Background and Aims The prevalence of acute coronary syndrome (ACS) has been rising in the younger population worldwide. To fully comprehend the effects of the condition, it is crucial to examine the evolving characteristics and treatment options. The purpose of this study is to evaluate the characteristics and treatment analysis for young ACS patients in a tertiary care setting. Methods This cross‐sectional, retrospective, single‐center study included a random sample of patients who had been hospitalized for ACS over the period of a year. We collected and analyzed data on risk factors, diagnoses, angiographic patterns, and potential treatments. Results The study involved 198 young ACS patients in total. The majority of patients (57%) had no risk factors, and the majority of them (44%) had ST‐elevation myocardial infarction (STEMI) as their diagnosis. The most common type (48%) was single‐vessel disease (SVD). Statins and antiplatelet medications made up the majority of the patients’ nonsurgical treatments (88% and 87%, respectively). A statistically significant difference exists between young and older ACS patients with gender ( p < 0.01). However, it is not clinically relevant. Conclusion Men were the majority of young ACS patients, and STEMI, SVD were more prevalent. The majority of young ACS patients had no significant risk factors. To determine the risk factors of young ACS patients, a more thorough case–control study is critically needed.
Introduction: Mitral Stenosis (MS) is a chronic complication seen among patients with Rheumatic Heart Disease (RHD). Percutaneous Transvenous Mitral Commissurotomy (PTMC) is a non surgical intervention indicated exclusively for MS with favourable valve morphology. Aim: To determine the outcomes of PTMC in middle aged Indian population in relation to clinical and haemodynamic parameters. Materials and Methods: This retrospective cross-sectional study conducted at a tertiary care hospital in Chennai, Tamil Nadu, between 1994 and 2019. Study was based on analysis of data from 82 patients diagnosed with MS, that underwent successful PTMC. Patients in the age group of 40 to 60 years with symptomatic MS {Mitral Valve Area (MVA) <1.5 cm2 on echocardiogram} were included in this study. Successful PTMC was defined in terms of MVA >1.5 cm2. Participants were divided into two groups based on Wilkins score of 8 as a cut-off. The continuous variables of the study subjects were described and interpreted by averages and compared between the groups by independent t-test. The pre, post and follow-up characteristics were analysed by averages and interpreted by paired t-test and confirmed by repeated measures of ANOVA. Results: Group A with Wilkin’s score ≤8 showed better results in terms of functional status improvement [New York Heart Association (NYHA) classification], MVA, mean gradient across mitral valve and Pulmonary Arterial Pressure (PAP) with p-values <0.05 after a mean follow-up period of one year. Conclusion: Long-term outcomes of PTMC is better in patients with lower Wilkin’s score than those with higher scores in terms of functional status improvement, maintenance of MVA and mitral valve mean gradient pressure. These factors favour the optimal utilisation of PTMC as an alternative to surgery especially among middle aged population.
Objective: Ventricular Septal Rupture (VSR) following Acute Myocardial Infarction (AMI) is a fatal mechanical complication with high incidence of mortality. The aim of this study is to explore the clinical outcomes and to identify the factors related to early mortality in patients with VSR after AMI. Materials and Methods: This was a retrospective study and we collected clinical data of 21 adult patients with VSR following AMI from April 2012 and October 2020 who got admitted at our tertiary care centre. The patients were classified into two groups. The first group consisted of patients who died within two weeks from the diagnosis of VSR following AMI and the second group comprised of patients who survived more than two weeks after VSR. Results: A total of 21 patients (mean age of 66.19±9.47 years) were enrolled in this study. The most common MI was Anterior MI (71.4%) and the location of VSR was predominantly in the anterior and apical septum (76.2%). The overall early mortality was 85.9% (n=18). 80.95% (n=17) of patients died within two weeks of diagnosis of AMI. Of the 4 patients who survived more than two weeks, three patients survived. The operative mortality in our study was 47%. Conclusion: The prognosis for VSR in AMI remains poor. Renal failure is accompanied with high rate of early mortality in patients with VSR complicating AMI. History of smoking is associated with poor outcome.
Myxomas arising from the left ventricle (LV) are extremely rare and can be easily mistaken for a thrombus. We report a case of a 35-year-old man who presented with an acute cerebrovascular accident, having had a prior history of an anterior wall myocardial infarction 2 years back with an echocardiographic evaluation showing mild LV systolic dysfunction. His present prothrombotic workup revealed hyperhomocystinaemia and elevated levels of factor VIII. Present echocardiography revealed a mass arising from a scarred LV wall. Considering the possibility of a thrombus, he was initially started on parenteral anticoagulation. Unfortunately, consequent echocardiogram evaluation showed no reduction in size of the LV mass hence surgical removal was done. Histopathological evaluation unveiled the mass to be a myxoma.
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