Medico-Legal Update

Ahmed Moyed Hussein ¹, Bahaa Abdullah Ali ², Merah Subhi Mohammed ³

Affiliations
1 M.B.Ch.B, FIBMS (medicine), CABMS (medicine), FIBMS( cardiology), CABMS(cardiology). Interventional cardiologist. Lecturer, department of medicine, Ninevah College of medicine. Mosel, IQ
2 M.B.Ch.B, CABMS (medicine), FIBMS (cardiology). Interventional cardiologist, Salahaddin general hospital.Tikrit, IQ
3 M.B.Ch.B, FIBMS (anesthesia), CABMS (anesthesia). Cardiac anesthetist, Ibn albitar cardiac center. Baghdad, IQ

Abstract

Objectives: to evaluate the prevalence of significant coronary artery disease (CAD) in patients referred for open heart surgery for various valvular and non valvular etiologies. Methods and materials: a total of 160 patients (73 males and 87 females) were included in this study: old age, male gender, hypertension (HT), diabetes mellitus (DM), hyperlipidemia, smoking and left ventricular (LV) systolic dysfunction are recorded as risk factors for CAD. Of the 160 patients: 143 (89.4 %) have valvular disease (VHD) and 17 (10.6%) have non valvular disease. Patients with VHD were classified according to valve lesions into: mitral stenosis (MS), mitral regurgitation (MR), aortic stenosis (AS), aortic regurgitation (AR), tricuspid regurgitation (TR) and mixed valvular disease. Correlation between various types of valve diseases and CAD are assessed. Results: CAD were detected in 26.9% (43) of patients. Old age, HT, DM, hyperlipidemia and smoking were significantly correlated with CAD. CAD were more common in patients with VHD than non VHD. 25(50%) patients with AS have significant CAD (P value= 0.0001), in patients with MR: 8(12.7%) have significant CAD, while patients with MS and AR were have CAD in 15.1% and 25% respectively. Among patients with non valvular heart disease (17 patients): 13 patients have atrial septal defect and 4 patients have atrial myxoma. 3 patients (6.1%) have significant CAD (P value=0.2), one of them had HT, DM and smoker man presented with chest pain on exertion. Conclusion: Obstructive CAD were more common in patients with AS and MR and higher in patients with risk factors for CAD.

Keywords

coronary artery disease, valvular heart disease, Aortic stenosis

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