Coronary angiography by right radial artery route using Optitorque Tiger catheter is on the rise given the low rate of local complications and feasibility to perform it as a day-care procedure. We report here a case of coronary angiography performed using Optitorque Tiger catheter (5-French) which resulted in a diagnostic error, missing the ostio-proximal left main coronary artery disease which was later detected using EBU 3.5 guide catheter (7-French) while performing angioplasty.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Tobacco use is one of the major avoidable and recognized causes of noncommunicable diseases globally. Tobacco use among adolescents is considered as priority health risk behaviors that contribute to leading causes of morbidity and mortality among youth and adults and are often established at young age, extend into adulthood and are preventable. Aims: This study aimed to estimate the prevalence of tobacco use and its contributing factors among adolescents in Bangladesh. Settings and Design: We used data from the Global Youth Tobacco Survey Bangladesh 2007, which were a school-based survey of 2135 students aged 13-15 years in grades 7-10. Materials and Methods: A two-stage cluster sample design was used to produce representative data for Bangladesh. At the first stage, schools were selected with probability proportional to enrollment size. At the second stage, classes were randomly selected and all students in selected classes were eligible to participate. Statistical Analysis Used: We used SUDAAN for statistical analysis of correlated data, it computes standard errors of the estimates and produces 95% confidence intervals. We used t-tests to determine the differences between subpopulations. All analyses conducted in this study were gender stratified. Results: The overall prevalence of ever cigarette smokers in Bangladeshi students was about 9%, which was more than 3 times higher in boys compared to girls (15.8% vs. 4.8%). Almost four in ten students start smoking before the age of 10. In addition, another 6% students reported to use other tobacco products. About 70.7% students reported that they desired to stop smoking, and 85.0% tried to stop smoking during the past year but failed. About 42.2% students were exposed to smoke from other people in public places. Among current smokers, 97.8% reported that they were not refused cigarette purchase because of their age. Conclusions: Implementation and enforcement of tobacco control act are an urgent public health priority.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Objective: To compare the clinical profile risk factors and in hospital outcome of acute myocardial infarction (AMI) in elderly patients (≥60 years) and nonelderly (<60 years) patients. Materials and Methods: This was a prospective observational cross-sectional analytical study which included all consecutive patients of AMI admitted to the Department of Medicine and Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh over a period of 1 year (June 2011 to June 2012). The patients were divided into two groups, Group I patients of <60 years and Group II patients of ≥60 years. The age more than 60 years is considered elderly as per Indian Council of Medical Research survey on Indian Geriatric population 2007. Results: Between June 2011 and June 2012, 206 patients were enrolled in the study. Total of 97 (47.1%) patients were of ≥60 years of age designated as elderly with a mean age of 69.28 ± 5.72 years, and 109 (52.9%) patients were nonelderly with a mean age of 50.54 ± 7.16 years. Family history of coronary artery disease (CAD) and dyslipidemia was significantly higher as a risk factor in nonelderly whereas other conventional risk factors of CAD were equally present in both groups. Atypical pain chest, non-ST segment elevation MI along with post-MI complications and in hospital mortality was significantly higher in the elderly age group of the study population. Conclusion: The profile of CAD differs in elderly as compared to young patients. This study highlighted that atypical presentation of AMI as well post-MI complications and mortality is more common in elderly patients as compared to nonelderly patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: The cardiac rhythm depends on the source and mode of spread of the generated impulse. ST-T segment represents the repolarization phase of the action potential. Racial variability has been established in the morphology of the ST segment among the adult population and four waveforms has been described among Nigerian adults which are different from that of Caucasian adults; therefore, there may be differences among the pediatric population. Materials and Methods: This study was a further review of the electrocardiograph (ECG) of 650 apparently healthy primary school children aged 5-15 years, in Kano metropolis. Twelve-lead ECG was recorded, and interpretation was manually done. The subjects were categorized into three age groups namely 5-7, 8-11, and 12-15 years, respectively. The ST segment morphology was classified using Araoye's criteria. Results: Early repolarization changes were recorded in the 12-15 years age-group. The presence of ECG variants such as T-wave inversion in precordial leads V ₁ -V ₃ was reported and left axis deviation was documented in 0.4% of the 5-7 years age-group. Type I morphology was common in leads I, II, aVF, V ₅ , V ₆ . Type II morphology was common in leads I, II, V ₄ R, V ₅ , V ₆ , while Type III morphology was common in leads V ₄ R, V ₅ , V ₆ but Type IV morphology was seen mostly in V ₁ . Conclusion: ST-segment elevation in the right precordial leads is a common finding in the pediatric ECG among Nigerian children; furthermore, T-wave inversion is also common in the right precordial leads and may extend way beyond precordial lead V ₂ unlike in Caucasians.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

The Kounis syndrome is described as an acute coronary syndrome after hymenoptera stings or exposure to environmental toxins or drugs. Bee sting may cause hypersensitivity reaction ranging from simple allergic reaction to life-threatening anaphylactic reaction, sometimes leading to death. Although rare, cardiac involvement is a possible complication, varying from vasospasm to acute ST-elevation myocardial infarction (MI). We report a case of honeybee (Apis cerana indica) sting causing Kounis syndrome. A 36-year-old female, beekeeper in a farm with known allergy to bee venom without any significant cardiovascular risk factors and history had stung by a honeybee on the neck. She presented with features of anaphylaxis and acute inferior wall MI, which was transient and responded to therapy of anaphylaxis. Angiography revealed normal coronaries and patient responded to the standard treatment of anaphylaxis.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

In the present day, there is an overall increase in the incidence of various tumors of the body though tumors of the heart are not common. Metastatic tumors of the heart are more common than primary tumors. Among primary tumors of the heart, myxoma is the most common tumor. However, glandular differentiation in myxoma is rare. Hereby, we present a rare case report of glandular differentiation in cardiac myxoma of the left atrium.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Mitral balloon valvuloplasty (MBV) is the safest procedure and one of the frequent procedures observed in cardiac cathertization lab especially in developing countries were the incidence of rheumatic fever is high. Though it is very safe procedure few complications like post MBV mitral regurgitation, cardiac tamponade are observed. In this case report we mention about a rare association of pericardial effusion secondary to MBV in HIV patient.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Pheochromocytoma is a rare, catecholamine-secreting tumor derived from chromaffin cells. It usually presents with palpitations, diaphoresis, headache, and paroxysmal hypertension. Rarely, it may associate with acute myocardial infarction (MI) and other cardiovascular complications. Here, we are reporting a case of a 40-year-old male with adrenal pheochromocytoma presented with a history of repeated episodes of acute pulmonary edema along with electrocardiographic changes and serum cardiac marker elevation, suggestive of MI, with complete reversal of these abnormalities after surgical removal of the tumor.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]