Background: Cardiovascular diseases (CVD) are the main cause of mortality and disability in India. Early and sustained exposure to behavioral risk factors leads to development of CVD. The present study was conducted to compare different cardiovascular calculators for CVD risk assessment models in young Indian patients presenting with myocardial infarction.Methods: This study included 85 patients with myocardial infarction (MI). Their predicted 10-year risk of CVD was calculated using three clinically most relevant risk assessment models viz. Framingham Risk score (RiskFRS), American College of Cardiology/American Heart Association (RiskACC/AHA) and the 3rd Joint British Societies risk calculator (RiskJBS).Results: RiskFRS recognized the highest number of patients (15.4%) at high CVD risk while RiskACC/AHA and RiskJBS calculators provided inferior risk assessment but statistically significant relationship. RiskFRS and RiskACC/AHA (Pearson's r 0.870, p<0.001).Conclusions: RiskFRS seems to be as most useful CVD risk assessment model in young Indian patients. RiskFRS is likely to identify the number of patients at ‘high-risk’ as compared to RiskJBS and RiskACC/AHA.

BackgroundCoarctation of aorta is a very common congenital heart malformation occurring in 6%–8% of all congenital heart diseases. However in neonates coarctation may be missed or underestimated by echocardiography, especially with patent ductus arteriosus or severe concurrent illness. The carotid-subclavian artery index has been proposed in previous studies for establishing the diagnosis of coarctation of the aorta.MethodsEchocardiographic evaluations was retrospectively reviewed in patients with coractation of the aorta as well as control group admitted at a tertiary cardiac centre in the period between January 2010 to December 2014. All patients admitted with coarctation of aorta either had surgery or catheter intervention which confirmed the diagnosis. 39 patients with Coarctation as well as 20 patients in controls were included in the study. End systolic measurements were obtained from 6 different sites of the aortic arch.ResultsThe median age of diagnosis was 5 days (Range 0–24 days) with presence of Bicuspid aortic valve in 9 patients (21%). In all patients the arch was left sided and ductus artersious was patent at the time of evaluation. The distance between the origins of the great vessels were longer in patients with coarctation than in controls and the dimension of the proximal transverse arch(Z score: median 4.21, range 0.28 to 7) and distal transverse arch (Z score: median 3.4, range 2.8 to 9) were significantly smaller in the coarctation group. Carotid-subclavian artery index: The ratio of the aortic arch diameter at the left subclavian artey to the distance between left carotid artery and the left subclavian artery was significantly smaller (Mean 0.65, Range 0.35 2.05) with Index <1 in 92% in patients with coarctation.ConclusionThe carotid-subclavian artery index is a simply obtainable noninvasive screening parameter, showing high sensitivity and specificity for coarctation and may be useful in unstable patients or in those with a patent ductus artersious in which coarctation may be overlooked. Neonates with large patent ductus artersious and any of these findings need close observation until the patent ductus ateriosus closes.

Acute thrombosis of ascending aorta and arch is a relatively rare entity. Multiple rare etiologies are described in literature. We report a rare case of acute thrombosis of aorta in a young obese lady with metabolic syndrome.