Background: Dyslipidemia is one of the main risk factors with prognostic significance in relation to coronary heart disease. Aggressive treatment has been recommended in acute coronary syndrome (ACS). We examined pattern of dyslipidemia in ST Elevation myocardial infarction (STEMI) and Non- ST elevation myocardial infarction (NSTEMI). We also compare the lipid status in between two types of myocardial infarction (MI).Methods: This cross sectional observational study was carried out enrolling 100 subjects with ST elevation and Non ST elevation Myocardial Infarction, in the Department of Cardiology, BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from January 2012 to June 2012. Fasting lipid profile was done in next morning of admission in both type of MI.Results: Mean age and gender difference was significant between STEMI and NSTEMI. Mean Cholesterol (chol), Triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were not statistically significant between male and female groups. All mean cholesterol, TG, HDL, LDL were significantly high in older age group. The Mean cholesterol (220.7±28.1Vs208.4±20.9), triglyceride (182.8±34.4 Vs 147.4±28.9), HDL (35.14±5.7 Vs 41.65±3.8) and LDL (160.7±26.2 Vs148.3±16.8)were also statistically significant between STEMI and NSTEMI groups (p<0.05).Conclusion: Dyslipidemia is the dominating coronary risk factors. It could be concluded that significant differences are observed between two types of MI. Lipid status is relatively more uncontrolled in ST elevated MI and must be managed with all possible therapeutic modules to minimize further complications.Bangladesh Crit Care J September 2017; 5(2): 106-109

Introduction:Diastolic dysfunction is characterized by impaired energy-dependent active relaxation, increased stiffness and resultant pulmonary congestion and low cardiac output state. Isolated diastolic dysfunction is a relatively common problem and accounts for up to 30% of heart failure. 1Prognosis of the patient with diastolic dysfunction is better than those with systolic heart failure. 2 The one year readmission rate approaches 50% in patients with diastolic heart failure. This morbidity rate is nearly identical to that for patients with systolic heart failure. 3,4,5 .Risk factors for diastolic dysfunction are: i) high blood pressure (i.e. hypertension, where, as a result of left ventricular muscle hypertrophy to deal with the high pressure, the left ventricle has become stiff), ii) scarred heart muscle (e.g. occurring after a heart attack, iii) scars are relatively stiff), diabetes (stiffening occurs presumably as a result of glycosylation of heart muscle), iv) severe systolic dysfunction that has led to ventricular dilation i.e. when the ventricle has been stretched to a certain point, any further attempt to stretch it more, as by blood trying to enter it from the left atrium, meets with increased resistance -it has become stiff, v) reversible stiffening as can occur during periods of cardiac ischemia, vi) ageing. 6 Jossup M et al 2003, showed that it is frequently common in female.So early diagnosis of diastolic dysfunction in high risk individuals is important to prevent overt heart failure. 7 Although Doppler echocardiography has been used to examine left ventricular diastolic filling dynamics, the limitations of this technique suggest the need for other measures of diastolic dysfunction. 8 Original Article Role of B Type Natriuretic Peptide in the Early

Background and objective : C-reactive protein (CRP) is a well-known inflammatory biomarker and is associated with cardiovascular risk. Our objective was to see whether it is also associated with hypertension and its complications.Methodology : This prospective observational study was carried out in general outpatient department (OPD) of a tertiary level hospital on a total of 112 patients, among them 71 were hypertensive and 41 were normotensive. Baseline CRP was measured in all subjects and followed them up to six months to see any association between the level of CRP and hypertensive complications.Results : It is found that mean CRP was 2.923 (± 0.294) in hypertensive subjects and 1.058 (± 0.330) in normotensive subjects. No association is found between level of CRP and hypertensive complications.Conclusion : CRP is raised in hypertension. But it is not established that its level can predict the complication of hypertension.Bangladesh Crit Care J March 2018; 6(1): 3-6

Background and objectives: Cardiovascular disease is the most common cause of death worldwide and Coronary Care Unit (CCU) plays a central role in reducing this mortality. Currently the data on mortality in CCU is very limited in our country. Our purpose of this study to provide data on mortality so that we can focus and improve the factors determining deaths in CCU. Methodology: The data of all death cases admitted inthe CCU of a tertiary level hospital between 1 January 2016 and 31 December 2017 were included for assessing the data on demography, diagnosis, and comorbidities at the time of death. Results: Among 802 cases admitted in CCU in two years, 40 patients died (5%). Male was 55% and female was 45%. Most of the death occurred in their 6 th decade of life, due to Non-ST-Elevation Myocardial Infarction (NSTEMI) and sepsis, within 24-hour of CCU admission.Common associated co-morbidities were DM (75%), hypertension (42.5%), CKD (27.5%), and hypokalemia (12.5%).Conclusions: The death rate is much lower in our CCU in comparison to global rate. The common cause of death is still NSTEMI. The common co-morbidities we found are DM, hypertension and CKD. Most of the deathsoccurred within 24-hour of admission.

Background: High prevalence of Chronic heart failure due to Idiopathic Dilated Cardiomyopathy (DCM) is animportant cause of heart failure in Bangladesh. This study was carried out to find the clinical characteristics of thepatients with Idiopathic DCM, so that the data can be used to treat symptoms and improve survival and treatment. Methodology: This prospective observational study was carried out in the Department of Cardiology, BIRDEMGeneral Hospital, Dhaka, Bangladesh from January 2012 to December 2018. Total 50 consecutive admittedpatients fulfilling the criteria of Idiopathic DCM were studied. Clinical information, findings fromEchocardiography and other relevant investigations were collected for analysis. Results: Among total 50 patients, 30(60.0%) were male and 20(40.0%) were female. Majority 20(40.0%) patientsbelonged to age 51-60 years and their mean age was found 55.34±13.24 years. Using NYHA (New York HeartAssociation) functional status classification of the patients, 18(36.0%) patients were found in NYHA class I,15(30.0%) in class II, 12(24.0%) in class III and 5(10.0%)in class IV. Almost all patients presented with three basicsymptoms i.e. exertional dyspnea, easy fatigability and pedal edema. Orthopnea, Paroxosmal Nocturnal Dyspnoea(PND), palpitation & chest pain wewe also reported in almost half of the patients. Mean pulse was found88.78±15.75 beat/min, respiratory rate 20.79±6.48 breath/min, BMI 23.12±3.29 kg/m2, systolic BP 119.03±22.22mmHg and diastolic BP 75.00±12.54 mmHg. Bilateral basal crepitation 45(90.0%), Pedal edema 43(86.0%),Raised JVP 39(78.0%), Hepatomegaly 35(70.0%) were also found. Third heart sound in 34(68.0%), Pan systolicmurmur of Mitral regurgitation 40(80.0%), Pansystolic murmur of Tricuspid regurgitation was present in42(84.0%) among study patients. Mean left ventricular ejection fraction was found 30.44 ±4.91%, LVIDs 5.24±0.51cm and LVIDd 6.18 ±0.52 cm. Conclusion: Majority of the Idiopathic DCM patients belonged to age 51-60 year age group with malepredominance and clinical presentation was variable. Bangladesh Crit Care J September 2019; 7(2): 86-89