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Background: Computed tomographic coronary angiography has been recognized as a reliable imaging modality with excellent negative predictive value and a good negative likelihood ratio to exclude coronary artery disease in stable, symptomatic patients with intermediate or high risk. 1) Coronary calcium scoring has been extensively shown to be an invaluable tool to exclude the presence of coronary artery disease in low-risk patients. 2) Our aim was to identify the presence and extent of coronary atherosclerosis in computed tomographic coronary angiography in stable symptomatic patients with a zero Coronary Calcium score.

Use of Statin and Target Low-density lipoprotein cholesterol attainment among post-ST elevation myocardial infarction patients in Shahid Gangalal National Heart Centre, Kathmandu, Nepal.

Background: and objective: Lipid-lowering is an important intervention to reduce cardiovascular morbidity and mortality in the secondary prevention of STEMI. There is no study to analyze the use of statin and LDL-C treatment target attainment among STEMI patients in Nepal. This study aims to assess the use of statin and LDL-C treatment target attainment among STEMI patients.

Challenges in Effective Referral of Cardiovascular Diseases in Nepal: A Qualitative Study from Health Workers' and Patients' Perspective.

Background: Nepal, currently facing a high burden of noncommunicable diseases (NCDs), including cardiovascular diseases (CVDs), which poses the highest mortality rate in the country, does not seem to have a proper referral strategy. This study explored the wide range of factors and challenges that affect the referral system of CVD cases in Nepal.

Methods: In this qualitative study, we conducted face-to-face and telephone interviews with purposely selected 57 key participants which included 35 healthcare professionals from tertiary, secondary, and primary levels from Bagmati Province and 22 CVD patients (myocardial infarction and stroke) from Bagmati and Madhesh Provinces.

Prevalence and Comparision of Conventional Risk Factors of Cardiovascular Disease Between Clinical and Nonclinical Staff.

Background: Cardiovascular disease is the leading cause of death around the globe. A number of studies have shown that hospital staff are vulnerable to cardiovascular disease due to a certain risk of shift duty. It is important to identify cardiovascular risk factors among hospital staff.

Patterns of Perception of Cardiac Symptoms by Patients Presenting with ST-Segment Elevation Myocardial Infarction and their Knowledge of Coronay Artery Disease Risk Factors.

Background: Proper knowledge regarding Coronary Artery Disease and their risk factors is essential for the early recognition of the disease and its presentation. This study was conducted to identify pattern of clinical symptoms and knowledge regarding Coronary Artery Disease risk factors among ST-Elevation myocardial infarction (STEMI) patients.

Methods: This cross-sectional, observational study was conducted among 340 ST-Elevation myocardial infarction patients in the inpatient Cardiology Department of Shahid Gangalal National Heart Centre Nepal, from November 2020 to February 2021.

Caseous calcification of the mitral annulus (CCMA) - A rare mimicker of a cardiac mass.

Caseous calcification of the mitral annulus (CCMA) is a less common variant of mitral annulus calcification mimicking an intracardiac mass. The caseous calcification of the mitral annulus is a harmless benign entity that is an infrequent and incidental finding. Awareness about the condition is a must to avoid misinterpretations leading to unnecessary investigations and interventions.

Safety and Efficacy of Single vs Dual Antiplatelets Therapy After Atrial Septal Defect Device Closure.

Background: Atrial septal defect device closure has become a standard procedure. Antiplatelet therapy is used to prevent thrombus formation in the device. There is no clear recommendation about the antiplatelets drugs.

Health system gaps in cardiovascular disease prevention and management in Nepal.

Background: Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal's health systems gaps to prevent and manage CVDs.

Atrial Septal Defect Size and Rims on Transesophageal Echocardiogram.

Rims and size of atrial septal defect (ASD) are crucial for the success of transcatheter ASD closure. The maximal diameter and dimensions of various rims of the ASD are essential for sizing and optimal placement of the device. We aimed to study the size and rims of ASD in our patients.

Percutaneous transluminal mitral valvuloplasty in post Mitral valve repair and Aortic valve replacement patient.

MV repair in the rheumatic population is feasible with acceptable long-term results. Incidence of mitral stenosis (MS) following mitral valve (MV) repair for severe rheumatic mitral regurgitation (MR) and usefulness of percutaneous transluminal mitral valvuloplasty in these patients is not described in literature. We report a case of successful PTMC in severe MS following MV repair for severe rheumatic MR.

Aldosterone Antagonists in ST Elevation Myocardial Infarction Patients with Low Left Ventricular Ejection Fraction: a Retrospective Study at Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal.

Background: Aldosterone antagonists (AA) improve survival in ST elevation myocardial infarction (STEMI) patients with left ventricular ejection fraction(LVEF) "T40% ,with either clinical heart failure or diabetes mellitus. Our aim was to assess the adherence of AA use in Shahid Gangalal National Heart Centre, Kathmandu, Nepal.

Methods: Medical records of 171 STEMI patients with LVEF "T40% and discharged from our centre between January 2012 and December 2012 were retrospectively reviewed, regarding the use of AA use.