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Background: Acute total occlusion of left anterior descending artery causes acute anterior wall myocardial infarction (AWMI) which could lead to left ventricular (LV) systolic dysfunction. Intervention by primary percutaneous coronary intervention (pPCI) can prevent severe LV systolic dysfunction by timely reperfusion of myocardium preventing irreversible damage. Objective: The aim of the study was to assess the LV systolic function by ejection fraction (EF) on transthoracic echocardiography (TTE) after pPCI in patients presenting with acute AWMI at 24 hours after procedure and 6 weeks follow-up. We also want to observe if duration of appearance of chest pain and time taken by patient to reach tertiary care hospital with pPCI setup has any link with the improvement of LV systolic function. Methods: The descriptive case series type of study conducted at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan for one year. Patients with acute AWMI who were treated with pPCI were included in study. LV function was assessed by EF calculated by eye ball method on TTE at 24 hours and 6 weeks interval. Duration of chest pain was noted. Results: Total 68 patients were included in the study. Mean age of patients was 44.82 years with standard deviation of 9.06 years. 82.4% patients were male. 45.6% patients were presented between 2 to 6 hours of chest pain. Maximum improvement in EF at 6 weeks follow up was seen in patients who presented within 30 minutes and patients have regained full LV function. 11 patients who presented after 6 hours of chest pain had no improvement in EF at 6 weeks follow-up. Conclusion: Timely intervention by pPCI after acute AWMI can prevent LV systolic dysfunction. [ABSTRACT FROM AUTHOR]

Objective: To determine frequency of left atrial thrombus in patients of mitral stenosis suitable for percutaneous trans-septal mitral commissurotomy. Methodology: It was a Descriptive cross sectional study conducted in the Outpatient Department of Chaudary Pervaiz Elahi Institute of Cardiology, Multan from April 2012 to October 2012. Ninty Five patients of tight mitral stenosis (Mitral valve area ⩽ 1cm2 and mean transvalvular gradient > 10 mm Hg) having sinus rhythm suitable for PTMC (as assessed on trans-thoracic echocardiography) were included in the study. Trans esophageal echocardiography was performed for the presence or absence of left atrial thrombus . Results: Out of 95 patients, male were 37.9% while female were 62.1%. Mean age of the patients was 26.88 ± 6.76 years. Left atrial thrombus was identified in 8(8.4%) patients. In age ⩽ 25 years, there were 42 patients and 4(9.5%) were diagnosed to have left atrial thrombus while in age > 25 years, there were 53 patients and 4(7.5%) patients had left atrial thrombus on trans-esophageal echocardiography. Among 59 females, left atrial thrombus was diagnosed in 5(8.4%), while in 36 males, left atrial thrombus was diagnosed in 3(8.3%) patients. Conclusion: Left atrial thrombus occurs in a significant proportion of patients with mitral stenosis and a normal sinus rhythm and thus should be monitored routinely with trans-esophageal echocardiography in patients who are planned to undergo percutaneous trans-septal mitral commissurotomy. [ABSTRACT FROM AUTHOR]

Background: Paroxysmal supraventricular tachycardia (PSVT) has always been a diagnostic and therapeutic challenge for the cardiologists. There are many modalities to treat the problem. Of the available pharmacological treatment, the role of verapamil and adenosine is under debate. This study was carried out to detect and compare the efficacy of both drugs. The objective of this study was to compare the efficacy of intravenous adenosine and verapamil in termination of PSVT., Methods: This experimental study was carried out in the Emergency department of Chauhdry Pervaiz Elahi Institute of Cardiology, Multan from to August 2008 to February 2010. A total of 120 patients with PSVT were divided in two groups. Patients in group A were treated with adenosine and group B patients received verapamil., Results: The efficacy of adenosine was proven among 56 (93%) patients, while verapamil in 43 (71%) patients. The results were statistically significant (p-value <0.05)., Conclusions: Although, both the drugs have high efficacy, adenosine is more effective than verapamil for termination of PSVT.