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Dr K K Aggarwal

Longer chest pain equals bigger MI risk

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Longer chest pain equals bigger MI risk

Patients with acute myocardial infarction (MI) have longer duration of chest pain than those without a myocardial infarction. Patients with chest pain of short duration, less than 5 minutes, are unlikely to have an acute infarction and have a good prognosis at 30 days. A single–center study showed that only 8.9% of the patients received a final diagnosis of acute MI, and these patients had a significantly longer duration of chest pain compared with the rest of the cohort (120 versus 40 minutes) according to Carlos Calle–Muller, MD, of Henry Ford Hospital in Detroit, and colleagues. Those who had chest pain lasting less than 5 minutes always had a good outcome, with no acute MIs or deaths within 30 days, as reported in the journal Critical Pathways in Cardiology. If the clinical assessment and ECG are benign, such patients might be able to be discharged directly from the emergency department without stress testing for outpatient follow-up. The median chest pain duration was 180 minutes among the 10 patients who died and only 40 minutes for the others. Among patients with acute MI, longer chest pain duration was not associated with higher 30–day mortality, but it was associated with a higher initial level of cardiac troponin-I.

Longer duration of chest pain means bigger MI risk

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Longer duration of chest pain means bigger MI risk

Patients with acute myocardial infarction have longer duration of chest pain than those without a myocardial infarction. Patients with chest pain of short duration, less than 5 minutes, are unlikely to have an acute infarction and have a good prognosis at 30 days. A single–center study showed that only 8.9% of the patients received a final diagnosis of acute MI, and these patients had a significantly longer duration of chest pain compared with the rest of the cohort (120 versus 40 minutes) according to Carlos Calle–Muller, MD, of Henry Ford Hospital in Detroit, and colleagues. Those who had chest pain lasting less than 5 minutes always had a good outcome, with no acute MIs or deaths within 30 days, as reported in the journal Critical Pathways in Cardiology. If the clinical assessment and ECG are benign, such patients might be able to be discharged directly from the emergency department without stress testing for outpatient follow-up. The median chest pain duration was 180 minutes among the 10 patients who died and only 40 minutes for the others. Among patients with acute MI, longer chest pain duration was not associated with higher 30–day mortality, but it was associated with a higher initial level of cardiac troponin-I.

ECG can be a marker for future sudden cardiac death

By Dr K K Aggarwal
Filed Under Heart Care Foundation of India | Tagged With: , , , | | Comments Off on ECG can be a marker for future sudden cardiac death

All school children enrolling for competitive games should have their ECG done.

Padma Shri & Dr. B C Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India, said that routine ECG, if read correctly, can be used as a marker for sudden cardiac death, especially in children.

Dr. Aggarwal who is also Senior vice President, Indian Medical Association, said that all children being recruited for competitive sports should have their resting ECG done. ECG consists of wave which need to be interpreted by the doctors.

The Width of the wave called QRS duration is something which can be picked up even by inexperienced doctors and  nurses. A QRS width duration of more than 120 micro seconds in adults and 100 micro seconds in children 4-16 years and more than 90 micro seconds in children less than 4 years of age should warrant a specialized opinion.

Any heart rate of less than 60 or more than 100 per minute should also warrant, a further evaluation, especially if it is associated with wide QRS duration, as mentioned above. The heart rhythm should be regular and any irregularity should be evaluated.

Missing beats is a common occurrence but if a person misses his beat on exercise, it may be a sign of underlying heart blockages. In children, one should also look for QT prolongation in the ECG and if it is prolonged, it is a matter of concern.