scholarly journals Clinical Outcome of Ventricular Septal Rupture Complicating Acute Myocardial Infarction – A Single Centre Retrospective Study

2021 ◽  
pp. 197-203
Author(s):  
Jayanty Venkata Balasubramaniyan ◽  
Ravanasamudram Hariharan Lakshmi ◽  
Harsimran Singh ◽  
J. S. Sathyanarayana Murthy ◽  
Vaishnavi Chandrakumar
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Retrospective Study ◽  
Tertiary Care ◽  
Early Mortality ◽  
High Rate ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Tertiary Care Centre ◽  
History Of

Objective: Ventricular Septal Rupture (VSR) following Acute Myocardial Infarction (AMI) is a fatal mechanical complication with high incidence of mortality. The aim of this study is to explore the clinical outcomes and to identify the factors related to early mortality in patients with VSR after AMI. Materials and Methods: This was a retrospective study and we collected clinical data of 21 adult patients with VSR following AMI from April 2012 and October 2020 who got admitted at our tertiary care centre. The patients were classified into two groups. The first group consisted of patients who died within two weeks from the diagnosis of VSR following AMI and the second group comprised of patients who survived more than two weeks after VSR. Results: A total of 21 patients (mean age of 66.19±9.47 years) were enrolled in this study. The most common MI was Anterior MI (71.4%) and the location of VSR was predominantly in the anterior and apical septum (76.2%). The overall early mortality was 85.9% (n=18). 80.95% (n=17) of patients died within two weeks of diagnosis of AMI. Of the 4 patients who survived more than two weeks, three patients survived. The operative mortality in our study was 47%. Conclusion: The prognosis for VSR in AMI remains poor. Renal failure is accompanied with high rate of early mortality in patients with VSR complicating AMI. History of smoking is associated with poor outcome.

scholarly journals Study of caesarean section at tertiary care centre: a retrospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2138
Author(s):  
Varsha Kose ◽  
Kumari Sadhvi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Audit And Feedback ◽  
Research Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Failure Of Induction

Background: Caesarean section (C-section) is one of the most widely performed surgical procedure in obstetrics worldwide. The WHO guidelines revised in 1994 states that the proportion of C-section birth should range between 5-15% but both in developed and developing countries C-section rate is on the rise. This study was conducted to analyse the frequency and indications for C-section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period from January 2018 to May 2019 at the department of obstetrics and gynecology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India. Data of patients who delivered by C-section in our hospital during the defined study period were studied and statistically analysed according to various parameters namely, the frequency of caesarean section, its indications, age, parity and gestational age of the patient.Results: The total number of women delivered over the study period were 2811. Out of which C-sections were done in 1461 women (51.97%). Previous C-section was the leading indication in 35.72% women followed by fetal distress 14.09%, failure of induction 12.93%, arrest of labour 7.93%, PIH 7.18%, oligo/IUGR 6.50%, breech 4.44%, refusal of vaginal birth 4.24%, CPD 1.71%, bad obstetrics history (BOH) 1.43%, malpresentation 1.30%, prematurity 1.23%,  and multifetal gestation in 1.09% women. Two women had classical C-section 0.07. 14.09% women had various complications. There was no maternal mortality.Conclusions: A high rate of caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines can help us to limit C-section. Audit and feedback are the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup.

scholarly journals Clinical profile of acute myocardial infarction patients: a study in tertiary care centre

2015 ◽  
Vol 3 (2) ◽  
pp. 412 ◽  
Author(s):  
Nagabhushana Seetharama ◽  
Ranganatha Mahalingappa ◽  
Ranjith GK ◽  
Virupakshappa Veerappa ◽  
Aravindh CL
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Ventricular Septal Rupture following Anterior Acute Myocardial Infarction: A Challenge to a Sub-District Physician

2021 ◽  
Vol 7 (1) ◽  
pp. 48-53
Author(s):  
Aditya Doni Pradana ◽  
Jarot Widodo
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Rare Complication ◽  
Hemodynamic Instability ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Anterior Myocardial Infarction ◽  
Mortality And Morbidity ◽  
Mechanical Complications ◽  
Resource Setting

Background: Ventricular septal rupture (VSR) is one of the most serious mechanical complications following acute myocardial infarction (AMI). Although a rare complication, it is associated with significant mortality and morbidity. The purpose of this report was to present a case of VSR following anterior AMI in our hospital. Case Description: A 54-year old Javanese male presented persistent episode of breathlessness and lower limb swelling for the last two days with prior chest pain 7 days ago. Physical examination revealed a grade 3/6 holosystolic murmer loudest over the apex, S3 gallop, rales bibasally of the lung. Electrocardiographic evidence revealed for a recent anterior myocardial infarction. Chest X-Ray showed a cardiomegaly and pulmonary congestion. Transthoracic echocardiography revealed VSR at mid-anteroseptal with estimated length of 8-10 mm, preserved LVEF 51% with mid-apicoseptal akinesis. Multiple readmissions were noted for this patient in the follow-up with worsened conditions. Discussion: This is a challenging case report since our hospital is an incapable cath-lab sub-district hospital and far from PCI-capable center. It is critical that all patients with AMI have a brief evaluation for mechanical complications such as VSR. All patients who developed hemodynamic instability during AMI should be comprehensively examined for the murmur and any other heart sound that may provide valuable information. Conclusion: Every clinician especially in the low-resource setting should be aware of this potentially fatal mechanical complication as the mortality remains significantly high. Early prompt diagnosis and treatment is the key of achieving an optimal outcome.

scholarly journals The Clinical Outcomes of Ventricular Septal Rupture Secondary to Acute Myocardial Infarction: A Retrospective, Observational Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Xin-Ying Zhang ◽  
Li-Zhao Bian ◽  
Nai-Liang Tian
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Revascularization ◽  
Serum Glucose ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Logistic Regression Models ◽  
Wbc Count ◽  
Risk Predictors ◽  
Large Infarct

Background. Ventricular septal rupture (VSR) is a severe mechanical complication secondary to acute myocardial infarction (AMI) with a dreadful prognosis. The goal of our study was to evaluate the mortality and to identify the predictors of mortality for this population. Methods. From June 2012 to July 2021, patients with VSR secondary to AMI were initially screened for eligibility in this study. The potential risk predictors were determined using appropriate logistic regression models. Results. In this retrospective study, a total of 50 cases were included, and 14 patients survived and got discharged successfully. Univariable analyses indicated that the heart rate (HR), white blood cell (WBC) count, neutrophils count, serum glucose, serum creatinine, serum lactic acid, and the closure of rupture were significantly associated with mortality among these special populations. Conclusion. This study found that such high mortality in patients with VSR after AMI was significantly correlated with these risk factors representing sympathetic excitation and large infarct size. Coronary revascularization combined with the closure of rupture might be helpful in improving their prognosis.

scholarly journals Pulmonary artery banding for initial treatment of ventricular septal rupture

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Yuta Koichi ◽  
Hiroto Kitahara ◽  
Naohiro Wakabayashi ◽  
Hayato Ise ◽  
Chiharu Tanaka ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Pulmonary Artery ◽  
Surgical Repair ◽  
Pulmonary Artery Banding ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Transcatheter Intervention ◽  
Flow Through

Abstract Ventricular septal rupture (VSR) is a serious and fatal mechanical complication after acute myocardial infarction. Emergent or urgent, surgical/transcatheter intervention is necessary to treat VSR, though the outcome is not favorable. We performed temporary pulmonary artery banding (PAB) in an 85-year-old man who presented with chest pain to adjust the shunt flow through the VSR, which prevented further pulmonary edema and delayed the timing of surgical repair. There has been no report showing successful PAB performed for VSR after myocardial infarction.

NASOPHARYNGEAL CARCINOMA: A CHANGING TREND IN EPIDEMIOLOGY ,INCIDENCE RATE AND TREATMENT PROSPECTS IN TERTIARY CARE HOSPITAL

2021 ◽  
pp. 37-39
Author(s):  
Nabajyoti Saikia ◽  
Priyanka Agarwal ◽  
Shilpi Gupta
Keyword(s):  
Retrospective Study ◽  
Nasopharyngeal Carcinoma ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Endoscopic Biopsy ◽  
High Rate ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Ajcc Staging

Introduction: Nasopharyngeal carcinoma is a rare disease all over the world. It has often been less evaluated, misdiagnosed, partially treated and above all has poor prognosis with high rate of recurrence. This study is a retrospective study which shows an increase in the incidence of Nasopharyngeal carcinoma in the upper- Assam region of India. There has been an upsurge in the number of cases reporting to Department of Otolaryngology and Head and Neck Surgery in Tertiary Care Centre, Assam, India. Methods: This is a retrospective study of eight cases reporting in a tertiary care centre In a span of 6months (Jan 19'- Jun 19').Detailed history and clinical examination of each case was done. Diagnosis conrmed with nasal endoscopic biopsy .Staging of all the cases were done with CT scan and MRI . A total of eight cases were included in study which reported in our department Results: in 6 months period.6 were male (75%) and 2 females (25%).AJCC staging of study group was Stage I- 1 patient ,Stage II-2patient,Stage III-2patient and StageIV-3patient. Increasing rate Conclusion: of Nasopharyngeal carcinoma in upper Assam region is alarming and cases should be properly evaluated and investigated as the available treatment is rewarding

scholarly journals Ventricular Septal Rupture after Acute Coronary Syndrome

2019 ◽  
Vol 4 (10) ◽  
Author(s):  
Pedro Rafael de Oliveira Nascimento ◽  
Gustavo Henrique Belarmino Góes ◽  
Caroline Bernardi Fabro ◽  
Mateus Lopes Barreto de Sousa ◽  
Diana Patricia Lamprea Sepulveda ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Emergency Room ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
Early Therapy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Objective: Ventricular septal rupture (VSR) is a rare but serious complication of acute myocardial infarction, which occurs in about 0.2 to 0.3% of patients with myocardial ischemia. If early therapy is not initiated, 90% of patients with VSR will die within the first month. This study aimed to evaluate the epidemiological and clinical characteristics of patients with VSR as a mechanical complication of acute myocardial infarction. Methods: A prospective study was conducted among nine patients who presented to the Cardiovascular Emergency Room of Pernambuco with acute coronary syndrome with ST segment elevation and VSR complications. Results: There were five women and 4 men, and the mean age of the patients was 72.5 years. The median time from the onset of the symptoms of acute coronary syndrome with ST segment elevation to the diagnosis of VSR was 3.5 days. Among the nine patients included in the study, three were treated surgically. Of all the patients, including those who underwent corrective surgery, eight patients died, 44.4% (N = 4), in the first four days after AMI. Conclusion: VSR occurs more frequently among elderly patients with multi-arterial involvement, lower wall infarction, and involvement of the right coronary artery. The prognosis is extremely limited, especially in patients who are already admitted to the cardiac emergency room with Killip IV, with > 24 hours of clinical evolution, and do not require surgical correction.

scholarly journals Drug prescribing pattern in patients of myocardial infarction in a tertiary care teaching hospital of North India

2020 ◽  
Vol 9 (9) ◽  
pp. 1357
Author(s):  
Akanksha Mehra ◽  
Nusrat K. Bhat ◽  
Sushil K. Sharma ◽  
Kanika Khajuria
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Family History ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Tertiary Care ◽  
North India ◽  
Drug Prescribing ◽  
Prescribing Pattern ◽  
History Of

Background: The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischemia. Aims of this study were to assess drug prescribing pattern in patients of myocardial infarction and to compare prevalence of MI according to age, gender, diet, smoker or non-smoker, alcoholic or non-alcoholic, family history of cardiovascular disease.Methods: This observational study was conducted at department of pharmacology, in association with department of cardiology and included all patients of myocardial infarction visiting cardiology outpatient department or indoor patients and proforma was used to evaluate drug prescribing pattern.Results: Total 200 patients of acute myocardial infarction were analysed. Incidence of MI was more common in males (76%); age group 51-60 years (28.5%); non-vegetarians (68.5%); smokers (52.5%) and reduced physical activity (70.5%). 59.5% of patients had family history of cardiovascular disease. Commonly prescribed drugs were antiplatelets (100%) followed by hypolipidemic (99.5%), proton pump inhibitors (92%), antianginal (90.5%), anticoagulants (68.5%), thrombolytics (24.5%).Conclusions: This study provides insight towards drug prescribing pattern in MI patients. Most frequently prescribed drugs were antiplatelets followed by hypolipidemic and proton pump inhibitors. Patients had multiple risk factors and these can be reduced by lifestyle modifications.

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