N. Swaminathan

• Head of Department at Madras Medical College

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...

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...

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...

Intravenous leiomyomatosis (IVL) is a rare neoplasm characterized by histologically benign-looking smooth muscle cell tumor mass which grows within the intrauterine and extrauterine venous system. In this report, we present an unusual case of IVL which had originated from uterus and extended throughout the right cardiac chambers. A 36-year-old fema...

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 Bedside ultrasonography is a promising noninvasive and rapid technique to assess body fluid status. Early detection of hypovolemia and hypervolemia is crucial to guide management in critically ill patients. There is a considerable demographic variability in the normal range of inferior vena cava dimensions as seen in numerous studies and...

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...

Background In patients with mitral stenosis (MS), right ventricular (RV) function may be altered due to an increase in the left atrial pressure and/or changes in pulmonary arteriolar vasculature or may be affected by rheumatic process directly. Aims In this study we have evaluated the recovery of RV function upto 3 months in patients undergoing mi...

The decrease of the incidence of rheumatic heart disease in developed countries had already begun in 1910, and it is now below 1.0 per 100 000. On the other hand, the occurrence rate of rheumatic heart disease in developing countries remains substantial. Because the decline in the prevalence of rheumatic fever in industrialized nations started even...

Introduction: PBMV has become the procedure of choice for mitral stenosis with suitable valve apparatus. Mitral valve apparatus is related to body surface area and it varies with racial origin. We studied the clinical profile and BSA indexed MVA of patients undergoing PBMV in our institute. Materials & Methods: This was a retrospective study consis...

Introduction: Health literacy is the degree to which individuals and groups can obtain, process, understand, evaluate, and act upon information needed to make informed health decisions. The objective of this study is to analyze the impact of health literacy on various cardiovascular disease risk factors and CVD risk factor outcomes. Methodology: Th...

While syphilis and pulmonary embolism are well known with the eponym of “The Great Masquerader,” atrial myxoma should also be given the eponym due to its variable presentations and frequent misdiagnosis. Myxoma is the most common primary tumor of the adult heart, which is silent and is discovered incidentally. We would like to present three consecu...

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...

Ventricular septal defect (VSD) is usually diagnosed in childhood. In adults, it is less often diagnosed due to spontaneous closure of some VSD's during the early years of childhood. Perimembranous VSD is a defect seen in the upper part of the septum and near the valves occurring in nearly 75% of patients. Although spontaneous closure has been repo...

An 18-year-old female presented with complaints of breathlessness on exertion for the past 6 months. Systemic examination was normal. Echocardiography showed a large hyperechoic well-defined right atrial mass occupying the entire right atrium and extending up to tricuspid valve. Mild pericardial effusion was noted. Visualized portions of pulmonary...

Introduction The occurrence of right heart thrombus (RiHT) in pulmonary embolism (PE) carries poor prognosis. Type A Thrombi are serpiginous, highly mobile with high mortality. Type B Thrombi are less mobile and have better prognosis. Type C is intermediate in all characteristics. Methods This is an observational study done in patients presenting...

Infective endocarditis (IE) is a life threatening infection of cardiac valves leading to high mortality, if it is not recognized earlier and promptly treated. Usually, IE affects single cardiac valve. Angry looking vegetations at multiple sites and vegetations invading the papillary muscles are rare. Such involvement is associated with even higher...

Left ventricular (LV) diverticulum is defined as a protrusion of the free wall of the ventricle, including endocardium, myocardium, and pericardium. It is classified into fibrous and muscular types. Most of the patients are asymptomatic. It is mainly diagnosed by echocardiography, magnetic resonance imaging, and ventriculography. Surgery is the tre...

Right-sided valve endocarditis is usually uncommon. Pulmonary valve endocarditis with septic emboli as the complication of a rare congenital heart disease is even unusual. Herein, we report a case of a 27-year-old male congenital cyanotic heart disease with pulmonary valve endocarditis presenting with 5 days history of fever and headache. Echocardi...

Anomalous origin of circumflex coronary is not an uncommon finding. However, dual origin of circumflex artery is a rare anomaly. An extensive literature search indicates that there have been only three such prior reports. We report the first such case from the Indian subcontinent. This was diagnosed by conventional angiography and CT angiography.

Hypothermia is an uncommon condition in a tropical country like India. It can present with various characteristic features on electrocardiogram (ECG). This is a case report of a 50-year-old male with hypothermia who presented with an abnormal ECG. Based on the clinical and ECG features, hypothermia was diagnosed and treated successfully.

The close relationship between pleural space and pericardial space and the dependence of their pressure kinetics are well known. This study evaluates the effects of increased intra pleural pressure due to pleural effusion on cardiovascular system. Forty patients above the age of 12 who had massive unilateral/bilateral pleural effusion due to non-ca...

Background: The underlying mechanism of cardiac failure in high output states has not been clearly understood. It is well known that left ventricular systolic functional indices are usually preserved. So, what causes the symptoms of cardiac failure?. We analysed the LV diastolic parameters in some of the common high output states Aim: The aim of th...

Hemodialysis is done for end stage renal failure. It is often done through femoral or jugular venous access until a permanent venous access is constructed.1 Although infection and thrombosis of the access site are quite common, accidental migration of catheter is rare. Here we report a case of accidentally migrated hemodialysis catheter and the sub...