About
134
Publications
25,277
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
443
Citations
Introduction
Justin Paul Gnanaraj currently works as a Professor and Unit Head at the Institute of Cardiology, Madras Medical college, Tamil Nadu Dr. M.G.R. Medical University. Justin does research in Cardiology.
Current institution
Publications
Publications (134)
Background & objectives
Timely reperfusion reduces mortality in ST-segment elevation myocardial infarction (STEMI). Telemedicine and social media have been shown to improve STEMI care in community settings as reported previously. We established a government-sponsored STEMI care system in the State of Tamil Nadu with a goal of enhancing guideline-di...
Background
Early revascularization in ST segment elevation myocardial infarction(STEMI) by Primary Percutaneous coronary Intervention (PPCI) or fibrinolysis, reduces mortality. In the absence of a well-functioning STEMI care system, patients may not get guideline directed revascularisation (GDR).
Objective
We sought to determine the prevalent mode...
Background
Timely reperfusion reduces mortality in ST segment Elevation Myocardial infarction (STEMI). Telemedicine and social media have been variably used to improve STEMI care in community settings. We established a new care system for STEMI in a public health setting serving a population of over 80 million, in a state with from a developing nat...
Background
Even though many risk assessment tools in pregnant women with valvular heart disease (VHD) are available, validation studies are few that assess their performance in diverse settings, which is needed prior to the application of routine clinical practice.
Objectives
To validate and establish the clinical utility of two risk stratificatio...
Background
Pregnancy outcomes in women with pulmonary hypertension remain suboptimal. Pregnant women with pulmonary hypertension (PH) are placed in the modified WHO category IV, regardless of the severity or etiology of PH. Earlier studies have indicated that pregnancy outcomes may differ based on the etiology, with more favourable outcomes observe...
Background
Acute pulmonary embolism (APE) is the third most common cause of vascular death. Data on APE from India and other low-and middle-income countries is sparse.
Objectives
Study the clinical characteristics, prognostic factors, in-hospital mortality (IMH) and 12 months mortality of patients with APE in India.
Methods
We prospectively enrol...
Cardiovascular disease complicates 1–4% of pregnancies. Women with heart disease going through pregnancy are on the increase. While global maternal deaths during pregnancy are decreasing, India remains a significant contributor to maternal deaths in the world. Cardiovascular disease during pregnancy is the leading cause of maternal mortality in dev...
Background
Women with heart disease undergoing pregnancy is on the increase, along with an increasing cardiac contribution to maternal mortality.
Aim
To identify the proposition of pregnant women with heart disease, who develop heart failure as a complication and to identify the predictors of heart failure in pregnancy
Methods
The Madras medical...
Background
Incidence of premature cardiovascular deaths in medical practitioners is on the increase. Lifestyle habits, psychosocial and emotional status of medical students has the potential to initiate the premature onset of cardiovascular disease. Gender differences in diagnosis and management of cardiovascular diseases is well known. However, da...
Background
Incidence of premature cardiovascular (CV) deaths in medical practitioners is increasing. Stress and emotional status have the potential to initiate premature CV disease. Rigors of medical course can worsen the stress and emotional wellbeing of medical students(MS), particularly as they move from preclinical to clinical years.
Purpose
T...
Introduction
The ruptured sinus of valsalva aneurysm (RSOV) portends an important cause for acute heart failure. Closure of the defect either percutaneously or surgically is of paramount importance. We report 38 cases of RSOV who presented with cardiac failure, among which 22 cases were selected and amenable for transcatheter closure.Transcatheter...
Background: Heart failure (HF) is a debilitating condition associated with enormous public health burden. Management of HF is complex as it requires care-coordination with different cadres of health care providers. We propose to develop a team based collaborative care model (CCM), facilitated by trained nurses, for management of HF with the support...
A Missed Opportunity! We were interested in the paper by Qamar et al 1 and appreciated their contribution of new observational data to the field. However, there are several points of concern that need to be addressed. First, despite 64% and 78% of ST-segment elevation myocardial infarction (STEMI) patients arriving within 1 and 3 hours of symptom o...
Background: Heart failure (HF) is a debilitating condition associated with enormous public health burden. Management of HF is complex as it requires care and coordination with different cadres of health care providers. In resource poor settings, physician driven initiatives to improve HF management is difficult due to multiple barriers. We propose...
Abstract
Aims
To evaluate the feto-maternal outcome, identify the adverse outcome predictors and test the applicability of modified WHO (mWHO) classification in pregnant women with heart disease (PWWHD) from Tamil Nadu, India.
Methods and results
One thousand and five pregnant women (mean age: 26.04 ± 4.2) with 1029 consecutive pregnancies were p...
Adverse cardiac remodeling refers to progressive structural and functional modifications in the heart because of increased wall stress in the myocardium, loss of viable myocardium, and neurohormonal stimulation. The guideline-directed medical therapy for Heart failure (HF) includes Angiotensin receptor-neprilysin inhibitor (ARNI) (sacubitril/valsar...
Objectives:
Patients with ST elevation myocardial infarction (STEMI) without standard modifiable cardiovascular risk factors (SMuRFs; dyslipidaemia, hypertension, diabetes mellitus and smoking) are reported to have a worse clinical outcome compared to those with SMuRFs. However, robust prospective data and low-and middle-income country perspective...
Iron deficiency (ID) with or without anemia is frequently observed in patients with heart failure (HF). Uncorrected ID is associated with higher hospitalization and mortality in patients with acute HF (AHF) and chronic HF (CHF). Hence, in addition to chronic renal insufficiency, anemia, and diabetes, ID appears as a novel comorbidity and a treatmen...
Background
Acute Pulmonary embolism the third most common cause of cardiovascular death in the world. Despite the large burden of acute pulmonary embolism, there is a paucity of prospective data from low-and middle-income countries.
Purpose
To study the clinical characteristics, treatment strategies employed, in-hospital outcome, one-year follow u...
Introduction
Congenital heart disease (CHD) is becoming an increasingly important cause of heart disease in pregnancy in low -middle income countries (LMICs). Preconception and contraception counselling based on risk stratification has the potential to reduce maternal complications. Data is lacking from LMICs on the availability and effectiveness o...
Background
Heart failure is the most common complication of women wiht heart disease going through pregnancy. Peripartum cardiomyopathy (PPCMP) is the most common cause of heart failure in pregnancy. PPCMP presents towards the end of pregnancy or in the early months following delivery and has devastating medical, mental and socio-cultural consequen...
Background
Cardiac disease in pregnancy is a major contributor to maternal mortality in high, middle and low-income countries. Availability of data on outcomes of pregnancy in women with heart disease is important for planning resources to reduce maternal mortality. Prospective data on outcomes and risk predictors of mortality in pregnant women wit...
BACKGROUND:Treadmill testing is the most widely used method for evaluating patients with coronary artery disease. Predicting the left main coronary artery disease (LMCA) before invasive procedure is important in risk assessment because of its grave clinical outcome. Lead aVR can be very useful in identifying LMCAobstruction. It is also valuable lea...
Background: Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. The adverse impact of HF on the economic well-being has been narrated in various anecdotal reports from India, with affected individuals and their dependents pushed into the vicious cycle of poverty. There is limited rese...
Background
COVID-19 pandemic has produced a great impact in the STEMI (ST Elevation Myocardial Infarction) care systems across the world. Patient hesitancy to seek medical attention for suspected STEMI, necessity of the health care systems to prioritize COVID-19 care, safety concerns of health care workers etc., have brought in unprecedented times...
Introduction
Congenital heart disease (CHD) is becoming an increasingly important cause of heart disease in pregnancy in low -middle income countries (LMICs). Preconception and contraception counselling based on risk stratification has the potential to reduce maternal complications. Data is lacking from LMICs on the availability and effectiveness o...
Background: Heart failure (HF), which is an emerging public health issue, adversely affects the strained health system in India. Additionally, the adverse impact of HF on the economic well-being of affected individuals and their families has been narrated in various anecdotal reports, with affected individuals and their dependents pushed into pover...
Thromboembolic complications are very common in patients with severe LV dysfunction. The commonest site of thrombus in these patients is the mural endocardium and the left atrium. The thrombus in the left atrium is due to a derangement of left atrial function and altered LA flow dynamics which can be determined by ECHO
p o s i t i o n s t a t e m e n t immune response, hypoxia and direct triggers contribute to the thrombotic milieu.
The unprecedented and rapidly spreading Coronavirus Disease-19 (COVID-19) pandemic has challenged public health care systems globally. Based on worldwide experience, India has initiated a nationwide lockdown to prevent the exponential surge of cases. During COVID-19, management of cardiovascular emergencies like acute Myocardial Infarction (MI) may...
Introduction:
Atrial Septal Defect by virtue of its left to right shunt induces geometric and electrical remodeling of the right sided chambers of the heart which produces prototypical changes in the Electrocardiogram. Various patterns produced by ASD in the ECG can give a clue in diagnosing the defect. Reversal of remodeling after the shunt closu...
Prosthetic valve thrombosis (PVT) is a rare but dreadful complication of mechanical prosthetic valves. Even though mechanical valves in pulmonary position are rarely implanted, obstruction by thrombosis warrants rapid diagnostic assessment and treatment. Transthoracic echocardiography plays an important role than transesophageal echocardiography be...
