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M Khalilullah

Publications and source records attributed to M Khalilullah.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Detection, frequency and clinical significance of silent myocardial ischaemia in patients with chronic stable angina.

Forty-two patients (mean age 50 years) with chronic stable angina pectoris were subjected to exercise treadmill testing, coronary arteriography and left ventricular cineangiography. Twenty-one of these patients also underwent Holter monitoring for 24 hours. On exercise treadmill testing, angina was the endpoint in 24 (57%), while 18 (43%) developed significant ST segment depression without symptoms. Holter monitoring in 27 patients revealed a total of 248 episodes of myocardial ischaemia of which 210 (84%) were asymptomatic. ST segment depression at 80 mS from J point varied from 1 to 4 mm, and the average duration of ischaemic episodes during Holter monitoring was 9 minutes (range 30 seconds to 1 hour). Heart rate during the ischaemic episodes varied between 65-85 beats/minute. Coronary angiography revealed triple vessel disease in 22 (52%) and double vessel and single vessel involvement in 10 (24%) each. Left ventricular ejection fraction was less than 50% in only 3 (7%) patients. Thus silent myocardial ischaemia is detected frequently in patients with angina pectoris. It occurs during routine daily activity, and on exercise. Heart rate at which silent myocardial ischaemia occurs is much less during daily activity as compared to exercise induced ischaemia. All patients who were detected to have silent myocardial ischaemia had significant coronary artery disease. These findings are of prognostic and therapeutic value.

Angina Pectoris↗
PubMedDate not supplied

Coronary angioplasty of 'complex lesions' in patients with unstable angina.

Out of 55 patients subjected to coronary angioplasty over the past 12 months, there were 33 (60%) who had unstable angina. Amongst these, 22 patients had coronary lesions classified as 'complex' on coronary angiography. These included tandem lesions, branch stenoses, distal lesions, total occlusions, vein graft stenoses, lesions with ulceration and intraluminal clot and associated with valvular lesions. We describe our experience of coronary angioplasty in these 22 patients of unstable angina having 'complex lesions'. All were males with a mean age of 48.7 +/- 13 years. Fourteen patients had single vessel and 8 multivessel disease. A total of 35 lesions were subjected to dilatation. The angiographic primary success was achieved in 85.7% of the lesions attempted. Except total occlusions and very distal lesions, all other types of 'complex lesions' could be dilated with a success rate of greater than 75%. There were 4 (11.4%) failures because of inability to cross the lesion with the guidewire or balloon catheter. One patient developed non-Q wave inferior wall infarction. There were no deaths. We conclude that coronary angioplasty of various types of 'complex lesions' can be performed with a good primary success and negligible complications in our setting.

Adult↗