Background: Cardiovascular changes and hence electrocardiographic changes do occur as duration of pregnancy proceeds. There is not much data available on particularly QT interval and corrected QT interval (QTc) in different phases of pregnancy. Pregnancy can precipitate cardiac arrhythmias in later phases in apparently healthy women due to changes in the electric activity of the heart and prolonged QTc is one of the causes. Since prolonged QT interval can precipitate arrhythmias, we thought it is essential to find baseline value for QT interval and QTc in different phases of pregnancy to detect pregnant women at risk. Aims: Our aim of the study was to record QTc in pregnant females during different phases to establish fact that QTc can be correlated with duration of pregnancy. Materials and Methods: Cross-sectional study, 202 pregnant individuals were selected from the antenatal clinic with different phases of pregnancy. All were subjected for electrocardiogram (ECG). QTc was calculated using Bazett's formula and QT intervals were correlated with duration of pregnancy. Results: There was significant gradual increase in QTc with duration of pregnancy. There was significant positive correlation between duration of gestation and QTc (r = 0.277) (P < 0.001). Conclusion: QTc prolongation occurs as pregnancy proceeds.

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Dilated cardiomyopathy (DCM) is mostly an idiopathic disease with a progressive and irreversible course. It carries poor prognosis and outcome. Rarely, a reversible metabolic etiology that is amenable to specific therapy is identified. Alteration in thyroid status can lead to changes in systolic and diastolic function of left ventricle. Heart is sensitive to thyroid hormone changes, and cardiac disorders are commonly associated with both hyper and hypothyroidism. Diastolic dysfunction is the most common abnormality reported in hypothyroidism. In systolic function, prolonged systolic time interval or normal cardiac function has been reported by most workers. DCM is a rare presentation of hypothyroidism. Here, we report a case of 40-year-old female diagnosed with DCM due to hypothyroidism

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Hyperkalemia is a life-threatening metabolic condition that can induce deadly cardiac arrhythmias. Here, we present a case of severe life-threatening hyperkalemia in a 35-year-old man with preexisting renal impairment who was managed only medically with close electrocardiogram and vital monitoring.

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Background: Atenolol is a widely used anti-hypertensive drug worldwide. Despite well-studied from other population, due to the paucity of data from Indians, this study was conducted. Materials and Methods: This was a prospective cohort study conducted in 566 tertiary care hospitals in India. Adult male or female naïve patients with Stage I ¹ or Stage II ² (Seventh Report of the Joint National Committee) essential hypertension or patients uncontrolled on current monotherapy or other combination therapy. Demographic details, blood pressure and heart rate readings (weeks 2, 8, and 12) and drug-related details of the study participants were collected and analyzed. Results: A total of 2657 participants were evaluated. The mean (standard deviation [SD]) baseline systolic and diastolic blood pressure of the study participants were 161.73 (15.13) and 99.21 (11.37), respectively. Mean (SD) of the baseline heart rate was 84.39 (10.17) beats/min. Statistically significant reductions (P < 0.05) were noted in both the blood pressures and heart rate at all the follow-up visits in comparison to baseline. Of the total 632 patients with Stage I hypertension, 153 (24.21%) achieved a reduction in blood pressure <120/80 mmHg, while 245 (38.77%) had their blood pressure between 121 and 140 mmHg systolic and/or 81-90 mmHg diastolic at 12 weeks of therapy. Global assessment of the efficacy and tolerability were found to be at least satisfactory in the majority of the study participants. Conclusion: To conclude, atenolol as an anti-hypertensive agent seems to be promising both in terms of effectiveness and safety profile in the Indian population.

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The extra-articular manifestations of Rheumatoid Arthritis (RA) have drawn as much interest as the disease itself and thus leading to it being labeled as a chronic inflammatory joint disease with a multisystem involvement. Of the various known extra-articular manifestations, one of the rare complications is the conduction abnormalities of the heart that is seen in the active disease. Here, we are reporting a case of a female patient with RA, who to begin with had conduction defects secondary to RA which later progressed to a complete heart block, as its sequelae.

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Background: Use of tobacco in cigarettes leads to an oxidant antioxidant imbalance. As a consequence of its addictive qualities, the consumption of cigarettes often becomes a lifelong habit with cumulative and deleterious effects on health. Previous reports have described long-term harmful effects of nicotine on various body parameters, including oxidative injury and a lack of antioxidants in the body. Fruits are known to be a rich source of dietary antioxidants. This study was conducted to know the effect of consumption of fruits in a group of short term smokers on cardio-pulmonary efficiency parameters. Materials and Methods: Treadmill exercise testing and pulmonary function tests were done before and after maximal exercise testing to assess cardiopulmonary efficiency in two groups' viz., healthy sedentary controls and healthy cigarette smokers on a fruit rich diet. Results: On studying the differences in cardiopulmonary efficiency in the two groups the resting heart rate (HR) was found to be statistically significantly higher in the study group and the delta HR (δHR) was found to be statistically significantly lower among cigarette smokers. There was no significant difference seen in parameters like maximal oxygen consumption max, maximum oxygen pulse, maximum voluntary ventilation, maximum minute ventilation as an acute effect of cigarette smoking. Conclusion: In this study, it appears that cigarette smokers are physically fit like controls, but after immediate smoking a lesser δHR suggests a higher risk for cardiovascular mortality. There seems to be no effect of including fruits in the diet of smokers. The predominant effect of smoking over dietary measures is obvious. Stopping smoking at this juncture can be helpful in reverting back the risk and parameters like resting HR, recovery HR and δHR can be used as prognostic assessment tools for any intervention therapy to stop cigarette smoking in asymptomatic individuals.

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Chest X-ray is a valuable modality that can point to the diagnosis in the appropriate clinical scenario. We are presenting a chest X-ray of a rare disease that can be spotted if the X-ray was critically analyzed. This simple test could fasten the appropriate management plan and save unnecessary referral.

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