a b s t r a c tBacterial endocarditis gives rise to a variety of complications due to local tissue damage, immunological phenomena, and embolic phenomena. Only a small number of cases of coronary embolization have been reported in infective endocarditis patients. This is a case of subacute bacterial endocarditis in a postpartum mother complicated by fatal left and right coronary artery embolization. A 32-year-old postpartum mother with a history of rheumatic heart disease presented with a history of fever, shortness of breath, and bilateral ankle edema for 1-week duration. On admission, the patient was alert, febrile with a pulse rate of 90 beats/min, blood pressure 105/70 mmHg, and her lungs were clear. Transthoracic echocardiography revealed vegetations attached to both mitral and aortic valves. She was started on intravenous antibiotics. Her fever was settled and during the following 2 weeks she was clinically improving with settling inflammatory markers. On the 20th day of the illness, the patient developed sudden onset of chest pain, dyspnea with sinus bradycardia, and later developed pulseless electric activity. She expired despite intense cardiopulmonary resuscitation. Postmortem revealed multiple vegetations in both mitral and aortic valves and complete occlusion of both left and right coronary ostia by embolized vegetative materials.

What is the commonest site of coronary artery involvement in diabetic patients with coronary artery disease?

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Background: Percutaneous coronary intervention (PCI) is an effective treatment modality of coronary revascularization. Since this is not curative, medication adherence with a better patient satisfaction have a major impact on final clinical outcome. This study aims to assess medication adherence and patient satisfaction following PCI.

BackgroundSexual life plays an important role in physical and mental well-being of a patient. Sexual maladjustments therefore may be associated with depression and anxiety contributing to poor quality of life. Objectives To evaluate the prevalence of sexual maladjustments, anxiety and depression among post myocardial infarction (MI) patients. Methods Cross sectional study was conducted at the Cardiology unit, Kandy on a sample of post MI patients with a self-administered questionnaire after ensuring patient confidentiality. Results A total of 150 post MI patients with a mean age of 60 years (range: 37-85 years) of which 81% were males, participated in study. The duration following MI ranged from 0.5 to 5 years. Majority (65%) had sexual activity within 12 months prior to the cardiac event. However, only 54% had sexual activity since the MI, of which 53% had less frequency, 14% had the same frequency and 1% had increased frequency of intercourse while 32% refused to answer. Only 16% received instructions on when to resume sexual activity following the MI. Majority (79%) had no depression. However, 5% had depression and 16% had borderline depression. Most (84%) had no anxiety disorder. However, 14% had borderline anxiety and 2% had anxiety. Prevalence of anxiety (p=0.397) or depression (p=0.99) had no gender disparity. Conclusion Post MI sexual care is a poorly discussed matter. There is a considerable prevalence of borderline depression and anxiety, which need special attention. This study emphasizes the requirement of implementing a cardiac rehabilitation programme in a standard manner to improve safety and quality of life of post MI patients.