A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Nivargi, V. V.
- Cardiac Sarcoidosis Presenting as Aborted Sudden Death
Authors
1 Ruby Hall Clinic, Pune, IN
Source
The Indian Practitioner, Vol 69, No 1 (2016), Pagination: 36-39Abstract
A 42 year old lady with a diagnosis of hyperreactive airway disease since 4 years, treated with bronchodilators presented with monomorphic ventricular tachycardia with syncope requiring direct current (DC) cardioversion. 2 dimensional echocardiography with cardiac colour doppler examination and magnetic resonance Imaging (MRI) revealed left ventricular dilatation, systolic dysfunction with patchy areas of thickening and regional wall motion abnormality not specific to any particular vascular territory and advanced diastolic dysfunction.
Review of records revealed persistently raised erythrocyte sedimentation rate which was previously ignored.
Gadolinium contrast cardiac MRI revealed late gadolinium enhancement suggestive of myocarditis. Thoracic MRI revealed a mediastinal lymphnode mass. A computed tomography (C.T.) directed lymphnode biopsy confirmed Sarcoidosis. She was offered implantable cardioverter-defibrillator device and immunosuppression therapy with prednisolone 1 mg/kg/day.
Keywords
Aborted Sudden Death, Cardiac Sarcoidosis.
- Pompe's Disease:A Rare Glycogen Storage Disorder
Authors
1 Ruby Hall Clinic, 2/A2/20 New Ajanta Avenue Kothrud, Pune, 411029, Maharashtra, IN
2 Poona Hospital, Pune, IN
3 Ruby Hall Clinic, Pune, IN
Source
The Indian Practitioner, Vol 69, No 10 (2016), Pagination: 25-26Abstract
Pompe's disease is an autosomal recessive disorder characterized by deficiency of acid alpha-glucosidase resulting in intra-lysosomal accumulation of glycogen and leading to progressive muscle dysfunction. The incidence of the disease is approximately 1 in 140,000 for infantile GSD II and 1 in 60,000 for adult GSD II. A seven months old male child four, kg in weight first product of non consanguinous marriage full term normal vaginal delivery presented with complaints of failure to thrive and delayed milestones and poor muscular tone. Electrocardiograph showed prominent R waves alongwith short PR interval in all leads suggestive of Pompe's disease Cardiac colour doppler showed biventricular hypertrophy with significant systolic dysfunction and advanced left ventricular diastolic dysfunction alongwith a small 4mm ostium secundum atrial septal defect with moderate pulmonary hypertension. Creatine kinase levels were high. Urine showed no myoglobinuria and liver function tests were normal Lysosomal enzyme studies confirmed lysosomal alpha 1,4 glucosidase enzyme deficiency with ratio of 0.16 [normal>0.2], thus establishing the diagnosis of Pompe's disease.Keywords
Glycogen Storage Disorder, Pompe’s Disease.References
- Wagner KR (2007). “Enzyme replacement for infantile Pompe disease: the first step toward a cure”. Neurology 68 (2): 88–9. doi:10.1212/01.wnl.0000253226.13795.40.PMID 17210887
- Ausems MG, Verbiest J, Hermans MP, et al. (September 1999). “Frequency of glycogen storage disease type II in The Netherlands: implications for diagnosis and genetic counselling”. Eur. J. Hum. Genet. 7 (6): 713–6. doi:10.1038/sj.ejhg.5200367. PMID 10482961.
- Yamaguchi Syndrome-An Underdiagnosed Entity
Authors
1 Ruby Hall Clinic, Pune, IN
Source
The Indian Practitioner, Vol 69, No 11 (2016), Pagination: 30-31Abstract
AHCM [apical hypertrophic cardiomyopathy] has typical findings on electrocardiography, echocardiography and left ventricular angiography. The electrocardiographic changes and symptoms associated with AHCM often mimic acute coronary syndromes also called pseudoinfarct pattern and coronary angiogram can be performed with pre-diagnosis of coronary artery disease several times. Physicians should consider AHCM in patients with similar electrocardiographic changes and symptoms as that of acute coronary syndrome.Keywords
Apical Hypertrophic Cardiomyopathy, Pseudoinfarct Pattern.References
- Duygu H, Zoghi M, Nalbantgil S, Ozerkan F, Akilli A, Akin M, et al. Apical hypertrophic cardiomyopathy might lead to misdiagnosis of ischaemic heart disease. Int J Cardiovasc Imaging 2008; Doi: 10.1007/s10554-008-9311-7.
- Wall EE, Bax JJ, Schalij MJ. Detection of apical hypertrophic cardiomyopathy; which is the appropriate imaging modality. Int J Cardiovasc Imaging 2008; doi:10.1007/ s10554-008-9325-1.
- Differentiating Transient Ischemic Attacks from Stroke Mimics with Radio-Imaging and Angiography
Authors
1 Dept. of Neurosurgery, B.J. Govt. Medical College & Sassoon General Hospitals, Pune 411 001, Maharashtra, IN
2 DNB Medicine, DNB Cardiology, IN
Source
The Indian Practitioner, Vol 70, No 6 (2017), Pagination: 53-60Abstract
Background: Physicians resistance for radio imaging pose problems differentiating transient ischemic strokes (TIA) from Stroke Mimics (SM). Secondly in hypertensive patients, its progressive- type and severity are ignored.
Objective: 1) Differentiating TIAs from SM with neuro radio imaging and understanding hypertensive behavior.
Materials and Methods: Forty five hypertensive patients with an 'initial-diagnosis' of TIAs were studied retrospectively between year 2008 and 2012. DW- MR radio-imaging and carotid-Digital Subtraction Angiography (DSA) differentiated SM from TIAs for the final diagnosis.
Results: Eight patients of TIAs and one with amaurosis-fugax (AF) included in group 1 category. Radio-imaging showed focal-parenchymal and paraventricular edema in TIAs. AF was due to transient retinal ischemia. The remaining 80% diagnosed as stroke- mimics. These are divided in Group 2-Thirty patients, 66.66% with varied oetiology and Group 3 -Six patients (13.33%) had a final diagnosis of psychosomatic- transient loss of consciousness (P-TLC).
Conclusion: Hypertension history over past eighteen months showed Increasingly-Changing Hypertension (ICh-P) in all stenotic -TIAs cases. Average age for TIAs' in hypertensive males found was 59 years and in hypertensive females 67 years. CAS and hypertension collectively showed long history with 20% incidence of stenotic -TIAs. Incidence of stroke mimics was 80% with mild hypertension.
Keywords
Transient Ischemic Attacks, Stroke-Mimics, Triggers, DW-MRI, Digital Subtraction Angiography.References
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- Kannel WB, Dawber TR, Sorlie P, and Wolf PA: Components of blood pressure and risk of atherothrombotic brain infarction: The Framingham Study. Stroke 1976; 7:327-331
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