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BACKGROUND: Transradial artery access for coronary intervention procedures is a safe and beneficial technique1. The safety aspects are well established in young individuals2. Elderly patients have been considered as a higher risk due to increased vascular tortuosity,calcifications and other access site related complications in comparison to younger individuals3. This study was done to assess the feasibility, efficacy and safety of transradial coronary angiography or intervention in the elderly. MATERIALS & METHODS:This study was conducted in the department of Cardiology,Chengalpattu Medical College Hospital in patients admitted coronary angiogram either for acute coronary syndrome or chronic stable angina during the period from November 2018 to April 2019. A total of 149 patients who underwent coronary angiography/ intervention through radial artery access were studied. Patients were divided into elderly population with age at or above 65 years (n = 24) & non elderly with age less than (n=125).Most of the patients who underwent procedure in both the groups are for acute coronary syndrome (ACS) than chronic stable angina (CSA) ,elderly arm (ACS vs.CSA – 91.6% vs.8.3%) & non elderly arm (ACS vs.CSA – 90.4% vs 9.6%).The two groups of population were analyzed with respect to complications such as vascular site bleeding,stroke,procedural time & access site cross over. RESULTS: The mean age was 72 ± 3.3 years in the elderly group and 49 ± 5.3 years in the non-elderly group. Baseline serum creatinine values were slightly elevated in elderly arm.The procedural time was higher in elderly arm than non elderly arm both in diagnostic (16 min 20 secs vs.2 min 45secs) as well as in interventional (41min 32 secs vs.19 min 18 secs)procedures. But the volume of contrast utilized is same in both arms with average of 40ml vs 42ml in elderly vs.non elderly arm respectively. Occurrence of puncture site bleeding or occlusion of radial artery showed no difference between two arms. The procedure completion was equally safe in both elderly and non elderly group (85 % vs.86% ). Access site cross over rate due to vessel tortuosity was higher in elderly arm (8% vs.1.5%) where as vasospasm was less in elderly compared to non elderly group (2.4% vs 7%). No case of thrombotic or bleeding risk or stroke were seen in both the arm. CONCLUSION: Transradial coronary angiography or intervention is safe and complication rates are comparable with those in non elderly patients.Procedural time for the completion of procedure is high in elderly than in non elderly due to tortuous vessel anatomy,difficulty in engaging the coronary artery & operator efficacy etc.

BACKGROUNDDiseases of heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide. In developing countries, Rheumatic Heart Disease (RHD) continues to be the predominant form of valvular heart disease. The current study was undertaken at a Tertiary Care Institute with an objective of establishing distribution and different patterns of valvular heart diseases by echocardiography. MATERIALS AND METHODS17,625 consecutive first time Echocardiograms performed between January 2016 and December 2016 were analysed. Echo was performed by consultant cardiologists using Philips HD11XE and Aloka SSD4000 machine following ASE guidelines. Applying exclusion criteria of trivial and functional regurgitant lesions yielded a total of 632 cases of organic valvular heart diseases. RESULTSIn our study 632 patients were diagnosed with valvular heart disease, out of which 428 patients (67.7%) were diagnosed with Rheumatic Heart Disease. Mitral valve was the most commonly affected followed by aortic and tricuspid valves. The least commonly affected valve was pulmonary valve. In Rheumatic heart disease, most common isolated lesion reported was MS with MR, most commonly reported in females between 21 -40 years' age group. CONCLUSIONIn non-RHD group, mitral valve prolapse (21.3%) was the commonest lesion reported followed by calcific degenerative aortic valve (6.17%) and congenital bicuspid aortic valve (3.4%); 118 patients were reported with multivalvular lesion. MS + MR + AR was the commonest multivalvular lesion found in 65 patients (55.08%).

BACKGROUND Pulmonary hypertension is a severe progressive disease ultimately leading to right heart failure and death. There is paucity of data regarding pulmonary hypertension from the developing countries including India. This retrospective descriptive study was carried out at a tertiary care institute with an objective of establishing the epidemiological data of pulmonary hypertension by Echocardiography. MATERIALS AND METHODS All patients who were referred for first time echo between January 2016 and December 2016 were included and analysed in this study. Echocardiogram was performed by consultant cardiologist using Philips HDIIXE and Aloka SSD-4000 machine following ASE guidelines. Pulmonary artery systolic was derived from right ventricular systolic pressure gradient from tricuspid regurgitation jet velocity by modified Bernoulli equation. RESULTS In our study, out of 17,625 cases, 281 (1.59%) patients were diagnosed as pulmonary hypertension with slight preponderance to Female 145 (451.9%) when compared to Male 125 (43.4%). The commonest aetiology was Rheumatic Heart Diseases (37.7%) followed by Coronary Artery Diseases (36.2%) and COPD (11%). Idiopathic pulmonary hypertension is seen in 5.3% of patients. The mean age group in our study was 35 to 45 years. CONCLUSION Pulmonary hypertension is gaining renewed interest in recent times due to its devastating nature and availability of newer effective pulmonary vasodilator drugs. In this study, the commonest aetiology of pulmonary hypertension is treatable rheumatic heart disease and coronary artery disease. So, treatment of pulmonary hypertension with newer drugs and management of aetiological diseases like Rheumatic Heart Disease and Coronary Artery Disease will improve the survival of patients with pulmonary hypertension.

BACKGROUNDRheumatic heart disease (RHD) is a major contributor to morbidity and premature death in poor and developing countries like India. RHD predominantly affects young and working age group. Objective-To evaluate relative frequency of the various cardiac valvular lesions in Rheumatic heart disease (RHD) in patients who underwent Echocardiogram in the Department of Cardiology, Thanjavur Medical College, Thanjavur, Tamilnadu. MATERIALS AND METHODSThis retrospective descriptive study was conducted at Cardiology Department based on transthoracic two dimensional echocardiogram reports, diagnosed as RHD (Rheumatic heart disease) from January 2016 to December 2016. The reports were retrieved from computerised database and demographic features like age, sex, type of valvular lesion were analysed. RESULTSOut of 17,625 patients who underwent echocardiogram in the Department of Cardiology, 428 patients (2.4 %) were diagnosed with rheumatic heart disease. The commonly affected age group was 21 to 40 years. The distribution being 120 males (28%), 288 females (67.2%) and 20 children (4.6%). Mitral Regurgitation was the predominant valvular lesion affecting 328 (76.6%) patients with female preponderance of 239 (72.8%) patients. The second most common valvular lesion was Mitral Stenosis. It was diagnosed in 287 patients constituting 67.05%. The incidence was most common in females (205 cases, 71%) when compared to males (82 cases 29%). Of those 287 patients, 139 (48.4%) patients had severe MS and 92 (32.0%) had moderate MS. Aortic Regurgitation (AR) was present in 126 (29.4%) patients and almost always (99 %) in combination. Mixed valvular lesions (MS with MR) were present in 117 (27.3%) of patients. The least common lesion was Aortic stenosis (AS) noted in 24 (5.6%) patients. Out of 118 patients with multivalvular lesions, MS with MR with AR were found in 65 (55.08%) patients. CONCLUSIONThe most common valvular lesion reported in our study was multivalvular lesion. The predominant pure lesion was Mitral regurgitation followed by Mitral stenosis, Aortic regurgitation and MS with MR.