Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as markers of stable ischemic heart disease in diabetic patients: An observational study.

Ischemic heart disease (IHD) is a pressing public health concern with high prevalence, mortality, and morbidity. Although the value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as markers of the acute coronary syndrome are well recognized, there is a paucity of data deciphering their role in screening for stable ischemic heart disease (SIHD) in the presence of type 2 diabetes mellitus (T2DM). The present study investigates the value of NLR and PLR as markers of SIHD in T2DM.

Arrhythmia occurring as the sole presenting feature in Covid-19.

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection is observed to be associated with several cardiac complications. Cardiac arrhythmias are frequently observed in critically ill patients and are usually associated with myocarditis. We report two patients with Covid-19, in whom serious arrhythmias were the sole presenting feature, in the absence of any of the known manifestations of the disease.

Transradial Coronary Intervention in Chronic Total Occlusion in a Patient With Mirror Image Dextrocardia.

Dextrocardia poses challenges in the percutaneous coronary intervention, particularly through radial access. The presence of chronic total occlusion further adds to the technical difficulties in such cases due to unfamiliar orientations of the coronary arteries, guide catheter instability, and problems in advancing the hardware across the occluded lesions. We report here a successful percutaneous intervention in a chronic total occlusion of the left anterior descending coronary artery, done through right radial access in a patient with situs-inversus and dextrocardia.

Role of routine fetal echocardiography in an unselected group of pregnant women for prenatal detection of cardiac malformations.

Objectives: We investigated the potential for improvement in prenatal detection of congenital heart disease (CHD) by routinely performing detailed fetal echocardiography (FE) in all pregnant women.

Methods: Following routine obstetric sonography, 1445 unselected pregnant women were prospectively subjected to FE at gestational ages between 16 and 24 weeks, or at first visit, if they presented later. Maternal or fetal factors, conventionally known to be associated with risk of CHD, were noted.

An observational comparison of distal radial and traditional radial approaches for coronary angiography.

Background: Several studies have recently reported regarding feasibility and safety of distal transradial access (d-TRA) in the anatomical snuff-box (ASB); however, literature comparing it with the conventional TRA at the wrist (w-TRA) is sparse. This study compares the technical efficiency and safety of ASB and wrist approaches for TRA for coronary angiography (CAG) and evaluates the radial artery (RA) anatomy at these sites.

Methods: Two hundred consecutive patients undergoing CAG via w-TRA or d-TRA (100 in each group) were investigated.

Comparison of three-dimensional echocardiography and speckle tracking echocardiography in quantification and mapping of intraventricular mechanical dyssynchrony.

Objectives: The aim of the study is to compare two advanced methods of evaluation of left ventricular mechanical dyssynchrony (LVMD), the speckle tracking echocardiography (STE) and the three-dimensional echocardiography (3DE).

Methods: One hundred thirty-six subjects, with or without LV dysfunction and with or without bundle branch block (BBB), were included in this study, designed to investigate agreement between magnitude and spatial pattern of LVMD as assessed by 3DE and STE. The frequency and severity of LVMD and localization of most asynchronous segments were compared.

Real-time three-dimensional echocardiographic left heart parameters in healthy indian adults.

Objective: Cardiac chamber dimensions are race and anthropometry dependent. We determined the age and gender specific 3-Dimensional echocardiographic (3DE) reference values for dimensions and function of left ventricle (LV) and left atrium (LA) in normal Indian adults.

Methods: This single center prospective study enrolled 133 adult Indians free of heart disease and/or hypertensions, subjecting them to 3DE measurements of left atrial (LA) & left ventricular (LV) volumes, function and left ventricular mass (LVM).

Adverse Drug Reactions Attributed to Fondaparinux and Unfractionated Heparin in Cardiovascular Care Unit: An Observational Prospective Pilot Study in a Tertiary Care Hospital.

Introduction: This study was carried out to collect and analyze the adverse drug reactions (ADRs) reported with use of anticoagulants, heparin and fondaparinux. These drugs are vital in the treatment of unstable coronary artery diseases and emergencies.

Materials And Methods: A cross-sectional study with active reporting of ADRs from cardiology and medicine department was conducted.

Three-dimensional echocardiographic evaluation of mechanical dyssynchrony in systolic heart failure with narrow QRS complex.

Objectives: To investigate the role of three-dimensional echocardiography (3DE) in evaluation of left ventricular mechanical dyssynchrony (LVMD) in heart failure (HF) patients with narrow QRS.

Methods: 143 subjects (70 with HF and narrow QRS, 23 with HF and LBBB and 50 controls) were subjected to 3DE, evaluating global and regional dyssynchrony using systolic dyssynchrony index, maximum segmental dyssynchrony and opposite segment dyssynchrony. Spatial distribution of LVMD was studied in each patient using 3DE derived regional time volume curves.

Role of closure of patent foramen ovale in cryptogenic stroke: Current status.

Ischaemic stroke is among the leading causes of disability and death. Despite extensive vascular, cardiac and serological evaluations, the cause remains unknown in 20%-40% of patients. These are classified as cryptogenic stroke.

Pituitary carcinoid coexisting with systemic lupus erythematosus: A rare combination.

Gastrointestinal carcinoids have occasionally been reported in patients with autoimmune diseases. We report a middle-aged woman who presented with episodic hypertension and a skin rash. Initial evaluation led to the diagnosis of systemic lupus erythematosus for which the patient was treated.

Malignant phyllodes tumor of the left atrium.

Metastatic tumors to the heart usually involve right sided chambers. We report a rare case of malignant phyllodes tumor of breast with metastatic involvement of left atrium occurring through direct invasion from mediastinal micro-metastasis and presenting as a left atrial mass causing arrhythmia.

Percutaneous treatment of Lutembacher syndrome in a case with difficult mitral valve crossing.

Most cases of combination congenital cardiac anomalies are treated with open-heart surgeries because the coexisting anomalies change the cardiac anatomy in an adverse way, making catheter manipulations complex. Lutembacher syndrome is a combination of acquired mitral stenosis and congenital ostium secundum atrial septal defect. The large defect in the septum makes an Inoue balloon catheter unstable, which provides excessive space for free floatation of the catheter, making its passage into the left ventricle difficult by Inoue technique.

Bivalirudin: a new promising direct antithrombin.

The deadliest manifestations of ischemic heart disease are initiated and propagated by intra-coronary thrombin generation. Thrombin is resistant to inactivation by heparin when it is bound to fibrin, fibrin degradation products or subendothelial collagen. Recognition of these limitations has led to development of a new class of antithrombin agents which directly target the active sites on the surface of thrombin molecule and are therefore designated as direct antithrombins.