Left ventricular (LV) diverticulum is defined as a protrusion of the free wall of the ventricle, including endocardium, myocardium, and pericardium. It is classified into fibrous and muscular types. Most of the patients are asymptomatic. It is mainly diagnosed by echocardiography, magnetic resonance imaging, and ventriculography. Surgery is the treatment of choice if the patient is symptomatic associated with other cardiac anomalies. In asymptomatic patient with isolated LV diverticulum, the treatment is controversial. Our patient is a 35-year-old male presented with progressive dyspnea on exertion for the past 1 month. Clinical examination was normal. His electrocardiogram revealed sinus tachycardia. There was no evidence of ischemic changes. Echocardiogram revealed aneurysmal outpouching of the posterolateral basal segment of the left ventricle adjacent to the posterior mitral leaflet [Figure 1]. Ejection fraction was 50% with trivial mitral regurgitation. His coronary angiogram showed normal epicardial coronaries. The patient was treated with furosemide, enalapril, metoprolol, and spironolactone. Then, the patient was referred to the cardiothoracic surgery department for further management.
Objective:This study aims to determine the prevalence of antinuclear antibodies in pregnant women with bad obstetric history (BOH) against healthy multigravid women in and around Tirunelveli districtMethods: This is a case-control study comprising 60 antenatal women with BOH against 60 multiparous pregnant women with no history of abortions. Antinuclear antibodies (ANA) were detected using indirect immunofluorescence with Hep-2 cell substrate, and enzyme-linked immunosorbent assay (ELISA).Results: Among BOH cases 19 (82.6%), 18 (78.26%) were positive by ELISA and indirect fluorescence antibody test (IFAT) method, respectively. Among controls, 4(17.39%) and 5(21.73%) individuals were positive by ELISA and IFAT methods, respectively. Of the 18 positives, homogenous pattern was most common followed by anticentromere pattern, fine speckled and coarse speckled patternConclusion: IFAT is considered to be gold standard in the diagnosis of autoimmune disorders, but ELISA appears to be a suitable simple alternative for testing rheumatological disorders.
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