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Abstract: Diabetes is considered as a coronary artery disease (CAD) riskequivalent and diabetics are prone to a more severe and diffuse atherosclerotic CAD. In this study, we evaluated a north Indian cohort of type II diabetics for their angiographic and morphological features and compared them with a similar nondiabetic subgroup. The study included 100 consecutive non-insulin-dependent diabetes mellitus (NIDDM) patients undergoing clinically indicated elective coronary angiography and 100 nondiabetic patients who were individually matched for sex, age, and clinical diagnosis. On analysis, we found that the frequency of single and multivessel CAD were statistically different between the two groups with single vessel disease (SVD) being more frequent in nondiabetic CAD patients (10 vs 26, p<0.05) and multivessel disease (MVD) being more common in diabetics (82 and 54, p<0.05), not only the incidence of MVD, but also the incidence of significant left main disease and left main coronary artery (LMCA) disease with associated MVD were more common in diabetics (22 vs 6, p<0.05) as well as the average number of lesions (2.65±0.7, 1.95±0.85, p<0.001) and mean stenosis (63.56±22.9 and 50.64±20.8; p<0.01) even when the patients were matched for age, sex, and clinical diagnosis. [Copyright &y& Elsevier]

Abstract: Diagnosis of myocardial infarction in patients with dextrocardia and situs inversus is considerably difficult. The clinical diagnosis and electrocardiography (ECG) recognition in this setting poses significant challenges, as the clinical signs may be misleading and the ECG changes may simply be interpreted to be due to improper lead placement. In this case report we report one such case of acute myocardial infarction in a patient of situs inversus totalis. A deviated apex beat and heart sounds coupled with right axis deviation of P wave and QRS complexes in lead I, and positive R wave in aVR lead to the diagnosis of dextrocardia. Elevated ST segment in Vl and right-sided leads indicated acute myocardial infarction which was later confirmed by raised creatine phosphokinase-MB (CPK-MB) levels, and transthoracic echocardiography. [Copyright &y& Elsevier]