A Study on Clinical and Coronary Angiographic Correlation of Patients with Unstable Angina
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 7
Abstract
Introduction: Unstable Angina (UA) is a clinical syndrome caused by atherosclerotic plaque rupture and thrombosis within a coronary artery. It is defined as angina that is new onset or abruptly increased in intensity, duration or frequency within the past 60 days. It may present as rest angina, new onset severe angina or increasing angina .Initial evaluation includes risk stratification based on history , clinical exam , ECG , cardiac enzymes . Among patients with UA who undergo angiogram, 85% will have significant coronary artery disease (CAD). CABG (coronary artery bypass grafting) confers a survival benefit in patients with > 50% LM stenosis or triple vessel disease with LV dysfunction, importantly patients with no significant lesions at angiography benefit from reorientation of their management. Symptomatic patients with normal coronaries may have significant atherosclerosis by IVUS secondary to coronary artery remodeling. AIM: 1. Risk stratification based on clinical history & presentation, ECG, Enzymes, 2. To Correlate the clinical profile with Coronary angiographic profile 3. To identify the high risk predictors for early intervention. Materials and Methods: Study design : Observational and Cross sectional Study ; Study population: Unstable angina patients admitted for coronary angiogram in cardiology ward at Azeezia Medical college and attached hospital, Meeyannoor; Kollam. Inclusion Criteria :Patients admitted with a history of chest pain diagnosed as unstable angina and subsequently underwent CAG in cardiology ward. Results and Conclusion: Unstable angina commonly affects the age group 45-60yrs in both sexes. 30% of patients in our study were women. Women have normal coronaries compared to men in patients with unstable angina, (30% vs 20%) which suggests a different patho physiological mechanism for their symptoms which leads to difficulty in making a firm diagnosis of UA. Smoking, diabetes, Hyperlipidemia, Hypertension are major risk factors for unstable angina in this study Braunwald class III angina (Rest angina) predicted severity of lesion ( left main & triple vessel disease) in our study. Patients who had High TIMI risk scoring had more severe coronary lesions compared to low TIMI risk score which helps in risk stratification and early intervention. Significant ST-T changes in ECG predicted more extensive disease which helps in decision making regarding treatment strategy (conservative vs invasive) aVR ST elevation in background of unstable angina predicts left main disease &Triple vessel disease in our study which helps risk stratification and early intervention. ECHO evidence of LV dysfunction predicted Triple vessel disease /LM disease. Out of the 100 pts who underwent coronary angiogram in our study 27 pts had Single Vessel disease ( type A lesions predominantly) 24 pts had two Vessel disease .( type B lesions predominantly) 26% had three vessel disease. (type B lesions predominantly) 14 patients had Left Main Coronary artery disease. 23 patients had normal or insignificant coronary artery lesions. 9 patients had thrombus containing lesion who had rest angina, out of whom 6 patients had SVD and 3 patients had multivessel disease. 3 patients had total occlusion with TIMI ‘0’ flow.
Authors and Affiliations
Dr Gireesh G. K.
Keywords
Related Articles
- EP ID EP620468
- DOI -
- Views 97
- Downloads 0
To Study Lipid Profile Status in Chronic Obstructive Pulmonary Disease Patients.
Background-According to the statistics, chronic obstructive pulmonary disease (COPD) accounts for almost three million (5%) deceases worldwide in 2015. This disease is likely to increase in the coming years due to the gr...
Perioperative Systemic Lidocaine for Postoperative Analgesia and Recovery after Laparoscopic Cholecystectomy: systematic review and meta-analyses of randomized controlled trials
Laparoscopic cholecystectomy is one of the commonest operations in the world. Pain is a known significant factor to either delayed postoperative recovery or discharges. Improvement of perioperative outcomes remains huge...
Comparative study of patients after laparoscopic surgery with and without drain for duration of gas under diaphragm: residual pneumoperitoneum.
Background: The role of routine drainage after LC to decrease postoperative morbidity is still an issue ofconsiderable debate. The main reason to use drains in laparoscopic cholecystectomy...
Management of Resorbed Ridge with Flabby tissue: A Case report
The presence of displaceable denture-bearing tissues over severely resorbed edentulous ridges often presents a difficulty in making complete dentures. Displacement and compression of the flabby ridge results in trauma to...
A cross section study on Iron Deficiency Anemia in Adolescent Girls in field practice area of Urban Health Training Centre, RVRS Medical College, Bhilwara.
Background: Iron deficiency is the most common cause of anemia and is one of the leading risk factors for disability and death worldwide, affecting an estimated 2 billion people Methods: This was cross-sectional study....