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Enhanced External Counterpulsation (EECP) is a non-invasive FDA approved therapy for patients with refractory angina pectoris. The EECP mechanism of action is similar to that of an intra-aortic balloon pump (IABP) by administering a vigorous pressure pulse via external blood pressure cuffs during the diastole. The benefit of EECP includes improvement in angina severity, angina stability, maximal walking capacity and generalized improvement in overall health. Seatle Angina Questionnaire (SAQ) is a valid, reliable and sensitive measure of healthrelated quality of life. It is also a sensitive and reproducible evaluation tool to measure the response to an intervention. We did a pre-test post-test designed prospective study to evaluate the effect of EECP on the quality of life in patients with CAD. There was a significant difference between SAQ-7 health-related quality of life between the pre-EECP and post-EECP groups (P value= <0.01). Moreover, a positive correlation was reported between the New York Heart Association (NYHA) Functional Classification before treatment and post-EECP SAQ-7 healthrelated quality of life (P value=0.015).

ST-elevation myocardial infarction (STEMI) has a poor long-term prognosis associated with early ventricular tachycardia (VT). Objective: To find out the frequency of ventricular tachycardia in the first 48 hours of ST-elevation myocardial infarction. Methods: After approval from the Hospital ethical committee, the study was conducted in the department of cardiology Hayatabad medical complex Peshawar from 1st October 2020 to 31st March 2021. All the patients having new onset ST-elevation Myocardial infarction as per Operational definition, both genders, aged between 40 and 75 years and who have given consent were included in the study.  Non-probability consecutive sampling technique is being used for the sampling. Results: Standard deviation was ±1.357 years, while the average age was 51.56. Gender-wise distribution among patients male was 89(53.6%) and female was 77(46.4%). Distribution of duration of disease among patients 12-24 hours 80(48.2%) and more than 24 hours 86(51.8%) was 100(52.4%). Family History of coronary artery disease (CAD) 84(50.6%), diabetes mellitus 93(56.0%), hypertension 110(66.3%) and smoking status was 118(71.1%). Distribution of ventricular tachycardia was present among 103(62.0%) patients and was absent in 63(38.0%) patients. Conclusions: Ventricular tachycardia is the most common tachycardia occurring in patients in the first 48 hours who sustained myocardial infarction. It was shown that bradyarrhythmia was more common in patients with inferior wall myocardial infarction while ventricular tachycardia was found to be more in patients with anterior wall myocardial infarction.

Takayasu arteritis is a type of large vessel vasculitis that mainly affects the aorta and its major branches. The disease can have a myriad of manifestations ranging from non-specific symptoms of low-grade fever and weight loss to lower limb claudication. A 21-year-old woman presented with uncontrolled hypertension for the last six months. The CT aortogram revealed total occlusion of the abdominal aorta with collateral vessels formed by the right and left internal mammary artery. We present a case of Takayasu arteritis in a 21-year-old woman with complete obstruction of the abdominal aorta. She was treated only with oral medications. The associated review of the literature is also discussed.