The unexpected and catastrophic cardiovascular effects of psychotropic drugs are well described albeit uncommon. The list of drugs which have been associated with prolonging QT interval and hence potentially causing Torsades de pointes is exhaustive. The insight into the plausible mechanisms are largely unclear. However, the practical implications of anticipating and recognizing QT prolongation cannot be overemphasized.

Introduction:Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India.Materials and Methods:The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis.Results:The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up.Conclusion:Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes.

Background: Electrocardiogram (ECG) is a non-invasive test which can provide clue for the presence of cardiac diseases. Simple, handheld devices, sufficiently miniaturized are useful for a widespread use. New devices, however, need to be compared with the standard ones for their performance in the real-world practice. Here in we report clinical utility of a handheld device.Methods: KardioscreenTM is a mobile and handheld device. It’s been approved for safety and performance standards and it has been certified for ‘Conformite Europeenne’ (CE). Using this device, a comparative blinded study with a conventional and commercially available standard 12 lead ECG machine was one. 604 ECGs recorded from 302 patients with various clinical disorders were coded and analyzed by two blinded observers. A third cardiologist adjudicated the reports. The reports were then correlated for the ECG patterns generated and with the clinical diagnosis. Computer generated measurements of various durations and intervals were also analyzed and compared. Regression analysis was used to compare the values. SPSS 21 software was used to analyze the data.Results: Kardioscreen device could provide recordings to diagnose including ST elevation (99%), non-ST elevation myocardial infarction (94.1%), chamber-hypertrophy (87%), conduction blocks (99%), and arrhythmias (96.4%), with good correlations with the comparator for pattern recognition. Also, computer generated measurements were significantly correlated with the comparator (R=0.96 for HR, R=0.82 for QRSd, R=0.86 for QT/QTc, R=0.76 for PR).Conclusions: The Kardioscreen device is a reliable tool for electrocardiographic diagnosis of common clinical cardiac disorders.

2D echocardiography was performed on a 4-year-old child suffering from right thigh abscess due to MRSA infection following diagnosis of pericardial effusion by USG abdomen. It revealed myocardial abscess and pericardial effusion. This child underwent series of 2D echocardiographic studies which showed image appearance of myocardial abscess with its time course of healing.