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Biomedical subjects

A K Kar

Publications and source records attributed to A K Kar.

16 recordsLinked to original sources
PubMed1992

Cardiac involvement in non-specific aorto-arteritis.

Cardiac involvement in 75 cases (mean age 21.1 +/- 6 years) with non-specific aorto-arteritis was studied. Detailed clinical examination, echocardiography and cardiac catheterization, including angiography, were done in all the cases, as was coronary angiography. Features of cardiac failure like sinus tachycardia, cardiomegaly, left ventricular third heart sound gallop and pulmonary congestion were detected in 27 cases with reduction of left ventricular ejection fraction (25-48%). Systemic hypertension was seen in 60 cases. Central aortic pressure, left ventricular systolic pressure and left ventricular end-diastolic pressure were increased in 66 cases. Pulmonary hypertension and increased pulmonary vascular resistance were detected in 6 cases. Aortic and mitral regurgitation were seen in 15 and 12 cases, respectively. Three patients had features of dilated cardiomyopathy such as generalized cardiomegaly, systemic and pulmonary congestion but without any cardiac murmurs and with normal central aortic pressure. The coronary angiogram revealed obstruction of the left anterior descending artery in 3 cases and right coronary artery obstruction in another 3 cases. Histopathological studies revealed non-specific inflammatory changes with fibrosis in cardiac musculature and the great vessels.

Adolescent↗
PubMed1991

Early experience with percutaneous transluminal coronary angioplasty in unstable angina.

Percutaneous transluminal coronary angioplasty was done in 13 of 105 patients with unstable angina, 10 of whom were males. Diagnostic coronary angiography revealed single vessel disease in 10 cases and two vessel disease in 3 cases; the degree of stenosis varied from 70-90%. Only a single major coronary artery was dilated. Immediate angiographic success was achieved in 12(92.3%) cases. The success rate at the time of discharge from hospital was 10 (76.9%) cases. Immediate complications encountered were acute myocardial infarction in 2 cases, they refused coronary artery bypass grafting and unsuccessful dilation in 1 case. No death occurred during the hospital stay. During follow-up of 6-9 months, 8 patients were symptom free (66.6%), 2 patients required repeat percutaneous transluminal coronary angioplasty and 2 patients died. In conclusion, percutaneous transluminal coronary angioplasty may be undertaken relatively safely in unstable angina, it leads to substantial improvement in symptoms during the early follow-up period. This therapeutic approach is highly beneficial particularly in single vessel disease.

Adult↗
PubMed1991

Cardiac changes implicated in chronic heart block.

Fifteen cases of chronic heart block were studied. Eight of them could be designated as idiopathic or primary heart block; the others were associated with hypertension, diabetes and ischaemic heart disease, either singly or in various combinations. In six cases, the whole heart was available for histopathological study of the conduction system. In the other 9 cases, only a portion of the heart muscle was available for examination. A V nodal fibrosis extending upto the proximal bundle of His was seen in all the six whole heart autopsy materials. Fibrosis of the adjacent myocardium was seen in five cases. In three cases, conducting system fibrosis was associated with atherosclerotic (1 case) or diabetic changes (3 cases) of the intramural vessels. In the 9 partial autopsy studies, myocardial fibrosis was seen in two cases, diabetic microangiopathy in one and atherosclerotic changes in two including an old thrombus in one. Thus, diabetic microangiopathy was seen in total four cases. These changes may be responsible for the cardiomegaly and cardiac failure associated with conduction defects observed in diabetes. In the idiopathic group also, heart block could be considered as a significant facet of a primary myocardial degenerative process.

Chronic Disease↗
PubMedDate not supplied

Low dose amiodarone in refractory tachyarrhythmias.

Fifty patients with drug resistant tachyarrhythmias were treated with amiodarone for 6-22 months; 16 for recurrent ventricular tachycardia (VT), 2 for VT followed by ventricular fibrillation (VF), 14 for complex ventricular ectopics, and 18 for supraventricular tachyarrhythmias (SVT). Amiodarone was administered in a dose much lower than that used in western trials. The actual incidence of successful amiodarone therapy was 81.2% at 22 months for patients with VT. Among the patients with SVT, 88.6% patients were successfully treated for 22 months (range 3-22 months). Amiodarone toxicity appeared in 22 of 50 patients (44%) treated for more than 12 weeks. Withdrawal of therapy was required in 4 patients. Despite the lower dose, clinical efficacy and onset of action were comparable to the western experience.

Adolescent↗