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Biomedical subjects

A K Kar

Publications and source records attributed to A K Kar.

At least 19 recordsLinked to original sources
PubMed1994

Ventricular late potentials after thrombolysis.

High frequency low amplitude signals that prolong the terminal portion of the QRS complex in the electrocardiogram are termed late potentials (LPs). It has been established for quite some time that the presence of LPs after acute myocardial infarction (AMI) is associated with an increased risk of ventricular tachyarrythmias and sudden cardiac death (SCD), and vice versa. It is also known that thrombolytic therapy after AMI significantly decreased the incidence of ventricular tachyarrythmias and SCD. The object of this study was to find out whether thrombolysis in AMI decreased the incidence of LPs. Fifty two male patients of the age group 41-46 years with first anterior wall AMI were studied. Thirty of them presented within 6 hours of chest pain and were given intravenous streptokinase (IVSK) in addition to conventional therapy. The remaining 22 received conventional therapy but no thrombolysis. There was no significant difference in these two groups regarding age, CKMB, hypertension, diabetes, smoking, prior use of beta blockers, and ejection fraction. Eight out of the 30 patients receiving IVSK were positive for LPs as against 13 out of the 22 in the control group. This difference was statistically significant (p > 0.02 < 0.01). Thus thrombolysis in the early hours of anterior AMI diminishes the incidence of LPs.

Adult↗
PubMed1993

Aortic regurgitation in hypertrophic cardiomyopathy.

Aortic regurgitation (AR) has been sparsely reported in Hypertrophic Cardiomyopathy (HCM) but neither its frequency nor severity has been determined. 30 patients of HCM were evaluated both by Echocardiography as well as by Cardiac Catheterisation and angiography over a 2 year period. Most of them had echocardiographically normal aortic cusps. Patients were divided into 2 groups, those with AR (Group-I) and those without AR (Group-II). Group-I patients (10 patients) were significantly older than group-II (51 +/- 4 years vs 38 +/- 3 years, p < 0.001) and had larger end-diastolic dimension (EDD) (5 +/- 0.5 vs 2.5 +/- 0.4 cms p < 0.001) and end-systolic dimension (ESD) (3.2 +/- 0.3 vs 2.7 +/- 0.4 cms p < 0.05) of Left ventricle (LV) in Echo. LC Wall thickness, and LV asymmetric septal hypertrophy (ASH) and fractional shortening (FS) were similar in the 2 groups. Mitral regurgitation (MR) was more common in Group-I (100% vs 45% p < 0.001) although there was no difference in left atrial (LA) size between the two groups. The HCM patients were compared with a control group of 20 normal subjects. None of them (Normal) had any AR murmur or Doppler or angiography proved AR. Thus nearly 1/3rd of patients with HCM had mild AR by Doppler or aortic root angio and about 10% of HCM patients also had aortic early diastolic murmur. The AR most probably results from high velocity systolic blood flow causing microscopic or macroscopic damage to the valve cusps.

Adult↗
PubMed1992

Cardiac involvement in non-specific aorto-arteritis.

Cardiac involvement in 75 cases (mean age 21.1 +/- 6 years) with non-specific aorto-arteritis was studied. Detailed clinical examination, echocardiography and cardiac catheterization, including angiography, were done in all the cases, as was coronary angiography. Features of cardiac failure like sinus tachycardia, cardiomegaly, left ventricular third heart sound gallop and pulmonary congestion were detected in 27 cases with reduction of left ventricular ejection fraction (25-48%). Systemic hypertension was seen in 60 cases. Central aortic pressure, left ventricular systolic pressure and left ventricular end-diastolic pressure were increased in 66 cases. Pulmonary hypertension and increased pulmonary vascular resistance were detected in 6 cases. Aortic and mitral regurgitation were seen in 15 and 12 cases, respectively. Three patients had features of dilated cardiomyopathy such as generalized cardiomegaly, systemic and pulmonary congestion but without any cardiac murmurs and with normal central aortic pressure. The coronary angiogram revealed obstruction of the left anterior descending artery in 3 cases and right coronary artery obstruction in another 3 cases. Histopathological studies revealed non-specific inflammatory changes with fibrosis in cardiac musculature and the great vessels.

Adolescent↗
PubMed1991

Early experience with percutaneous transluminal coronary angioplasty in unstable angina.

Percutaneous transluminal coronary angioplasty was done in 13 of 105 patients with unstable angina, 10 of whom were males. Diagnostic coronary angiography revealed single vessel disease in 10 cases and two vessel disease in 3 cases; the degree of stenosis varied from 70-90%. Only a single major coronary artery was dilated. Immediate angiographic success was achieved in 12(92.3%) cases. The success rate at the time of discharge from hospital was 10 (76.9%) cases. Immediate complications encountered were acute myocardial infarction in 2 cases, they refused coronary artery bypass grafting and unsuccessful dilation in 1 case. No death occurred during the hospital stay. During follow-up of 6-9 months, 8 patients were symptom free (66.6%), 2 patients required repeat percutaneous transluminal coronary angioplasty and 2 patients died. In conclusion, percutaneous transluminal coronary angioplasty may be undertaken relatively safely in unstable angina, it leads to substantial improvement in symptoms during the early follow-up period. This therapeutic approach is highly beneficial particularly in single vessel disease.

Adult↗
PubMed1991

Cardiac changes implicated in chronic heart block.

Fifteen cases of chronic heart block were studied. Eight of them could be designated as idiopathic or primary heart block; the others were associated with hypertension, diabetes and ischaemic heart disease, either singly or in various combinations. In six cases, the whole heart was available for histopathological study of the conduction system. In the other 9 cases, only a portion of the heart muscle was available for examination. A V nodal fibrosis extending upto the proximal bundle of His was seen in all the six whole heart autopsy materials. Fibrosis of the adjacent myocardium was seen in five cases. In three cases, conducting system fibrosis was associated with atherosclerotic (1 case) or diabetic changes (3 cases) of the intramural vessels. In the 9 partial autopsy studies, myocardial fibrosis was seen in two cases, diabetic microangiopathy in one and atherosclerotic changes in two including an old thrombus in one. Thus, diabetic microangiopathy was seen in total four cases. These changes may be responsible for the cardiomegaly and cardiac failure associated with conduction defects observed in diabetes. In the idiopathic group also, heart block could be considered as a significant facet of a primary myocardial degenerative process.

Chronic Disease↗
PubMedDate not supplied

Low dose amiodarone in refractory tachyarrhythmias.

Fifty patients with drug resistant tachyarrhythmias were treated with amiodarone for 6-22 months; 16 for recurrent ventricular tachycardia (VT), 2 for VT followed by ventricular fibrillation (VF), 14 for complex ventricular ectopics, and 18 for supraventricular tachyarrhythmias (SVT). Amiodarone was administered in a dose much lower than that used in western trials. The actual incidence of successful amiodarone therapy was 81.2% at 22 months for patients with VT. Among the patients with SVT, 88.6% patients were successfully treated for 22 months (range 3-22 months). Amiodarone toxicity appeared in 22 of 50 patients (44%) treated for more than 12 weeks. Withdrawal of therapy was required in 4 patients. Despite the lower dose, clinical efficacy and onset of action were comparable to the western experience.

Adolescent↗