF) is an irregular and often rapid heart rate that can increase the risk of stroke, heart failure and other heart-related complications. The acute coronary syndrome is a potential risk factor for atrial fibrillation. The aim of this work was to evaluate the impact of atrial fibrillation on in-hospital and short-term outcomes of patients with acute coronary syndrome.

Methods: This prospective cohort study was carried out on 80 patients with acute coronary syndrome with or without AF. Patients were classified into 3 groups: group I (50 patients) with acute coronary syndrome without AF, group II (15 patients) with acute coronary syndrome with new onset AF and group III (15 patients) with acute coronary syndrome with pre-existing AF. All patients were subjected to laboratory investigations (CBC, kidney functions and liver function tests) and twelve-lead surface ECG.

Results: ACEI, warfarin, amiodarone and PCI were significantly different among studied groups. ACEI was significantly lower in group 3 when compared to group 1. Warfarin, amiodarone, HF and AKI were significantly higher in group 2 and group 3 compared to group 1. PCI was significantly higher in group 1 and group 2 compared to group 3.

Conclusions: New-onset and pre-existing AF remained associated with an increased risk of in-hospital complications as heart failure and acute renal failure compared to patients presented with acute coronary syndrome without AF. Anticoagulation as warfarin and antiarrhythmic drugs as amiodarone were largely used in patients with AF during hospitalization.

A Contemporary Role of Beta Blockers in Myocardial Infarction

Shyam Sunder Bansal, . Chetan — Wed, 27 Apr 2022 00:00:00 +0000

Myocardial infarction (MI) is characterized by plaque formation in the inner layer of arteries which occurs due to insufficient or complete cessation of oxygen supply in the myocardium. The common symptoms of MI are crushing or squeezing chest pain which radiates to the arms, shoulders, neck, or jaw, nausea, anxiety, restlessness, fear, heartburn, shortness of breath, cold sweat, fatigue, and dizziness. The treatment of this medical condition includes antiplatelet and thrombolytic therapy, painkillers (morphine or meperidine), diuretics and digitalis glycosides drugs. Moreover, nitroglycerin and antihypertensive drugs such as Beta-blockers, ACE inhibitors, or Calcium channel blockers may also be administered to reduce the blood pressure and improve the oxygen supply in the heart. Among them, beta blocker therapy has several beneficial properties such as it reduces myocardial oxygen demand, preventing arrhythmias, and improves ventricular remodeling, etc. However, there is no study on the role of only beta blocker therapy in the survival of MI patent is found to date. Thus, the present study focused on the evidence-based validation of Beta blocker therapy in the treatment and survival of MI patients. The retrospective study was conducted on 51 MI patients under the observation of medical practitioners. 100% of patients with MI showed a good recovery as well as survival percentage with Beta blocker therapy. This study finally concluded that beta blocker therapy is a safe and effective treatment for MI patients with negligible life-threatening medical conditions. Furthermore, a large group study is suggested with a number of health-related parameters for a better understanding of beta blocker as a first line of treatment for MI patients.

Drug Eluting Stents versus Coronary Artery Bypass Graft Surgery for Patients with Diabetes Mellitus and Multivessel Disease

Fri, 13 May 2022 00:00:00 +0000

Background: through coronary artery bypass graft (CABG) or through utilization of percutaneous coronary intervention (PCI) with stenting, coronary revascularization can be achieved. Diabetics represents a particularly challenging group for both treatments. This work aimed to estimate clinical outcome in diabetic individuals with multiple vessels disease (MVD) who had either PCI or CABG over 30 days.

Methods: This prospective research was conducted on 200 diabetic individuals with MVD established as severe stenosis. Into 2 equal groups, individuals were divided: Group (A) [underwent CABG], and group (B) [performed Drug Eluting Stents (DES) PCI]. All individuals underwent full history taking, resting twelve-leads electrocardiogram, complete clinical examination, transthoracic echocardiography, coronary angiographic, SYNTAX score and Euro score.

Results: In CABG group, age, statin, ACE-I/ARB, β- -blocker and dual antiplatelet therapy was significantly higher than PCI group. PCI group had significantly higher PCI, MI and repeated revascularization than the group of CABG. In PCI group, stroke and MI, death, myocardial infarction (MI), were significantly higher than in group of CABGS.

Conclusions: DES have developed for the coronary artery disease (CAD) treatment and are increasingly being utilized for complex CAD treatment, such as multivessel or left main CAD. PCI is preferred over CABG in high surgical risk individuals due to the shorter hospital stay, faster time of recovery, and potentially decreased stroke rate.

Evaluation of Lipid Profile and Some Renal Parameters in Some Selected Ethnic Population with Fat-mass and Obesity-associated Gene (FTO) Variants in Niger Delta, Nigeria

N. O. Ekpete, I. Elekima, H. Brown, E. O. Nwachuku — Sat, 07 May 2022 00:00:00 +0000

Aim: To evaluate lipid profile and some renal parameters in some selected ethnic population with fat-mass and obesity-associated gene (FTO) variants in Niger Delta, Nigeria.

Study Design: Case-controlled observational study.

Place and Duration of Study: Federal Medical Centre, Asaba, Delta State and Safety Molecular Pathology Laboratory, Enugu, Nigeria, between March 2020 and February 2022.

Methodology: Changes in lipid profile and some renal parameters in FTO gene was studied in ninety-eight (98) type 2 diabetes (T2D) subjects (78 cases and 20 controls) from four different tribes in the Niger Delta region, Nigeria. Multistage sampling method was employed in the subject selection. The subjects were first separated into two groups – new cases (less than a year of diagnosis as Diabetic) and old cases (one year & above). Equal number of samples was then randomly collected from each of the cluster groups. 10mls of blood was collected into plain bottles for the assay of the above-named markers, and were assayed using spectrophotometric and ELISA methods. The data were analyzed using GraphPad Prism, version 8.0.2 and p values less than .05 were considered statistically significant.

Results: The results showed that the Ijaw tribe had the highest mean total cholesterol (TCHOL), low density lipoproteins (LDL), Castelli Risk Ratio (CRR), atherogenic coefficient (AC) values (5.36 ± 0.99, 3.36 ± 0.87 mmol/l,3.76 ± 1.18 and 2.86 ± 1.16) respectively, which were significantly higher (P<.05) than those of the control group, while the Urhobo tribe had the highest mean TG and AIP values (1.47 ± 0.51 mmo/l and 0.08 ± 0.01), The control subjects had the highest mean HDL values (1.51 ± 0.49mmo/l), which were significantly higher(P<.05) than that of the control subjects. Mean creatinine level was highest in the control group (101.1 ± 21.24 µmol/L), while the Urhobo tribe had the highest mean MDRD levels (94.15 ±36.17 ml/min). Special diets did not contribute to any significant difference in the biochemical indices of the subjects apart from significant changes in the levels of triglyceride.

Conclusion: From the results, we conclude that the levels of lipid profile varied with the tribe for subjects with FTO variants and control subjects and only triglyceride levels are affected by specific diets.

CHA2DS2-VASc-HSF Score as a Predictor of Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography

Mon, 09 May 2022 00:00:00 +0000

Background: Cardiovascular atherosclerosis, particularly coronary artery disease (CAD), represents the main reason for death prematurely over the world. Risk stratification and prevention by risk factor modification are crucial aspects of CAD therapy. The CHADS2 and CHA2DS2-VASc scores are effective in determining the risk of thrombosis in non-valvular atrial fibrillation (AF). The current research aimed to determine the CHA₂ DS₂-VASc-HSF score as a predictor for CAD severity in CAD patients after coronary angiography.

Methods: This cross-sectional study was assessed on 100 patients who attended the coronary care unit and underwent coronary angiography. They were categorised into three groups: Group I: Low syntax scores (2-13), Group II: Intermediate syntax score (14-20), and Group III: High syntax score (21-40).

Results: Our study showed that the SYNTAX score revealed a statistically significant relation with patient's age, gender, and presentation. Regarding the medical history of the studied participant in relation to SYNTAX score, most patients reported a history of HTN, DM, Dyslipidemia, CHF, and previous history of vascular disease showed intermediate and high SYNTAX score in comparison to those with normal blood pressure, glucose level, lipid profile, no CHF history and those no previous history. SYNTAX score showed significant relation with ejection fraction and CHA2 DS2-VASc-HSF score of the patient. Significant low ejection fraction in high SYNTAX score patients compared to low SYNTAX score patients. Significant high average of CHA2 DS2-VASc-HSF score among those with high and intermediate SYNTAX score compared to those with low SYNTAX score.

Conclusions: CHA2DS2-VASc-HSF should be constituted as the ideal scoring scheme for predicting the severity of CAD. Risk scoring systems may be effective as predictors due to their simplicity and easy employment by physicians in ordinary practice without incurring additional costs.

Role of Black Salt to Reduce in Hypertension, Reality and Evidence Based Studies

Naresh Sen, Sonal Tanwar — Thu, 21 Apr 2022 00:00:00 +0000

Salt in diet is very important to make our life healthy and energetic. Quantity and quality of salt with appropriate ratio or balance in electrolytes which are responsible for volume of body, blood velocity, for functions of receptors and enzymes, to prevent inflammation, proliferation and to make balance in muscles contraction and nerve conduction through to avoid high stimulation of sympathetic nervous system. Hence, scanning and focus with monitoring and supply of healthy salt in limits may prevent volume overload, renal dysfunction & left ventricular hypertrophy, to prevent cardiac functions, to avoid the weaken gut immunity and also to prevent cerebral oedema, cerebral aneurysm and hypertension cause stroke. Control of salt with intake of low quantity and high quality with more frequency of intervals during 24 hours in required amount of salt in balanced electrolytes may help to avoid high salt sensitivity. Balanced salt intake is also important to avoid volume expansion and obesity with reduction of insulin resistance leads to prevent hypertension and diabetes which are leading risk factors for cardio-renal syndrome, cardiovascular morbidity and mortality. Our data suggested a 2.5-fold higher risk for high blood pressure in sea or white salt users versus black salt or Himalayan rock salt which showed more potassium and magnesium with low sodium ions as compared to sea salt.