TO CORRELATE ECG CHANGES AND CLINICO-RADIOLOGICAL FINDINGS WITH THE SEVERITY OF VSD.

Author(s):  
Deepak Kumar Uikey ◽  
Ankur Roy

Background & Method: This study was conducted in 56 children in age group of 02 months to 14 years with Echocardio graphically proved Ventricular Septal Defect, over a period of 01 and a half year, after taking consent from the parents and explaining them the purpose and method of this study. Result: Out of these 27 patients in 2 to 6 months age group, 11 were large VSDs, 16 were moderate VSDs and 2 were small VSDs. Out of 17 patients in age group 6 to 12 months, 10 patients were large VSDs, 5 patients had moderate VSDs and 3 patients were with small VSDs. Among patients with moderate VSDs only 4out of 25 patients had signs of right ventricular hypertrophy (16%). Left ventricular hypertrophy was evident clinically in 24 patients out of 25 (96%) & obviously no patients had biventricular hypertrophy. A loud ESM was heard (grade II-IV). Conclusion: Clinical examination can also suggest LVH in moderate VSD & sometimes BVH in large VSD, Palpable P2 and loud P2 are very important findings that suggest pulmonary hypertension. Pansystolic murmur is heard in small-moderate VSD and ESM in large VSD. Complications like CCF, pulmonary hypertension, malnutrition and FTT are mostly present in moderate-large VSD. Chest x-ray suggests cardiomegaly, plethora and also enlargement of PA segment in moderate –large VSD. Keywords: ECG, Clinico-radiological, VSD & Severity. Study Designed: Observational Study.

Author(s):  
Hye-Bin Gwag ◽  
Su-Hyun Lee ◽  
Hyeon-Jun Kim ◽  
June-Soo Kim ◽  
Young-Keun On ◽  
...  

Low QRS voltage (LQRSV) in electrocardiography (ECG) often occurs in limb leads without apparent cause. However, its clinical significance is obscure in healthy populations. We reviewed patients aged over 60 who were scheduled for non-cardiac surgery in two hospitals. Patients underwent pre-operative ECG, echocardiography, pulmonary function test, and chest X-ray. Patients with LQRSV isolated to limb leads and patients without LQRSV were selected from separate hospitals. Among the 9832 patients screened in one hospital, 292 (3.0%) showed LQRSV in limb leads. One-hundred and ninety-four without LQRSV were selected as the control from the 216 patients screened at the other hospital. For primary analysis, patients with structural heart disease or classic etiologies of LQRSV were excluded. Patients with LQRSV had a higher proportion of male and a greater body mass index. Precordial QRS voltages were smaller, whereas left ventricular mass index and the prevalence of echocardiographic left ventricular hypertrophy (LVH) was higher in patients with LQRSV than in those without. Consequentially, diagnostic performance of precordial voltage criteria for LVH was particularly poor in patients with LQRSV in limb leads. LQRSV in limb leads frequently occurs without apparent etiologies. ECG voltage criteria may underestimate LVH in a relatively healthy population with LQRSV in limb leads.


2020 ◽  
Vol 1 (3) ◽  
pp. 32-35
Author(s):  
Muchammad Dzikrul Haq Karimullah ◽  
Hiradipta Ardining

Pulmonary hypertension (PH)has been associated with hemolytic anemia. The prevalence of PH in hemolytic anemia is estimated to be as high as 10-40%, and reportsarepresenting poor prognosis in this subset of patients. PH associated with autoimmune hemolytic anemia (AIHA) is still rarely discussed,and there is paucity of literature regarding its precise pathophysiology and treatment. Here, we describe a case of PH associated with AIHA. A 34-year old woman came to our center with chief complaint of dyspnea on exertion. She was previously diagnosed with AIHA with positive direct Coomb's test. Physical examination, chest X-ray and echocardiography were consistent with pulmonary hypertension. The diagnosis of group 5 pulmonary hypertension was made. Although rare, the association between chronic hemolytic anemia and PH is evident, through several mechanisms involving nitric oxide inactivation, direct injury oftheendothelium, oxidative damage, thromboembolic formation, and left ventricular dysfunction. The management of PH in hemolytic disorders comprises treatment of underlying hemolytic disorder and PH-specific therapies. For PH specific therapy, to date, there are no therapies that have been fully studied for these specific patient population. Our patient was given bisoprolol, furosemide, amlodipine, spironolactone, candesartan, beraprost sodium and sildenafil. On follow up twomonths later, her functional status was improved. In summary, PH associated with AIHA develop via multifactorial and complex mechanisms. PH in AIHA could be detected with meticulous history taking, physical examination, chest X-ray and echocardiography, and treatment with vasodilating agents were shown to improve the PH.


1970 ◽  
Vol 2 (2) ◽  
pp. 223-226
Author(s):  
WA Jahan ◽  
A Azam ◽  
M Rahman ◽  
N Meah ◽  
AY Meah ◽  
...  

Background: The non-invasive tests like X-ray, ECG and Echocardiography are viewed as an extension of clinical art in cardiology and have become an integral part of history taking, physical examination and other diagnostic method. Atrial Septal Defect (ASD) of secundum type is defined as a through and through communication at atrial level. Previously the diagnosis and decision of surgery for ASD, mandatorily advocate cardiac catherization. Now cardiologist and cardiac surgeon very hardly asked for cardiac catheterization. Non-invasive diagnosis with the help of ECG, X-ray and Echo is sufficient for its diagnosis and treatment for surgery. In Bangladesh there is no study upon it. Considering this ground the study is perform on Bangladeshi patients.Methods: Forty six consecutive patients with clinical (auscultatory and electrocardiographic) signs of uncomplicated atrial septal defect of secundum type were examined by chest x-ray, ECG and echocardiography, before right heart catheterisation.Result: Thirty four (74%) had ASD, four patients (9%) had insignificant pulmonary stenosis, and eight subjects (17%) were normal. No false positive diagnosis of atrial septal defect was made by chest x-ray examination, whereas increased vascular markings were incorrectly interpreted as pulmonary congestion in one case. Eight patients had x-ray films showing questionable signs of left-to-right shunt. Twelve of 30 patients with a large left-to-right shunt were correctly selected for surgery based on radiological findings. Conclusion: Analysis of non invasive diagnosis and management of ASD secundum conform the usually described pattern in western literature. Keywords: Atrial Septal Defect; Cardiac Imaging DOI: 10.3329/cardio.v2i2.6645Cardiovasc. j. 2010; 2(2) : 223-226


2020 ◽  
Vol 8 (2) ◽  
pp. 65-72
Author(s):  
Priyal Chouhan ◽  
Pranav Kumar Dave ◽  
Monika Puranik ◽  
Krati Khandelwal ◽  
Vivek Gupta ◽  
...  

–PCR. Portable chest radiography is the first imaging modality that can be used to detect lung abnormalities and get follow up when required. Radiological findings observed in various CXR are ground-glass opacity/haziness, Consolidations, Peripheral air space opacities, diffuse air space involvement, and uncommon findings – pleural effusion, cavitation, pneumothorax, subcutaneous emphysema and pneumomediastinum. Use of Portable CXR is helpful to avoid transport of patients to CT room and subsequently avoid frequent decontamination of the CT room. Portable CXR is of much value where CT facility is not available and its use reduces radiation dose to patients and radiation staff. The objective is to analyze chest X-ray findings in proven cases of COVID -19 as per classification of British Society of Thoracic Imaging (BSTI) in the form of various radiological patterns and severity assessment. Subjects and Methods: This is a retrospective study of chest x-ray of COVID-19 positive patients, confirmed by RT-PCR and was admitted to designate COVID center: LNMC and JK Hospital, Bhopal in the duration of 31 July 2020 to 31 Aug 2020. Chest X-ray of 739 patients was studied and the mean age group was calculated. Lung involvement and pattern of distribution of disease were analyzed and classified according to BSTI classification and documented in frequencies and percentages. Results: In our retrospective analysis of a total of 739 CXR of which the number of males was 457 (61.84% ) and the number of females was 282 (38.16%). The average age group was ranging from 0 (1month) year age to 90 years age with the mean age group of 41 to 50 (20.2%). The mean age of the patients was 40.5 years. 393 (53.1%) patients have normal chest radiographs. Conclusion:The radiological findings in patients with COVID-19 infection varies with the severity of the disease. In the early phase of the disease, CXR was normal. The most common findings are basal / lower lobe consolidation more on right, followed by ground glass densities, peripheral air space densities, diffuse airspace disease. Basal / lower lobe consolidation was the usual findings in the mild category. In the moderate category, a variable pattern of all findings was seen. In the severe category of disease, diffuse air space densities and peripheral air space opacities were seen. Pleural effusion is the least seen.


2020 ◽  
pp. 76-78
Author(s):  
Dharmendra Prasad ◽  
Mahendra Kumar ◽  
Raj Kumar Deepak ◽  
Sumit Kumar ◽  
Debarshi Jana

Background: Heart failure (HF) is a common cardiovascular condition whose prevalence and incidence is increasing in the recentpast. Multiple risk factors involved in its genesis makes it more complex in the prevention and management. Objective: The present study aimed to assess the clinical profile of the patients suffering with heart failure. Methods: Prospective observational study was undertaken among the patients admitted in the Medical unit of Govt. Medical College and Hospital, Bettiah during October 2018 and September 2019. Patients fulfilling EuropeanSociety of Cardiology (ESC) criteria of HF were included in the study. Prevalence of congestive HF was estimated based on community study and hospital OPD. Results: Smoking, alcoholism, ischemic heart disease and hypertension were the leading risk factors in developing HF. Breathlessness(100%), swelling of the feet (92.3%), cough (57.7%) and palpitation (50%) were the most common symptoms observed inthe patients. Oedema feet (100%), basal crepitations (80.3%), raised Jugular Venous Distention (JVD) (57.7%) and S3 (57.7%)were the leading signs in the patients. Chest X-ray (CXR) findings indicate that 76.9% of the patients reported with increasedCardiothoracic ratio. Arrhythmias (predominantly AF-19.2%) and Left Ventricular Hypertrophy (LVH) accounted for 26.9% each. The prevalence of HF was estimated to be in between 0.51 to 27.27 respectively.


2017 ◽  
Vol 2 (2) ◽  
pp. 69-74
Author(s):  
Mohammad Aminullah ◽  
Fahmida Akter Rima ◽  
Asraful Hoque ◽  
Mokhlesur Rahman Sazal ◽  
Prodip Biswas ◽  
...  

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74


2017 ◽  
Vol 1 (3) ◽  
pp. 10-16
Author(s):  
Prakashkumar Kyada ◽  
Kunal Jadhav ◽  
T. K. Biswas ◽  
Varshil Mehta ◽  
Sojib Bin Zaman

Objective: Hypertension is one of the common risk factors for cardiovascular and cerebrovascular diseases/disorders A developing country like India faces the double burden of communicable and non-communicable diseases; of the which, hypertension is the most important treatable cause of mortality and morbidity with loss of functional capacity and decline in the quality of life. Aim: To study the prevalence of end organ damage in the hypertensive geriatric age group. Method: The present study was a cross sectional study, conducted in 150 elderly patients admitted in MGM Hospital, Navi Mumbai, India with the diagnosis of stage I or II hypertension from 2011 to 2013. Results: Data analysis of the present study showed that 68% of elderly population aged between 60 to 69 years were suffering from hypertension. Compared to males, females had a higher rate of target organ damage. This study found that out of all patients with total end organ damage, 54.6 % had CVS complications, 15.7 % had hypertensive retinopathy, 25.9 % and 18.51 had raised creatinine and proteinuria respectively. 19.4 % had cerebrovascular accident (CVA) complications. Among Cardiovascular related complications Coronary artery disease (CAD) was found in 21 patients, out of them 7 had Congestive cardiac Failure (CCF). Left Ventricular Hypertrophy (LVH) was the most common complication and seen in 38 patients. 13.8 % patients had Regional Wall Motion Abnormality (RWMA) Conclusion: The present study concluded that Isolated Systolic Hypertension (ISH) is the commonest type of hypertension in geriatric age group. This study concluded that the most common risk factors of HTN in the elderly are sedentary life style, dyslipidemia and extra salt intake while the most common end organ damage was observed to be Left Ventricular Hypertrophy followed by renal dysfunction. Keywords:  Hypertension,  Isolated Systolic Hypertension, Dyslipidemia.


2018 ◽  
Vol 13 (4) ◽  
pp. 241-246 ◽  
Author(s):  
Saif Aldeen AlRyalat ◽  
Mohammad Al-Essa ◽  
Rawan Ghazal ◽  
Enas Abusalim ◽  
Dia Mobaideen ◽  
...  

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 859-860
Author(s):  
David H. Baker ◽  
Walter E. Berdon

In reference to the article by Sane et al. entitled "Value of Preoperative Chest X-ray Examinations in Children" (Pediatrics 60:669, November 1977), we would like to know if the authors broke down the abnormalities by age group—for instance, five-year segments. If so, did a preponderance of abnormalities of any variety occur at any particular age? We believe that should be stated, as it would strengthen their thesis if there was no difference between 0 and 19 years of age.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ekaterina Borodulina ◽  
Alexander M Shutov

Abstract Background and Aims An important predictor of cardiovascular mortality and morbidity in hemodialysis patients is left ventricular hypertrophy. Also, pulmonary hypertension is a risk factor for mortality and cardiovascular events in hemodialysis patients. The aim of this study was to investigate cardiac remodeling and the dynamics of pulmonary arterial pressure during a year-long hemodialysis treatment and to evaluate relationship between pulmonary arterial pressure and blood flow in arteriovenous fistula. Method Hemodialysis patients (n=88; 42 males, 46 females, mean age was 51.7±13.0 years) were studied. Echocardiography and Doppler echocardiography were performed in the beginning of hemodialysis treatment and after a year. Echocardiographic evaluation was carried out on the day after dialysis. Left ventricular mass index (LVMI) was calculated. Left ventricular ejection fraction (LVEF) was measured by the echocardiographic Simpson method. Arteriovenous fistula flow was determined by Doppler echocardiography. Pulmonary hypertension was diagnosed according to criteria of Guidelines for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology. Results Pulmonary hypertension was diagnosed in 47 (53.4%) patients. Left ventricular hypertrophy was revealed in 71 (80.7%) patients. Only 2 (2.3%) patients had LVEF<50%. At the beginning of hemodialysis correlation was detected between systolic pulmonary arterial pressure and LVMI (r=0.52; P<0.001). Systolic pulmonary arterial pressure negatively correlated with left ventricular ejection fraction (r=-0.20; P=0.04). After a year of hemodialysis treatment LVMI decreased from 140.49±42.95 to 123.25±39.27 g/m2 (р=0.006) mainly due to a decrease in left ventricular end-diastolic dimension (from 50.23±6.48 to 45.13±5.24 mm, p=0.04) and systolic pulmonary arterial pressure decreased from 44.83±14.53 to 39.14±10.29 mmHg (р=0.002). Correlation wasn’t found between systolic pulmonary arterial pressure and arteriovenous fistula flow (r=0.17; p=0.4). Conclusion Pulmonary hypertension was diagnosed in half of patients at the beginning of hemodialysis treatment. Pulmonary hypertension in hemodialysis patients was associated with left ventricular hypertrophy, systolic left ventricular dysfunction. After a year-long hemodialysis treatment, a regress in left ventricular hypertrophy and a partial decrease in pulmonary arterial pressure were observed. There wasn’t correlation between arteriovenous fistula flow and systolic pulmonary arterial pressure.


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