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  • 1
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    Online Resource
    PROLONGED QRS DURATION〉140 MILLISECONDS AS A PREDICTOR OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION IN PATIENTS WITH LEFT BUNDLE BRANCH BLOCK
    Pakistan Cardiac Society ; 2020
    In:  Pakistan Heart Journal Vol. 53, No. 3 ( 2020-11-07)
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 53, No. 3 ( 2020-11-07)
    Abstract: Objective: To determine the diagnostic accuracy of prolonged QRS duration 〉 140 milliseconds (ms) on electrocardiography (ECG) for diagnosing left ventricular systolic dysfunction (LVSD) in patients of left bundle branch block (LBBB). Methodology: This cross-sectional study included 128 patients with LBBB. QRS duration was calculated in every patient and duration 〉 140ms was considered as positive criterion for predicting LVSD. Echocardiography was done in all patients to diagnose LVSD. Specificity, sensitivity, negative predictive value (NPV) and positive predictive value (PPV) of QRS duration 〉 140 ms on ECG in predicting LVSD taking echocardiography as a standard were calculated by using 2x2 contingency table. Results: An ECG QRS duration 〉 140 ms criterion was 76.3% sensitive and 75.4% specific in diagnosing LVSD while PPV was 72.6% and the NPV of 78.8% in diagnosing LVSD. Conclusion: An ECG QRS duration 〉 140 ms is reasonable in predicting LVSD.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v53i3.1914
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2020
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  • 2
    Online Resource
    Online Resource
    TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT ATRIAL THROMBUS IN PATIENTS OF RHEUMATIC SEVERE MITRAL STENOSIS WITH NEGATIVE RESULT ON TRANSTHORACIC ECHOCARDIOGRAPHY
    Pakistan Cardiac Society ; 2021
    In:  Pakistan Heart Journal Vol. 54, No. 1 ( 2021-05-26), p. 40-43
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 54, No. 1 ( 2021-05-26), p. 40-43
    Abstract: Objective: The objective of the study was to assess the frequency of clot in left atrium by transesophageal echocardiographic diagnostic procedure (TEE) in patients with rheumatic severe mitral stenosis (MS) in those patients in whom transthoracic echocardiographic diagnostic procedure (TTE) did not observe any clot in left thrombus. Methodology: The descriptive cross-sectional study was carried out on 369 patients with rheumatic severe MS. Patients having mitral valve are of 1.5 cm2 or less planned for PMV were included in study. Non-cooperative patients were excluded. It was decided to do TEE on a similar day before the intervention to assess LA thrombus. Results: The mean age of the included patients was 45.65 ±11.54 years. There were 122 (33.1%) male patients and 247 (66.9%) female patients. In this study, clot in LA was diagnosed in 29.5% patients having negative TTE. LA clot was found in 33 male patients (30.3%) and 76 female patients (69.7%). Conclusion: There is a high risk of missing LA thrombus on transthoracic echocardiography, therefore we recommend performing TEE in patients with normal TTE study before the procedure.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v54i1.2063
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2021
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  • 3
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    Online Resource
    DIABETIC JEOPARDIZE OF ACUTE MYOCARDIAL INFARCTION CHEST PAIN
    Pakistan Cardiac Society ; 2021
    In:  Pakistan Heart Journal Vol. 53, No. 4 ( 2021-01-19)
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 53, No. 4 ( 2021-01-19)
    Abstract: Objective: Diabetic neuropathy may mask the typical ischemic chest pain and diabetics may carry longer presentation times in cases of acute STEMI. Diabetics may complain of chest pain less frequently, while atypical clinical presentations of STEMI could be more common compared to non-diabetics. Aim of this study was to assess the potential impact of diabetes on STEMI related chest pain, its severity, characteristics and non-specific clinical features. Methodology: The descriptive, cross-sectional study included 254 patients with first episode of STEMI. Data was acquired regarding feeling of chest pain, its severity, different characters, sites of radiation, and occurrence of associated clinical features. These variables were compared among diabetic and non-diabetic groups by Pearson’s Chi-square test. Results: Diabetics were more likely ‘not to feel’ any STEMI related chest pain compared to non-diabetics (22.2% vs. 2.4% p 〈 0.001), severe chest pain was a less frequent complaint in diabetics compared to non-diabetics (21.1% vs. 89% p 〈 0.001). The characters of “chest tightness”, “strangulating pain” and “squeezing chest pain” were less frequent in diabetics (45.6% vs. 68.3% p 〈 0.001, 8.9% vs. 56.7% p 〈 0.001 and 1.1% vs. 18.3% p 〈 0.001 respectively). Syncope and shortness of breath were observed more frequently in diabetics (37.8% vs. 20.7% p=0.003 and 23.3% vs. 17.1% p=0.001 respectively). Conclusion: Diabetics can frequently present without pain or with less severe chest pain and infrequent typical characters compared to non-diabetics and may have atypical symptoms like syncope and shortness of breath more commonly than non-diabetics.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v53i4.1983
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    ASSOCIATION OF HYPERURICEMIA WITH THE PRESENCE AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY
    Pakistan Cardiac Society ; 2021
    In:  Pakistan Heart Journal Vol. 54, No. 2 ( 2021-06-24), p. 157-161
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 54, No. 2 ( 2021-06-24), p. 157-161
    Abstract: Objectives: To determine the association of hyperuricemia with the presence and severity of coronary artery disease in patients undergoing coronary angiography. Methodology: This case control study was carried out in the Department of Cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan for six months. Total number of 292  patients (146 cases with coronary artery disease and 146 controls with normal coronary arteries) having age 40-60 years of both genders were included in this study. Coronary angiography was performed using standard angiographic techniques. After undergoing coronary angiography, patients with 50% luminal stenosis or more in any one of the coronary arteries were labeled case group. Patients with normal coronaries or less than 50% luminal stenosis in any one of the coronary vessels were taken as control group. Serum uric acid was advised and value was noted along with the basic demographic data and established risk factors of coronary artery disease. Results: Mean age was 50.79±6.08 years. Mean serum uric acid was 7.54±3.60 mg/dl. Hyperuricemia was diagnosed in 94 (64.40%) patients with significant CAD (case group) and in only 59 (40.40%) in control group. The odds ratio was 2.66 (95% CI 1.66 to 7.28) with p-value of 〈 0.001. Triple vessel disease was diagnosed in 66.7% patients with hyperuricemia and in only 33.3% patients without hyperuricemia [OR 4.0 (2.09-7.64), p-value 〈 0.001]. Conclusion: There is a significant association between the presence and severity of coronary artery disease with hyperuricemia.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v54i2.2092
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2021
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  • 5
    Online Resource
    Online Resource
    ASSOCIATION OF HYPERURICEMIA WITH CRITICAL CORONARY ARTERY DISEASE
    Pakistan Cardiac Society ; 2020
    In:  Pakistan Heart Journal Vol. 53, No. 2 ( 2020-07-17)
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 53, No. 2 ( 2020-07-17)
    Abstract: Objective: The study was conducted to determine the association of increased serum Uric acid level (SUA) with critical coronary artery disease (CAD) in patients subjected to coronary angiography. Methodology: 360 patients (180 cases with critical CAD and 180 controls without critical CAD) were enrolled in the study after taking informed consent. Demographic data like age, gender, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, smoking and BMI was collected. Serum uric acid was advised and recorded in the questionnaire. Results: 360 patients with mean age 51.37 ± 6.5 years were included. 262 patients (72.8%) were male. 54 patients (20.8%) had hyperuricemia.  26.6% cases and 15.0% controls had hyperuricemia. Hyperuricemia was significantly associated with critical CAD (OR=2.06, CI 1.22-3.49, p=0.007). The association persisted after stratification according to age, gender, diabetes, hypertension, dyslipidemia, smoking, family history of IHD and BMI. Conclusion: There is a positive association between critical CAD and hyperuricemia. Keywords: Coronary artery disease, Hyperuricemia, IHD
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v53i2.1813
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2020
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  • 6
    Online Resource
    Online Resource
    Clinical Memory of COVID-19 Pandemic: A Comparative Analysis of Clinical and Angiographic Characteristics of Patients with Acute Coronary Syndrome
    Pakistan Cardiac Society ; 2023
    In:  Pakistan Heart Journal Vol. 56, No. 1 ( 2023-04-01), p. 101-109
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 56, No. 1 ( 2023-04-01), p. 101-109
    Abstract: Objectives: To describe the clinical characteristics and angiographic features of COVID-19 patients presenting with acute coronary syndrome (ACS) and to compare with non-COVID-19 ACS patients presenting simultaneously. Methodology: In a case control design, data were extracted from a prospectively collected COVID-19 and NCDR registry. All ACS patients who underwent cardiac catheterization from April 2020 to May 2021 were included. All of the patients were taken to the Cath lab for diagnostic coronary angiography and possible percutaneous intervention. Demographic and clinical characteristics, angiographic features, and in-hospital outcomes were compared between ACS patients with and without COVID-19. Results: A total of 4027 COVID-19 negative patients, and 80 COVID-19 positive were included. Total of 83% in COVID-19 and 88% in non-COVID-19 group had ST elevation myocardial infarction. Majority of the COVID-19 positive patients had sub-optimal TIMI flow grade ( 〈 III) post procedure and had a high thrombus burden (11.2% vs. 2.9%; p 〈 0.001). Majority of the patients who had COVID-19 and ACS required mechanical circulatory support (48.8% vs. 0.3%; p 〈 0.001). The mortality rates were also higher in COVID-19 positive group (38.8% vs. 1.3%; p 〈 0.001). Among the COVID-19 positive patients 66.3% (53) had high thrombus burden (≥4 grade), intervention was performed in 73.7% (59). Post-intervention myocardial blush grade ≤2 was observed in 57.6% (34), slow flow in 85.3% (29), and phasic flow possibly due to elevated LVEDP in 41.2% (14) patients. Conclusion: COVID-19 patients with ACS had a higher severity of illness at presentation and worse outcomes as compared to simultaneously presenting non-COVID patients.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v56i1.2450
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2023
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  • 7
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    Online Resource
    SEVERE MITRAL REGURGITATION AFTER PMBV? COMPARISON BETWEEN INOUE AND MULTI-TRACK TECHNIQUES
    Pakistan Cardiac Society ; 2022
    In:  Pakistan Heart Journal Vol. 54, No. 4 ( 2022-01-08), p. 333-338
    Details
    In: Pakistan Heart Journal, Pakistan Cardiac Society, Vol. 54, No. 4 ( 2022-01-08), p. 333-338
    Abstract: Objectives: To compare the frequency of severe mitral regurgitation after percutaneous mitral balloon valvuloplasty (PMBV) via Inoue balloon and multi-track balloon technique in our population. Methodology: In this retrospective observational study which was conducted at a tertiary care cardiac center of Karachi, Pakistan between 2015 and 2020 on Hospital registry of PMBV patients. Data were categorized in to two groups, Inoue balloon or multi-track balloon technique. Post procedure echocardiographic and catheterization parameters and in-hospital outcomes and complications, including severe MR, were compared between two groups. Results: Out of 470 PMBV procedures, 286 (60.9%) were performed with multi-track and 184 (39.1%) with Inoue balloon. Improvement in mitral value area was significantly higher with multi-track as compared to Inoue balloon (0.66±0.31 cm2 vs. 0.56±0.29 cm2; p 〈 0.001). Severe MR was not significant, 3.5% (10/286) vs. 4.3% (8/184); p=0.639 for multi-track and Inoue balloon. One patient in Inoue balloon group and two patients in multi-track group required emergency valve surgery. Stroke was observed in two patients of multi-track group and two patients from the same group developed tamponade. No in-hospital mortality was observed. Conclusion: Post-procedure severe MR is a significant and frequent complication. Rate of post procedure severe MR are similar for PMBV via Inoue balloon and multi-track balloon. Both methods are equally effective with equal success rate.
    Type of Medium: Online Resource
    ISSN: 2227-9199 , 0048-2706
    URL: Article
    DOI: 10.47144/phj.v54i4.2133
    Language: Unknown
    Publisher: Pakistan Cardiac Society
    Publication Date: 2022
    detail.hit.zdb_id: 2696529-X
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