Background: Coronary artery disease is the most common and life threatening cardiac emergency presenting to a hospital. Having significant mortality and morbidity are on the rise in Pakistan. The objective of the study is to examine the association of elevated level of serum uric acid with ischemic heart disease among adult population, to guide planning for primary and secondary prevention of this disease in community.Subjects and Methods: This cross-sectional study studied 110 consecutive patients from 20-80 years of age presenting with IHD (Myocardial infarction, unstable angina). All the subjects who were approached to participate in the study, gave their consent. Face-to-face interviews were conducted using a structured questionnaire followed by laboratory tests.Results: Association of serum uric acid were lined up as gender, smoking, hypertension, diabetes mellitus, menopause, dyslipidemia, family history and obesity. In this study, out of 110 patients 35 (32%) were females and 74 (68%) were males. Minimum Age of patients in this study was 30 years and maximum age was 70 years This study revealed that chest pain was the most occurring symptom which was observed in 39 patients which are 35.45% of the total patients and the second most occurring symptom was Dyspnea which was observed in 32 patients which 29.09% of the total patients. The study reveals that the major risk factor observed in CAD patients is ‘HTN’ which was found in 81 patients which are 73.64% of the total patients. However, ‘Smoking’ and ‘DM’ are proximate in occurrence and were found in 59 (53.64%) and 56 (50.91%) patients respectively. The study revealed that hyperuricemia was more in males that was 34(22.67) than in females.Conclusion: This study concluded that there was no significant association between hyperuricemia with ischemic heart disease.

Objectives: To identify factors which cause deterioration with worsening ofsymptoms in previously stable heart failure patients. Study design: Descriptive case seriesSetting: Gulab Devi Chest Hospital, Lahore. Duration: 01-04-2017 to 30-09-2017. Patientsand Methods: The study was done on 100 patients diagnosed with LV systolic dysfunctionor cardiomyopathy with LVEF<40%. Patients were examined regarding clinical signs ofdecompensation and detailed history was taken to probe the cause of decompensation. Allinformation was noted down on a pre-defined questionnaire. Mean ± S.D was applied forquantitative data like age and LVEF. Frequency (%) was used for qualitative data like gender.Results: Non compliance to drugs was the most common cause of decompensation (56%),amongst them 73.21% cases were noncompliant due to poor awareness about the importanceof continuing use of medicines. Infection was the second common precipitating factor(51%), where chest infection was the most common cause in 74.51% cases. Other causes ofdecompensation were ischaemia (28%), renal impairment (36%), and arrhythmias (23%) whilemore than one precipitating factors were found in 41% of cases. Conclusion: Multiple factorscan trigger deterioration in patients with previously stable heart failure. Recognition of thesefactors is important for good long term outcome in these patients.

Background: Development of heart failure is always secondary to presenceof risk factors like diabetes mellitus, hypertension, age, smoking and underlying coronaryartery disease. Objective: The objective of this study was to find the frequency of risk factorsand coronary artery involvement in patients of heart failure after myocardial infarction. StudyDesign: A non-randomized cross sectional study. Setting: Gulab Devi Chest Hospital. Period:Six months. Methods: 100 patients was done. Using non probability (purposive) samplingtechnique; all patients with ages between 20 to 80 years, irrespective of gender, diagnosedwith heart failure (with ejection fraction ≤ 40%) secondary to STEMI were included in thestudy. Patients that were not having heart failure secondary to STEMI and those that hadn’ttheir coronary angiography done were excluded from the study. The data were analyzed usingSPSS Version 20. Descriptive statistics was used to see analyze the data. Results: Mean ageof patients was 52.61±10.2years. There was an overall male predominance (81%). Commonrisk factors that we observed were smoking (65%), hypertension (62%), diabetes (58%) andpositive family history (38%). In this study 51% patients had triple vessels disease, 15% patientshad double vessels disease and 34% patients had single vessel disease. Most common lesionwas of LAD following LCX, RCA and LMS. Conclusion: Our study conclude that coronaryartery disease is the main causative factor for the development of heart failure in patients ofmyocardial infarction and even a single vessel disease can lead to heart failure with severesystolic dysfunction. Most common associated risk factor was smoking, hypertension being thesecond most common following diabetes and positive family history.

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