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Objective: To determine the frequency of disorders leading to sudden cardiac death (SCD). Study Design: Cross-sectional study. Place and duration of study: Pathology Lab in collaboration with the Cardiology Department, AFIC & NIHD, Rawalpindi Pakistan, from Jan 2017 to Dec 2018. Methodology: A total of 305 cases of sudden cardiac death reported within the last 24 hours of a death to AFIC Rawalpindi were included consecutively. Cases with a history of extracardiac diseases leading to sudden death were excluded. Most of the included cases were diagnosed phenotypically based on clinical examination, biochemistry, ECG, echocardiography, angiography, thallium scan, electro-physiological studies, cardiac CT scan, MRI and routine autopsy whenever recommended. Results: Out of 305 cases, 197 (65%) were males and 108 (35%) females. Disorders leading to SCD were found in 178 (58.3%) cases due to ischemic heart disease (IHD), aortic dissection (0.7%), hypertrophic cardiomyopathy (HCM) (0.3%), dilated cardiomyopathy (DCM) (10.5%), congenital heart disease (12.1%) and valvular heart disease (7.9%). While in cardiac channelopathies, catecholaminergic polymorphic ventricular tachycardia (CPVT) in 5 (1.6%) and congenital long QT syndrome (LQTS) in 2 (0.7%) cases. However, 24 (7.9%) cases remained as sudden unexplained deaths (SUD). Conclusion: In our setup, ischemic heart disease and dilated cardiomyopathy were the commonest causes of sudden cardiac death, followed by congenital heart disease and valvular heart diseases. [ABSTRACT FROM AUTHOR]

Objective: To determine the in-hospital outcomes of primary percutaneous coronary intervention approach in a tertiary care cardiac center. Study Design: Retrospective observational descriptive study. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Jan 2018 to Dec 2019. Methodology: A total of 143 consecutive ST-elevation myocardial infarction patients presented to the ER within 24 hours of the onset of chest pain were included in this study. We included patients of both genders, aged >20 years and met the diagnostic criteria of ST-elevation myocardial infarction. Patients with cardiogenic shock, puncture site infection were excluded from the study. Results: Average age of patients was 54.2 ± 12.7 years (min-max age=24-92 years). Majority 130 (90.9%) of cases were males, while 55 (38.5%) patients had diabetes, 52 (36.4%) were hypertensive, 38 (26.6%) were smokers, family history of CAD was found in 10 (7%) cases and 8 (5.6%) cases had prior percutaneous coronary intervention or coronary artery bypass graft. Mostly 64.3% procedures were performed by trans-radial approach. Mean ± SD door-to-balloon time was 60.31 ± 29.8 minutes. About 72% patients received primary percutaneous coronary intervention within ≤60 min and 40 (28%) cases received primary percutaneous coronary intervention with door-to-balloon time >60 min. This study shown 100% success rate with zero mortality only one patient developed arrhythmia during procedure. Conclusion: Primary percutaneous coronary intervention through trans-radial approach was safe option with excellent success rates in terms of both morbidity & mortality rates. [ABSTRACT FROM AUTHOR]