5 research outputs found
An unusual presentation of left ventricular pseudoaneurysm following CABG in a 55 year old female
No full text
Multiple Causes Leading to Massive Splenomegaly in an Elderly Female
Get PDFSplenomegaly is defined as enlargement of the spleen measured by size or weight. The spleen is an essential site for hematopoiesis and immunosurveillance. Splenomegaly may be diagnosed clinically or radiographically using ultrasound, CT imaging or MRI. Splenomegaly may be a transient condition or may be due to serious underlying acute or chronic condition. A combination of clinical examination, serology and imaging may diagnose splenomegaly and the underlying cause. Derangement in the complete blood (cell) counts and morphology including WBC, RBC and platelets will vary based on underlying disease. Abnormalities in liver function tests, lipase, rheumatologic panels and disease-specific infectious testing help in ascertaining the cause of splenomegaly. We present here a rare case of massive splenomegaly which had multiple causes within the same patient contributing to a massive spleen and a diagnostic enigma
Prevalence of Coronary Artery Disease in Patients of Rheumatic Heart Disease
No full textBackground: Few studies have focused on the prevalence of CAD in RHD. Coronary angiography should be routinely done in patients of valvular heart disease prior to surgery, especially in patients above 40 years of age. Overlooking CAD can lead to complications and poor results in post-operative period of valvular surgery. Clinical symptoms are common in both CAD and RHD. Indian studies by V. Jacob Jose and Satya N Gupta have studied this aspect in detail and their results are quite different from Western literature.Material & Methods: This study was conducted in all patients of valvular heart disease (RHD) above 40 years of age. Apart from basic investigations and echocardiography, coronary angiogram was done in all patients and were evaluated for presence of CAD (significant ≥ 50% or insignificant). They were also evaluated for SVD/DVD or TVD and risk factors (hypertension, diabetes mellitus, dyslipidemia) and symptoms especially angina were correlated to the presence of CAD.Results: Out of the 100 patients of RHD from Jan 2008- June 2009 at PGIMER, Chandigarh, 38 were males and 62 were females. 12 had significant CAD, while 9 had non-significant CAD. Mean age for significant CAD was 52.58 years. Age distribution was statistically significant in the 51-60 year age group. 66 patients had mitral valve disease, 31 had combined mitral and aortic valve disease, while 3 had predominantly aortic valve disease. Angina was the only symptom which correlated with presence of CAD especially in aortic valve disease group, but p value was non-significant. In risk factor category, only hypertension and total cholesterol were statistically significant with CAD.Conclusion: Prevalence of significant CAD was 12%. 5 patients had SVD, 4 had DVD & 3 had TVD. 2 patients with MS, 4 with MS/MR, 4 with MV+AV and 2 with predominant aortic valve group had significant CAD. Angina was not found to be a useful clinical symptom to predict CAD. Hypertension and total cholesterol were the only risk factors which could be correlated with CAD in RHD group
Impact of HbA1c on Outcomes of Acute Coronary Syndrome in Non-Diabetic Patients
No full textBackground: Elevated glucose levels have been previously shown to be associated with adverse outcomes in patients of acute coronary syndrome. However, admission glucose levels are affected by various factors like meals, circadian cycle and also the stress response. HbA1c is a better marker of long- term glucose status. The value of HbA1c as a predictor of prognosis in acute coronary syndrome has not been extensively studied.Objective: To study the relationship between admission HbA1c levels and short-term outcome in non-diabetic patients admitted with acute coronary syndrome.Material and Methods: This open-label, hospital based, cohort study was conducted on 200 patients without previously known diabetes admitted with acute coronary syndrome. A detailed history and clinical examination were carried out. Admission plasma glucose, fasting glucose and HbA1c levels were recorded. Those presenting with fasting plasma glucose of >126 mg% or HbA1c >6.5% were labeled as “Undiagnosed Diabetic Patientsâ€. Outcome was measured mainly by assessing the left ventricular systolic function. Data were analysed using chi square test, student t-test, ANOVA and partial correlation regression, wherever applicable.Results: Mean age of patients was 56.38 years. Average BMI was 25.1±3.5 kg/m2. Mean HbA1c was 6.3±1.5%. 79 (39.5%) patients had HbA1c between 6 and 6.5. There was a linear correlation between ejection fraction and HbA1c (p value =0.019).Conclusion: HbA1c is a strong predictor of left ventricular dysfunction in non-diabetic patients presenting with acute coronary syndrome, therefore, measurement of HbA1c levels may improve risk assessment in patients presenting with acute coronary syndrome
