Introduction Irrespective of underlying hyperlipidemia, the serum lipid profile witnesses a phasic fluctuation immediately after a major cardiovascular event. This study aims to evaluate the change in serum lipid profile in patients with acute myocardial infarction (AMI). Methods It was a prospective, cross-sectional study conducted in the department of cardiology, Shalamar Hospital, and Punjab Institute of Cardiology, from October until December 2018, focusing on patients admitted with ST-elevation myocardial infarction (STEMI). The patient's demographics and lipid profile (in mg/dl) within the first 24 hours and after 48 hours of the event were recorded. Results The mean serum total cholesterol (TC) levels decreased from 207.5 ± 30.5 to 192.4 ± 49.3 after 48 hours (p-value <0.0001). Mean serum triglyceride (TGs) levels increased from 153.8 ± 10.2 to 183.8 ± 14.8 (p-value <0.0001). Mean serum low density lipid-cholesterol (LDL-C) decreased from 149.0 ± 41.2 to 133.4 ± 54.0 (p-value = 0.0003). Mean serum high density lipid-cholesterol (HDL-C) decreased from 46.6 ± 9.9 to 40.7 ± 11.8 (p-value <0.0001). Conclusion Phasic fluctuations in serum lipid profile are observed after acute myocardial infarction (AMI). The trend that follows include reduced TC, LDL-C, and HDL-C, and increased TGs. Periodic lipid profile must be evaluated in all patients admitted for AMI to understand the changing trend, initiate lifestyle measures to reach target lipid levels, and predict the choice of lipid-lowering therapy.

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Introduction Coronary artery bypass graft (CABG) is the most potent of surgical procedures; in this procedure, the narrowing of the coronary artery due to atherosclerotic plaque is bypassed by forming an alternate route for blood flow to the heart. There are various risk factors associated with the procedure. The aim of this study was to observe if postoperative outcomes are affected by preoperative hematocrit (hct) levels in patients. Methods This longitudinal study was conducted from April 2019 to December 2019. Eighty-two (82) participants who were to undergo CABG surgery were divided into two groups based on their preoperative hct levels. Group 1 had 42 participants with lower levels of hct (less than 35.5% for women and 38.3% for men), whereas group 2 consisted of 40 participants with normal hct levels (greater than 35.5% for women and 38.3% for men). Results The results showed that participants undergoing CABG with lower than normal hct levels had increased blood loss through drainage as compared to participants who had normal hct levels (680.1 ± 301 mL vs. 500.7 ± 412 mL; p-value: 0.02). Group 1 participants also had an increased need for blood and blood product transfusion as compared to group 2 (3.2 ± 1.8 units vs. 1.8 ± 0.9 units; p-value: <0.0001). Furthermore, the participants in group 1 had longer stays in the ICU relative to the other group (5.2 ± 3.1 days vs. 3.4 ± 2.5 days; p-value: 0.003). Conclusion Based on our findings, patients who undergo CABG surgery with lower than normal hct levels are at increased risk of certain complications, including excessive blood loss, need for transfusion, and increased duration of ICU stay. Therefore, preoperative hct levels should be routinely checked in patients undergoing CABG to prevent these complications.

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Ventricular septal defect (VSD) with prolapse of the right coronary cusp and aortic regurgitation can be managed surgically with the anatomical correction technique. However when the VSD is located underneath the non coronary cusp surgical management differs due to anatomical constraints and secondary pathological changes seen in the non coronary cusp. It is therefore important that the location of the VSD and the morphology of prolapsing cusp be characterised preoperatively in order to plan appropriate surgical repair. We present a case study in which we discuss the salient differences in the surgical management of the prolapsing right and the prolapsing non coronary cusps.