S. Gupta, S. Pervez, Jagadananda Roy, Bhabesh C Mandol, Mozibul Hoque, P. Chanda
{"title":"Successful Repair of a Post-opcabg Distal Ascending Aortic Pseudoaneurysm through Lateral Thoracotomy – A Case Report","authors":"S. Gupta, S. Pervez, Jagadananda Roy, Bhabesh C Mandol, Mozibul Hoque, P. Chanda","doi":"10.3329/bhj.v37i1.60107","DOIUrl":"https://doi.org/10.3329/bhj.v37i1.60107","url":null,"abstract":"A large ascending Aortic pseudoaneurysm is a rare life threatening complication after off pump coronary artery bypass surgery. We herein describe such a case of massive ascending Aortic pseudoaneurysm, with impending rupture which was adherent to undersurface of sternum, was successfully treated by us at Square Hospitals Limited.\u0000Bangladesh Heart Journal 2022; 37(1): 72-76","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116438890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MG Azam, Md. Shafiqul Islam, S. Mondal, Nobiul Islam, Mizanur Rahman, Abdullah Al Matin, N. Ahmed, M. Arefin
{"title":"The Outcome of LM PCI: A Single Center Experience of First 50 Cases without In-site IVUS Facility","authors":"MG Azam, Md. Shafiqul Islam, S. Mondal, Nobiul Islam, Mizanur Rahman, Abdullah Al Matin, N. Ahmed, M. Arefin","doi":"10.3329/bhj.v37i1.60098","DOIUrl":"https://doi.org/10.3329/bhj.v37i1.60098","url":null,"abstract":"Introduction: Left main disease (LMD) is related to significant morbidity and mortality. This study was done to evaluate the clinical major adverse cardiovascular event (MACE), including unstable angina, myocardial infarction, heart failure, target vessel revascularization, stroke and death in patients undergoing left main stem stenting without availability of in-site intravascular imaging (IVUS). Methods & Materials: It was a prospective observational study done in National Institute of Cardiovascular Diseases & Hospital (NICVD) from March 2014 to June 2019. Our study included 50 patients who underwent Percutaneous Coronary Intervention for left main disease without use of IVUS. All the patients were followed up for 1 year & 2 years, one patient was lost to follow-up. Outcomes included in MACE were death, myocardial infarction, unstable angina, heart failure, stroke and target vessel revascularization (TVR). Results: Fifty patients (mean age 58.4 ± 4.1 years, 44 male, 06 female) were treated with a mean SYNTAX score of 24.8 ± 2.6. Thirty two (64%) patients had stable angina, 17 (34%) had unstable angina/non ST-elevation myocardial infarction, and 1 (02%) had ST-elevation Myocardial infarction. Among the risk factors, 21(42%) had DM, 33 (66%) were hypertensive, 22 (44%) were smoker, 19 (38%) had dyslipidemia, 09 (18%) had previous h/o MI, 11 (22%) had family h/o CAD & 01 (02%) had previous h/o CVD. Preprocedural LVEF was 49.92± 6.60 % and post procedural 54.84 ± 4.55% which showed significant improvement of LVEF after PCI (p=0.003). Most of the patients presented with LM with SVD (82%). Among all patients, 39 (78%) underwent complete revascularization in compare to 11 (22%) had incomplete revascularization. Thirty eight (76%) patients received a single-stent DES and 12 (24%) received two-stents DES. Among double stent strategy, majority underwent TAP (50%). All access was femoral & No reflow phenomena were found in any of the patients during the procedure. No perioperative mortalities were noted and no urgent coronary bypass graft surgery was required. One patient was lost to follow-up. After 1-year follow-up period, 1 (02%) patients had non-fatal myocardial infarction, 7 (14%) had episodes of unstable angina (UA) and 3 (06%) had heart failure (HF). After 2-years there was no new MI but 09 (18%) had UA & 4 (08%) patients had HF episode in total. TLR was 2 (04%) in first year and 3 (06%) in 2nd year. Total mortality was 1(02%) in first year & 3(06%) in 2nd year. The multivariable analysis showed a good prognosis in patients receiving LM PCI with a total event rate of 28% & mortality 6%. A multivariate regression analysis with risk factors for coronary artery disease as predictive variables showed that high SYNTAX score (p = 0.013), incomplete revascularization (p=0.002) & low post procedural LVEF (p= 0.001) was an independent predictor of MACE. Conclusion: Percutaneous coronary intervention of left main coronary disease without use of IVUS showed ","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122011964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Gupta, Md Ali Haider, M. Uddin, Bhabesh C Mandol, P. Chanda
{"title":"Redo MIDCAB in a Septuagenarian in our Setting, Fantasy or Fact? - A Case Report","authors":"S. Gupta, Md Ali Haider, M. Uddin, Bhabesh C Mandol, P. Chanda","doi":"10.3329/bhj.v36i2.56041","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56041","url":null,"abstract":"Worldwide growth in elderly population has led to an upsurge in the number of septuagenarian (>70 years of age) patients requiring surgical treatment for coronary artery disease. Elective coronary artery bypass grafting (CABG) in the older patients are associated with acceptable risks of adverse events and should be undertaken for appropriate indications without unnecessary hesitation. Redo coronary surgeries carries one of the highest mortality rates amongst redo cardiac surgeries, both separately or in combination with other pathologies. As a result, minimally-invasive direct coronary artery bypass (MIDCAB), was preferred to avoid the complications of re-sternotomy. We hereby present a case report of a septuagenarian patient with post CABG (2014) unstable angina with old myocardial infarction (extensive anterior) who was treated successfully, by us and to our best knowledge in the published articles this is probably the first time, a re-do MIDCAB technique has been implemented in our country.\u0000Bangladesh Heart Journal 2021; 36(2): 145-150","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127635926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Bala, A. Reza, M. A. Ali, M. Khan, Nighat Islam, Sadeed Araf Reza
{"title":"A Case Report on Chronic Digoxin Toxicity","authors":"P. Bala, A. Reza, M. A. Ali, M. Khan, Nighat Islam, Sadeed Araf Reza","doi":"10.3329/bhj.v36i2.56040","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56040","url":null,"abstract":"Digitalis glycosides are among the oldest drugs used in cardiology. Nowadays, due to the limited indications for their use (advanced heart failure, usually concomitant with atrial fibrillation), cases of toxicity induced by this class of drugs are rarely observed. Digoxin produces a positive inotropic and bathmotropic effect on the heart, but has a negative chronotropic and dromotropic effect. Cardiac glycosides have a narrow therapeutic window, so digitalis treatment can easily lead to symptoms of overdose. In patients taking digoxin, the drug therapeutic level should be maintained at 1-2 ng/ml; the toxic effects occur at concentrations > 2.8 ng/ml and are mainly related to disturbances of cardiac function and of the circulatory system, as well as gastrointestinal symptoms and CNS disturbances. Here, a 65-years-old patient who was hospitalized following chronic ingestion with acute renal impairment. In spite of rapidly applied gastric irrigation and administration of activated charcoal, the drug level in the patient’s blood was estimated at 8.5 ng/ml. During her stay on the ward, typical symptoms of severe toxicity were observed: from gastric symptoms (severe nausea, vomiting) to conduction disturbances. Type I, moitz type 1 and 2 AV blocks were detected, as well as some supraventricular extrasystoles. These conduction disorders required the use of temporary endocardial pacing. Due to the unavailability of specific antidotes (antidigitalis antibodies) and lack of efficient methods of extracorporeal elimination of the drug, symptomatic treatment comprising the correction of electrolyte disturbances and heart rate control remains the most effective.\u0000Bangladesh Heart Journal 2021; 36(2): 139-144","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132774108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Awal, Kazi Shamim Al Mamun, M. Karim, Md Saif Uddin Azad, Fannana Ahmed
{"title":"Prognostic Value of Electrocardiographic Abnormalities and Troponin-I Elevation in Hospitalized COVID-19 Patients","authors":"A. Awal, Kazi Shamim Al Mamun, M. Karim, Md Saif Uddin Azad, Fannana Ahmed","doi":"10.3329/bhj.v36i2.56036","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56036","url":null,"abstract":"Background: Corona Virus Disease (COVID -19) patients present mainly with respiratory manifestations and viral pneumonia. The cardiovascular presentation includes early signs of acute myocardial injury. Troponin elevation is a frequent laboratory finding in hospitalized patients with the disease, and may reflect direct vascular injury or nonspecific supply-demand imbalance. In this work, we assessed the correlation between different ranges of Troponin elevation, Electrocardiographic (ECG) abnormalities and mortality.\u0000Methods and materials: It was a prospective observational study, conducted in four tertiary care Private Hospitals of Chattogram City of Bangladesh. The study enrolled 181 consecutive patients admitted to hospital from June 01, 2020 to December 31, 2020 due to Covid-19 disease on the basis of presentation of signs and symptoms severity. Upon admission, routine investigations cTnI and ECG were carried out.\u0000Results: Mean age of the patients was 54.3±7.3 years with 63.5% male. Hypertension was the most common comorbidity followed by diabetes and obesity. 57.1% of the patients had abnormal ECG. Abnormal axis deviation [26 % (left axis deviation 23.9% vs right axis deviation 2.0%)], Poor R wave progression (22.9%), T inversion (14.5%), left ventricular hypertrophy (LVH) (11.4%) followed by ST segment depression (8.3%) were major findings observed in the study population. Presence of LVH (p=0.008), ST segment elevation (p≤0.001), ST segment depression (p≤0.001) and T inversion (p=0.003) showed statistically significant association with Severe COVID-19 disease. 48.2% had raised cTnI level. Thirteen (7.2%) patients expired in hospital. The mortality rate increased with incrementally higher troponin group: 12/18 than mildly elevated troponin 1/63 (p < 0.01). The presence of an abnormal ECG finding resulted in significant in the intermediate Troponin elevation group (0.05-1 ng/ml) but not in the low (<0.05 ng/ml) or high (> 1 ng/ml) Troponin elevation groups. There were statistically significant association between between cTnI level and death; and between ECG findings and death.\u0000Conclusion: Study conclude that Troponin-I level and ECG are a prognostic factor for mortality in hospitalized COVID-19 patients.\u0000Bangladesh Heart Journal 2021; 36(2): 105-112","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134229223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fazila-tun-nesa Malik, -. Md Kalimuddin, N. Ahmed, M. Badiuzzaman
{"title":"Extremely Late Stent Thrombosis in a First Generation Drug- Eluting Stent 10 Years After Stent Deployment: A Case Report","authors":"Fazila-tun-nesa Malik, -. Md Kalimuddin, N. Ahmed, M. Badiuzzaman","doi":"10.3329/bhj.v36i2.56044","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56044","url":null,"abstract":"Stent thrombosis is one of the gravest complications of percutaneous coronary intervention which usually manifest as ST-segment elevation myocardial infarction or sudden death. There are a very few case reports in the literature regarding extremely late stent thrombosis in a drug-eluting stent. Here we report a case of extremely late stent thrombosis in a first generation drug-eluting stent in a 54 year old gentleman. To the best of our knowledge, this is the first case report with the longest duration (10 years) after sirolimus eluting first-generation DES in Bangladesh.\u0000Bangladesh Heart Journal 2021; 36(2): 164-168","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122580516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Requirement of Postoperative Ventilation and analgesics during Off-Pump Coronary Artery Bypass (OPCAB) surgery – A Comparison between Combined High Thoracic Epidural Anaesthesia (HTEA) with GA and GA Alone","authors":"S. Azad, A. Beg","doi":"10.3329/bhj.v36i2.56032","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56032","url":null,"abstract":"Beckground: This is often difficult to achieve optimal pain relief after coronary artery bypass surgery and also great challenge to choice appropriate analgesics with minimize the duration of mechanical ventilation. In the postoperative period inadequate analgesia may increase morbidity by causing adverse haemodynamic, metabolic, immunologic and haemostatic attentions and prolong mechanical ventilation with more ICU stay. High Thoracic Epidural Anaesthesia (HTEA) as an adjunct to general anaesthesia has been shown to be potentially beneficial in postoperative pain relief and the requirement of mechanical ventilationin patients with off-pump coronary artery bypass surgery (OPCAB). HTEA provides good protection from stress response, ensures hemodynamic stability, improves distribution of coronary blood flow with reducing demand of oxygen, less requirement of postoperative analgesia , mechanical ventilation and ICU stay.\u0000Objective: This study has been undertaken with a view to compare requirement of postoperative mechanical ventilation and analgesics in OPCAB surgery between HTEA with GA and GA alone.\u0000Methods: This prospective, randomized case control comparative study was carried out in sixty patients without having left main coronary artery disease, left ventricular ejection fraction <30% or contraindication of regional anaesthesia scheduled for OPCAB. They were divided into two groups, thirty in each group. Group A received GA alone and group B received high thoracic epidural anaesthesia with GA. Requirement of postoperative analgesics, pain score, consciousness score, sedation score, satisfection level and duration of ventilation with length of stay in intensive care unit were recorded in the post-operative period.\u0000Results: Rescue analgesics received and found 16(53.3%) and 6(20.0%) needed analgesia in group A and group B respectively and the difference was statistically significant (p<0.05). Regarding the pain score (VAS) during maintenance with ventilator with awareness at first fourth hour significant (p<0.05) change between two groups. After extubation at rest in different time interval and found significant (p<0.05) change between two groups in all follow-up times. Post-operative pain score (VAS) after extubation at movement in different time interval and found significant (p<0.05) change between two groups. Post-operative pain score (VAS) after extubation at during coughing in different time interval and found significant (p<0.05) change between two groups. Post-operative sedation score at first six hour (hourly) and found significant (p<0.05) change between two groups except 1st hour, which was not significant (p>0.05). The mean extubation hours were 7.4±1.09 hours in group A and 5.3±0.81 hours in group B. The mean ICU stay was 72.9±9.2 hours in group A and 57.1±12.0 hours in group B and the difference was statistically significant (p<0.05) in unpaired t-test. No postoperative complication was observed in both groups.\u0000Conclusion: HTEA wit","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128962418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RA Ahmed, Pinaki Das, A. Tushar, T. Saha, Mahboob Ali, A. Choudhury, N. Kar, M. A. Razzaque, J. Saha
{"title":"Comparison of Angiographic Severity of Coronary Artery Disease between Premenopausal and Postmenopausal Women with Acute Coronary Syndrome","authors":"RA Ahmed, Pinaki Das, A. Tushar, T. Saha, Mahboob Ali, A. Choudhury, N. Kar, M. A. Razzaque, J. Saha","doi":"10.3329/bhj.v36i2.56037","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56037","url":null,"abstract":"Background: The risk of coronary artery disease in women after menopause sharply rises in contrast to that of women before menopause because of hormonal protection against atherosclerosis. No research work has been done so far to see the angiographic pattern and severity of coronary artery disease in premenopausal women and their comparison with those of postmenopausal women. This study will help understand the pattern and severity of CAD both in premenopausal and postmenopausal women.\u0000Methods: This cross sectional analytical study was conducted over 100 ACS female patients who were purposively selected and agreed to do coronary angiogram during index hospital admission. Among them 50 patients were premenopausal status with CAD constituted study group I and another 50 postmenopausal women with CAD constituted study group II. The main objective of the study was to compare the angiographic severity of coronary artery disease between premenopausal and postmenopausal women with acute coronary syndrome. Angiographic severity of CAD was assessed by vessel score, Gensini score and Friesinger score.\u0000Results: LAD was the common artery involved (76% vs. 56%) followed by RCA (72% vs. 36%) and LCX (62% vs. 30%) in group-II compared to group-I and involvement of individual coronary artery was statistically significant (P values were 0.03, 0.003 and 0.001 respectively). Critical stenosis (70-99%) involving the all three major epicardial vessels (LAD, LCX and RCA) were found most frequently in group-II and the percentage of lesions were 56% vs. 30%; 56% vs. 22% and 54% vs. 22% respectively (p< 0.05). The vessel score of the study patients revealed that singe vessel involvement was significantly higher in group-I (52% vs. 24%) (p=0.003) and triple vessel involvement was found significantly higher in group-II (40% vs. 12%) (p=0.001). Severity assessment by Friesinger score showed normal (0) and low (1-4) Friesinger score significantly higher in group-I patients (P=0.04 and P=0.007 respectively) and high Friesinger score (11-15) was found significantly higher in patients in group II (p=0.001). Severity assessment by Gensini score of the study patients revealed significantly higher mild Gensini score in group-I patients (P=0.002) and severe Gensini score in group II patients (p=0.002).\u0000Conclusion: Coronary artery disease is one of the major important problems not only in postmenopausal women but in premenopausal women also. Postmenopausal women suffer from more triple vessels involvement, more diffuse and severe disease. This study results point out that premenopausal women suffer from less severe coronary artery disease and there is a trend to involve mid LAD more frequently in comparison to other two major coronary arteries and LM coronary artery in comparison to postmenopausal women.\u0000Bangladesh Heart Journal 2021; 36(2): 113-123","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121125696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fazila-tun-nesa Malik, -. Md Kalimuddin, -. Mir Ishraquzzaman, M. Al Mamun, Ashok Dutta, Md. Habibur Rahman, Smita Kanungo, N. Laila, Md. Shamim Chowdhury, S. Choudhury
{"title":"Coronavirus Disease 2019: One Year Experience at Tertiary Care Cardiac Hospital","authors":"Fazila-tun-nesa Malik, -. Md Kalimuddin, -. Mir Ishraquzzaman, M. Al Mamun, Ashok Dutta, Md. Habibur Rahman, Smita Kanungo, N. Laila, Md. Shamim Chowdhury, S. Choudhury","doi":"10.3329/bhj.v36i2.56034","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56034","url":null,"abstract":"Background: The Coronavirus Disease 2019 (COVID-19) pandemic is a significant challenge particularly for low and middle-income countries like Bangladesh. Interventions such as home isolation, frequent hand washing, wearing face mask, maintaining social distancing are difficult to implement in densely populated areas. The aim of the study was to delineate demographics, clinical manifestations, treatment modalities and outcomes of COVID-19 affected patients of our hospital.\u0000Methods: This prospective observational study was carried out at National Heart Foundation Hospital & Research Institute of Bangladesh between 08 March 2020 to 07 March 2021. During this period all admitted patients who subsequently were diagnosed as COVID positive and health care personnel of this hospital, who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace & become COVID positive were included.\u0000Results: During this one-year period a total of 769 COVID positive patients were detected in our hospital. Mean age of the patients was 48.16 ±15.63 years (range 1-92 years). Two third were male (64.9% vs 35.1%) and had multiple co-morbidities. One fifth of the patients were (19%) asymptomatic. The mean duration of onset of symptoms to test was 3.72±3.7 days. Most common symptoms were fever (65.3%), cough (37.1%), shortness of breath (33.6%) and fatigue (27.8%). Other symptoms were bodyache (18.6%), headache (16.6%), anosmia 16%), sore throat (12.1%), diarrhoea (6.8%), dizziness (5.3%), generalized itching (3.8%). Nearly two third of the COVID positive patients (63.2%) had a diagnosed cardiovascular disease at onset and remaining 36.8% patients presented with only COVID-19 disease. About 75% patients received ivermectin, 5.1% patients received favipiravir and 4.4% patients received remdesivir. Three fourth (74.38%) of patients were hospitalized and remaining one fourth (25.62%) patients were treated either in home isolation or in institutional isolation. Most of the patients recovered, with a case fatality rate of 3.5%. Diabetes, hypertension and age ≥50 years were the independent predictors of mortality.\u0000Conclusion: Although most of the patients had good outcome the study revealed 3.5% case fatality. Male with multiple co-morbidities were predominantly affected by COVID 19. Fever, cough, shortness of breath and fatigue were common presenting symptoms.\u0000Bangladesh Heart Journal 2021; 36(2): 89-97","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132387597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sayeedur Rahman Khan, Fazila-tun-nesa Malik, M. Ahmed, A. Biswas, Mainul Islam, Bivash Kumer Sheel, Sharmin Tahmina Khan, H. Iqbal, Md. Rafiqul Islam
{"title":"Comparison of Risk Factors & Angiographic Profiles between Young Patients with ST Segment Elevation Myocardial Infarction and Non-ST Segment Elevation Myocardial Infarction","authors":"Sayeedur Rahman Khan, Fazila-tun-nesa Malik, M. Ahmed, A. Biswas, Mainul Islam, Bivash Kumer Sheel, Sharmin Tahmina Khan, H. Iqbal, Md. Rafiqul Islam","doi":"10.3329/bhj.v36i2.56038","DOIUrl":"https://doi.org/10.3329/bhj.v36i2.56038","url":null,"abstract":"Background: Coronary artery disease is the leading cause of death in the world. Advancing age is a well-recognized risk factor for acute myocardial infarction (AMI). Myocardial infarction is less common in young adults. Prevalence of acute coronary syndrome in young individuals is increasing progressively. These patients have different risk profile, presentation and prognosis. Early recognition and risk factor modification in this population sub-set is of key importance.\u0000Objectives: The purpose of the present study was to determine the differences in risk factors and coronary angiographic profile of young patients with ST-segment elevated myocardial infarction (STEMI) vs. those with non-ST-segment elevated myocardial infarction (NSTEMI). Methods: In this cross sectional analytical study total 135 patients (70 STEMI and 65 NSTEMI) aged ≤45 years were enrolled to see the differences of risk factors and angiographic profile.\u0000Results: The mean age of the study population was 39.39±5.12 years and the study showed male predominance (90.40 % was male and 9.60 % was female). Smoking/tobacco consumption was significantly higher in STEMI patients, whereas diabetes mellitus and hypertension were more prevalent in NSTEMI patients. The frequency of single vessel disease and involvement of left anterior descending artery was significantly higher in young STEMI patients. In case of young NSTEMI patients frequency of triple vessel disease, noncritical coronary artery disease and involvement of left circumflex coronary was significantly higher. The frequency of double vessel disease and involvement of left main coronary artery was also nonsignificantly higher in young NSTEMI patients. There was no significant difference regarding involvement of right coronary artery.\u0000Conclusion: There are significant differences between young STEMI and young NSTEMI patients in respect to risk factors and angiographic profile. Key words: Young patient, STEMI, NSTEMI, Risk factors, Coronary angiographic profile.\u0000Bangladesh Heart Journal 2021; 36(2): 124-132","PeriodicalId":247590,"journal":{"name":"Bangladesh Heart Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134314236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}