Nepalese Heart Journal最新文献_第3页

Effect of Early Coronary Collateral Circulation in Patients with ST Elevation Myocardial Infarction ST段抬高型心肌梗死患者早期冠状动脉侧支循环的影响

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.54993

Parash Koirala, Ratna Mani Gajurel, Chandra Mani Poudel, Hemant Shrestha, Sanjeev Thapa, Rajaram Khanal, Smriti Shakya, Shovit Thapa, Surya Raj Pathak

{"title":"Effect of Early Coronary Collateral Circulation in Patients with ST Elevation Myocardial Infarction","authors":"Parash Koirala, Ratna Mani Gajurel, Chandra Mani Poudel, Hemant Shrestha, Sanjeev Thapa, Rajaram Khanal, Smriti Shakya, Shovit Thapa, Surya Raj Pathak","doi":"10.3126/njh.v20i1.54993","DOIUrl":"https://doi.org/10.3126/njh.v20i1.54993","url":null,"abstract":"Background and Aims: Coronary collateral circulation can develop early after STEMI and patients having these coronary collaterals have favorable outcomes. The aim of this study was to evaluate the prognostic impact of coronary collateral circulation in STEMI. Methods: This is an observational prospective study of 106 consecutive STEMI patients undergoing Primary PCI admitted and treated at a tertiary cardiac centre from May 2019 to April 2020. Clinical profile, complications at index admission and atone month follow up were analyzed. Results: Out of 106 consecutive patients, 50(47%) had early coronary collateral supplying the infarct related artery. The baseline characteristics of the patients in the two groups, with collateral and without collateral, were similar. Among patients with collateral circulation, only 5% had very well developed (Rentrop3) collaterals. The presence of collateral was strongly associated with presence of preexisting angina (p=0.007) and delayed presentation to hospital (p= 0.04). Coronary collateral was more common in non-diabetics, non-anterior wall STEMI and those with mutivessel disease. Compared with the patients without collateral supply, those who had collateral had fewer incidence of in-hospital heart failure (p=0.03) and post MI pericarditis (p=0.04). Conclusion: In STEMI, development or recruitment of early collateral supply to the infarct related artery was associated with lower rates of heart failure, post MI pericarditis, cardiogenic shock, hospital stay and in-hospital deaths. At 1 month, patients with collateral supply had fewer angina recurrence, reinfarcton and stent thrombosis.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051141","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}

引用次数: 0

Intrapericardial antibiotics and fibrinolysis to shorten course of antibiotics and prevent constrictive pericarditis in acute purulent pericarditis due to staphylococcus aureus 对金黄色葡萄球菌引起的急性化脓性心包炎给予心包内抗生素和纤溶，缩短疗程，预防缩窄性心包炎

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.55194

Neeraj Sharma, Parag Karki

{"title":"Intrapericardial antibiotics and fibrinolysis to shorten course of antibiotics and prevent constrictive pericarditis in acute purulent pericarditis due to staphylococcus aureus","authors":"Neeraj Sharma, Parag Karki","doi":"10.3126/njh.v20i1.55194","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55194","url":null,"abstract":"Acute purulent pericarditis, although rare in modern antibiotic era, is a life-threatening condition requiring timely diagnosis and aggressive treatment modalities. We report a successfully treated previously healthy immunocompetent 23 years old male patient diagnosed as secondary acute purulent pericarditis caused by methicillin sensitive Staphylococcus aureus with a primary skin abscess. The patient initially presented with complains of fever, chest pain and occasional cough with no significant finding in clinical examination. Electrocardiography showed widespread ST elevation and echocardiography revealed fluid collection with echogenic floaters in pericardial space. Diagnostic pericardiocentesis was done and fluid showed growth of methicillin sensitive Staphylococcus aureus. The patient was managed with anti-inflammatory drugs, appropriate intravenous antibiotic for two weeks, therapeutic pericardiocentesis with intrapericardial vancomycin instillation and fibrinolysis with alteplase to prevent constrictive pericarditis and persistent purulent pericarditis. The patient was followed up in three months and was found to have no residual disease or complication.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051138","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}

引用次数: 0

Predictive Value of EuroSCORE II in a Nepalese Tertiary University Hospital – Prospective Observational Study EuroSCORE II在尼泊尔第三大学医院的预测价值——前瞻性观察研究

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.54995

Krishnaprasad Bashyal, Ravi Kumar Baral, Anil Bhattarai, Prabhat Khakural, Prashiddha B. Kadel, Bhagawan Koirala

{"title":"Predictive Value of EuroSCORE II in a Nepalese Tertiary University Hospital – Prospective Observational Study","authors":"Krishnaprasad Bashyal, Ravi Kumar Baral, Anil Bhattarai, Prabhat Khakural, Prashiddha B. Kadel, Bhagawan Koirala","doi":"10.3126/njh.v20i1.54995","DOIUrl":"https://doi.org/10.3126/njh.v20i1.54995","url":null,"abstract":"Background and Aims: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is an important tool for risk stratification in cardiac surgery. Updated EuroSCORE II (ESC II) is widely regarded as essential for risk stratification and several studies validate its efficacy, but these are fewer in Southern Asia and none in Nepal. Aim of this study was to compare the predicted versus observed early mortality in adults undergoing major cardiac surgeries in Nepalese population. Methods: A prospective observational study was conducted from September 2019 to May 2021 at Manmohan Cardiothoracic Vascular and Transplant Center. Calibration and discrimination of scoring system were main parameters analyzed in total sample and subgroups. Discrimination were observed by plotting receiver operating characteristic (ROC) curves and calculating area under curve (AUC). Two sample t test, McNemar’s test, Fisher’s exact t test and Chi square test were used to derive P value. Results: In this study, 249 patients were evaluated. Poor mortality prediction was shown by statistically significant p value <0.05 across all surgical groups. AUC for total cases, CABG and valve surgeries were 0.835, 0.766, 0.82 respectively. Conclusion The present study underpredicted mortality but displayed good discrimination for overall cardiac surgeries, with excellent discrimination in valve surgeries. As current sample is not entirely comparable to parent study, weak calibration could be attributed to it as etiology was mostly rheumatic with poorer cardiopulmonary reserve in this study versus degenerative etiology in original study.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051146","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}

引用次数: 0

Transcatheter Aortic Valve Implantation with balloon-expandable valve in low-flow low-gradient severe aortic stenosis in Nepal 经导管球囊扩张瓣植入术治疗尼泊尔低流量低梯度重度主动脉瓣狭窄

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.55038

Chandra Mani Adhikari, Birat Krishna Timalsena, Amrit Bogati, Barkadin Khan, Anjana Acharya, Vijay Ghimire, Kshitij Mehta, Dipanker Prajapati

{"title":"Transcatheter Aortic Valve Implantation with balloon-expandable valve in low-flow low-gradient severe aortic stenosis in Nepal","authors":"Chandra Mani Adhikari, Birat Krishna Timalsena, Amrit Bogati, Barkadin Khan, Anjana Acharya, Vijay Ghimire, Kshitij Mehta, Dipanker Prajapati","doi":"10.3126/njh.v20i1.55038","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55038","url":null,"abstract":"Transcatheter aortic valve implantation is the most preferred treatment of aortic stenosis in elderly patients at high surgical risk; however, few data exist on the adoption of transcatheter aortic valve implantation for the management of low-flow, low-gradient severe aortic stenosis patients. We present a recent case experience with a 77-year-old man suffering from low-flow, low-gradient, symptomatic severe aortic stenosis with concomitant coronary artery lesions in the left anterior descending and right coronary arteries. He was treated successfully with balloon-expandable transcatheter aortic valve implantation after the percutaneous coronary intervention of the left anterior descending artery and right coronary artery lesion. Post-procedural and 30-day follow-ups showed good functional and hemodynamic improvements with the mean aortic gradient of 3 mmHg (baseline: 30 mmHg) without residual paravalvular leakage. Our first experience with a balloon-expandable transcatheter valve was satisfactory as we observed clinical efficacy and good performance of the balloon-expandable transcatheter aortic valve in low-flow, low-gradient, symptomatic severe AS patients.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"262 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051140","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}

引用次数: 0

Demystifying Cardiac Amyloidosis with Cardiac MRI: A case report 心脏MRI诊断心脏淀粉样变性1例

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.55050

Nirmal Prasad Neupane, Kritisha Rajlawot, Rikesh Tamrakar, Keshika Koirala, Ram Kumar Ghimire, Benu Lohani

引用次数: 0

Clinical profile of patients admitted with pericardial effusion in Shahid Gangalal National Heart Centre, Kathmandu, Nepal 尼泊尔加德满都Shahid Gangalal国家心脏中心因心包积液入院患者的临床概况

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.55003

Keshab Raj Neupane, Rabindra Simkhada, Reeju Manandhar, Subodh Kansakar, Dharmanath Yadav, Arun Kadel, Sushant Kharel, Aashika Thapa, Prinsa Shrestha, Ravi Sahi

{"title":"Clinical profile of patients admitted with pericardial effusion in Shahid Gangalal National Heart Centre, Kathmandu, Nepal","authors":"Keshab Raj Neupane, Rabindra Simkhada, Reeju Manandhar, Subodh Kansakar, Dharmanath Yadav, Arun Kadel, Sushant Kharel, Aashika Thapa, Prinsa Shrestha, Ravi Sahi","doi":"10.3126/njh.v20i1.55003","DOIUrl":"https://doi.org/10.3126/njh.v20i1.55003","url":null,"abstract":"Background and Aims: Pericardial effusion is a common finding in every day clinical practice. It is caused by a range of local and systemic disorders, many of which could be idiopathic. Pericardial effusions can be acute or chronic. The etiology of pericardial effusion varies in different parts of the world and is related to the relative prevalence of different diseases. Methods: This is a retrospective study where data from all the cases admitted with pericardial effusion in the SGNHC from January 2021 to December 2022 were included. Altogether 218 cases diagnosed with pericardial effusion established by Echocardiograpy were included. Evaluation for the cause of pericardial effusion was done. Iatrogenic (cardiac surgery, catheterization) and post-traumatic cases and age <15 years were excluded. Demographic profile, common causes, the presentation and the clinical outcome of the patients were documented. Results: Majority of patients were aged between 56-75 years. Most common etiology of pericardial effusion was tuberculosis (56%) followed by heart failure (11%), Hypothyroidism (6.4%) and malignancy (5.6%). Tachycardia was the most common ECG finding in 152 (69.7%) followed by Low voltage ECG in 96 (44%). The most common clinical feature was breathlessness in 85% followed by tachycardia in 56% of the patient. Conclusion: Tuberculosis, Heart Failure and Hypothyroidism were the common causes of Pericardial effusion with male predominance. Breathlessness was the most common presenting symptom.","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135051147","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}

引用次数: 0

Report of the successful Senning procedure from Nepal 尼泊尔Senning手术成功的报告

Nepalese Heart Journal Pub Date : 2023-06-10 DOI: 10.3126/njh.v20i1.55056

Rabindra B. Timala, Marisha Aryal, Santosh Parajuli, Rupak Pradhan, Rheecha Joshi, Nivesh Rajbhandari, Nishes Basnet, Navin Gautam

引用次数: 0

Cardiac MRI in the Diagnosis and Prognosis of patients with Hypertrophic Cardiomyopathy (HCM) - A Case Report 心脏MRI在肥厚性心肌病(HCM)患者诊断和预后中的作用- 1例报告

IF 0.2

Nepalese Heart Journal Pub Date : 2022-11-21 DOI: 10.3126/njh.v20i2.48871

N. Neupane, Kritisha Rajlawot, K. Koirala, S. Phuyal

引用次数: 0

Consensus Statement of Cardiac Society of Nepal on Diagnosis, Management and Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease in Nepal 尼泊尔心脏学会关于尼泊尔急性风湿热和风湿性心脏病诊断、管理和预防的共识声明

IF 0.2

Nepalese Heart Journal Pub Date : 2022-11-21 DOI: 10.3126/njh.v20i2.48955

D. Sharma, D. Prajapati, U. Shakya, M. Shrestha, Samir Shakya, N. Gautam, R. Manandhar, K. Sherpa, M. Kc, P. Regmi, C. Poudel, C. Adhikari, R. Gajurel, Bijoy G Rajbanshi

引用次数: 0

Clinical Profile and Conventional Risk Factors of Acute Coronary Syndrome in Late Elderly Patients 老年晚期患者急性冠状动脉综合征的临床特点和常规危险因素

IF 0.2

Nepalese Heart Journal Pub Date : 2022-11-21 DOI: 10.3126/njh.v20i2.48834

R. Simkhada, B. Khan, S. Kc

{"title":"Clinical Profile and Conventional Risk Factors of Acute Coronary Syndrome in Late Elderly Patients","authors":"R. Simkhada, B. Khan, S. Kc","doi":"10.3126/njh.v20i2.48834","DOIUrl":"https://doi.org/10.3126/njh.v20i2.48834","url":null,"abstract":"Background and Aims: Acute coronary syndrome is an important health issue. There is paucity of its data in late elderly. We aimed to study their clinical profile and prevalence of conventional risk factors. \u0000Methods: Descriptive cross-sectional study conducted at Shahid Gangalal National Heart Centre from February 2022 to May 2022 including 71 consecutive patients of acute coronary syndrome of age >75 years. They were evaluated focusing their chief complaints and cardiovascular risk factors. \u0000Results: Mean age was 80.32±4.06 years. Forty (56.33%) were male and 31 (43.66%) were female. Thirty-nine (54.92%) were hypertensive, 29 (40.84%) were diabetic, 18 (25.35%) were smoker, 10 (14.08%) had history of dyslipidemia and 6 (8.45%) had family history of cardiovascular disease. Chest pain was present in 54 (76.05%), dyspnea in 28 (39.43%), sweating in 15 (21.12%) and nausea/vomiting in 8 (11.26%). Palpitation was present in 7 (9.85%), and epigastric pain in 13 (18.30%). Seven (9.85%) gave history of pre-syncope/ syncope and 6 (8.45%) had altered mental status. There was significant correlation of smoking (p=0.02) and types of ACS (p=0.001) with gender. \u0000Conclusion: Acute coronary syndrome were plausibility common in late elderly female. Chest pain was commonest complaint in both genders. Dyspnea, sweating and epigastric pain were also common. Pre-syncope/ syncope and altered mental status were also present in some cases. Conventional risk factors were quite common in both genders. These symptoms can be features acute coronary syndrome in elderly hence should be evaluated cautiously. ","PeriodicalId":52010,"journal":{"name":"Nepalese Heart Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45227093","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}

引用次数: 0