Objective: To determine the frequency of myocarditis in patients recovered from COVID-19 infection. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Cardiac Magnetic Resonance Imaging Department, Armed Forces Institute of Cardiology/National Institute of Heart Disease, Rawalpindi Pakistan from Jul 2020 till Apr 2022. Methodology: All patients who underwent Cardiac Magnetic Resonance Imaging after recovery from COVID-19 were enrolled. Non-probability consecutive sampling technique was used for sample selection and was calculated on the basis of Gpower. Data of patients fulfilling the inclusion criteria was selected. All PCR positive cases of COVID-19 who recovered from COVID-19 and completed their 12 days of isolation not exceeding 60 days of 1st Polymerase chain reaction positive, and who have any symptoms of shortness of breath, fatigue and chest pain with reduced left ventricular ejection fraction (LVEF) on 2Dechocardiogram were included in the study. Data was recorded, stored, and analyzed by using SPSS version-21. Quantitative data was reported as Mean±SD. Categorical variables were reported as frequency and percentage. To determine theassociation between different variables Chi square test was used. Results: Total 83 patients were included in this study who recovered from COVID-19 and underwent Cardiovascular magnetic resonance. Mean age of the patients was 39.17±12.9 years. 67(80.72%) were male while 16(19.28%) were females.50(60%) had myocarditis after recovery from COVID-19. This study showed statistically significant association of all the Cardiovascular magnetic resonance imaging findings with Myocarditis (p<0.05) at 95% confidence interval and 5% margin of error. Conclusion: Early detection of COVID-19 related myocarditis will help in better management of patient. In such patients,cardiac Magnetic Resonance Imaging is the modality of choice, since it allows for noninvasive assessment of myocardial edema and fibrosis, as well as therapeutic guidance and improved patient outcomes.

Although most interventional cardiologists favor radial artery (RA) access because to its ergonomic practicality, data on distal artery (DRA) access with relation to RA patency has not been compared in major trials. Objective: To compare the access feasibility of distal radial artery vs Forearm radial artery for cardiac catheterization operations. Methods: A cross sectional study of total of 198 patients undergoing radial coronary operations were monitored for radial artery occlusion (RAO) and other local problems with DRA and FRA access. Purposive sampling was performed. The inclusion criteria include all participants who had a palpable distal or proximal radial pulse. The patient was free to choose between the two approaches. Patients having an inappropriate radial pulse were eliminated. Results: The main objective was fulfilled by 11.7% in the FRA and 10.4% in the DRA group (p-value=0.24). Cannulation time was greater in the DRA group compared to the FRA group; however, this had no effect on hemostasis time (254 20 vs. 254 17; p-value=0.72). Hematoma (26.4% vs. 12.5%; OR (95% CI): 3.18 (1.09–5.63); p-value 0.001) was more prevalent with FRA, while radial artery spasm (18.6 % vs. 22.9 %; OR (95 % CI): 0.53 (0.03 – 0.95); p-value=0.01). Conclusions: When compared to Forearm Radial Artery access, Distal Radial Artery access is linked with poorer cannulation success rates and greater RAO rates. It is, however, linked to the production of lower hematomas

Due to the high frequency of in-stent restenosis, repeat coronary angiography and left main percutaneous coronary intervention is recommended. But Computed Tomography Angiography is a noninvasive procedure for evaluating coronary arteries. Objectives: To assess the proportion of InStent restenosis in left main per-Cutaneous coronary intervention and to evaluate diagnostic efficacy of Computed Tomography Angiography in detecting In stent Restenosis. Methods: We assessed 263 consecutive LM PCI patients; 130 patients were chosen for this study procedure as they meet our criteria. CTA was conducted three months following the LM PCI. Results: The vast majority of patients (73.8 %) had PCI from LM to LAD and 16.2 % from LM to LCX. Only 10% of patients had bifurcation PCI, and all patients had DES (100%). The average period for ISR development was 125 months, with ISR rates of 32.2 % in the LM to LAD cohort and 38 % in the LM to LCX cohort. The median time between PCI and CTA was 194 days, with a mean basal heart rate of 69 ± 12 beats per minute. CTA exhibited a positive predictive value of 84.7%. Conclusion: CTA enables an accurate noninvasive assessment of selected patients following LM PCI. And CTA can be used as a first-line treatment instead of coronary angiography.

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Objective: To evaluate the role of Cardiac Magnetic Resonance Imaging in differentiating cardiac masses (thrombus vs tumor and benign tumor vs malignant tumor) in local population. Study Design: Analytical cross-sectional study. Place and Duration of Study: Tertiary Cardiac Care Center, Department of Cardiac Magnetic Resonance Imaging, Rawalpindi Pakistan, from Oct 2017 to Jun 2021. Methodology: This retrospective study included (n=56) patients via universal sampling, enrolled for Cardiovascular magnetic resonance imaging with a suspicion of cardiac masses either on echocardiography or Computed Tomography scan. Cardiovascular magnetic resonance imaging sequences were reviewed as SSFP cine images for mass location, size and mobility.T1 weighted turbo spin echo, T2 weighted turbo spin echo with and without fat saturation and TIRM sequences told their intensity as compared to normal myocardium, myomaps evaluated the relaxation time, while contrast first pass perfusion indicated the vascularity and delayed gadolinium enhancement images with standard and long TI were analyzed for contrast enhancement. Results: Total n=56 patients with a confirmed diagnosis of mass were included for the analysis. Mean age of participants was found to be 45.21(18.3%), height 168.4(8.69%) and weight 68.6(14.94%). There were 47(83.9%) males and females were 9(16.1%). 22(39.3%) had hypertension, 12(21.4%) had diabetes mellitus, 24(42.9%) had previous myocardial infarction. Maximum number of masses were found in LV 31(55.4%) followed by RV 11(19.6%). Sensitivity of T1 map to detect fibrosis intumor is 100%. Sensitivity of T2 map to detect edema in tumor is 82%. Conclusion: Cardiac masses like thrombi and tumors accurately diagnosed by cardiac MRI with etiology..