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Background: No/slow flow after percutaneous intervention(PCI) for acute coronary syndromes (ACS) is common. Whether a comprehensive intravascular ultrasound (IVUS) analysis of atherosclerotic plaque can define characteristics which predict suboptimal flow following PCI is largely unknown., Objectives: To identify IVUS correlates of suboptimal flow in patients with ACS undergoing PCI., Materials & Methods: We performed a prospective multicentre, investigator initiated study. Patients with ACS, who underwent IVUS guided PCI were enrolled. Clinical, angiographic and imaging characteristics of patients who developed suboptimal flow after PCI were analysed and compared with patients with normal flow., Results: Between October 2021 and August 2022, we enrolled 187 patients (195 lesions) with ACS who underwent IVUS guided PCI. Mean age of patients was 58 ± 10.4 years; Incidence of slow/no reflow in our study was 14/195 (7.2 %). Presentation as ST elevation myocardial infarction, presence of angiographically complex lesion type (type B2/C) and pre procedural TIMI flow 0 were significantly more in patients who developed suboptimal flow after PCI. Pre PCI plaque attenuation length (9.51 mm Vs 4.35 mm p = 0.037), lesion site positive remodelling (Odds ratio 6.4 : 95 % CI; 1.1-38.4 p = 0.042) were predictors of slow flow.Post PCI length of plaque prolapse (9.73 mm Vs 6.58 mm p = 0.029) correlated with slow flow., Conclusions: Plaque characteristics on IVUS in patients with ACS helps to identify patients who may develop suboptimal flow following PCI., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sajan Narayanan reports financial support was provided by Society for coronary imaging and physiology (SCIP). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier, a division of RELX India, Pvt. Ltd.)

The contractility of the heart is a result of the interplay of ionic movements in and out of its individual cells. Calcium ion plays an important role in the ventricular function. We report a 34 year old female who presented with cardiogenic shock having had no cardiac symptoms previously. She had underwent a total thyroidectomy five years back for medullary thyroid cancer. Laboratory tests revealed her calcium levels to be very low and a diagnosis of hypocalcemic cardiomyopathy secondary to hypopituitarism was made. With vigorous calcium supplementation apart from diuretics the patient had rapid clinical improvement., (© Journal of the Association of Physicians of India 2011.)

Background: Gender disparity, with respect to women receiving less medical therapy, undergoing fewer invasive procedures, and experiencing worse outcome than men, has been noted in various observational and randomized trials, though guidelines on acute coronary syndrome (ACS) are gender-neutral. Indian data with focus on women with ACS are lacking., Aim: This study was undertaken to give us an insight on the clinical presentation, risk factors, and in-hospital outcome of ACS in women and at 30 days., Materials and Methods: 133 successive cases of women presenting with ACS, who met the inclusion criteria between 2012 and 2014, were included. Cases were grouped into ST elevation myocardial infarction (STEMI), non ST elevation myocardial infarction (NSTEMI), and unstable angina (UA)., Results and Conclusion: The mean age was 64.4±11 years. The mean BMI was 23.64±3.23kg/m(2). Diabetes was present in 58.3% in NSTEMI, 65.1% in STEMI, and 57.1% in UA group. Hypertension was found in 75% of NSTEMI, 60.2% of STEMI, and 71.4% of UA group. Severe MR was found in 11.1% of NSTEMI and 3.6% of STEMI patients. 8.3% of NSTEMI and 15.7% of STEMI patients presented in Killips class IV. Single vessel disease was most commonly found across the spectrum of ACS. 68.7% patients in STEMI group underwent primary angioplasty. 5.6% of NSTEMI and 7.2% in STEMI group had contrast-induced nephropathy (CIN). All deaths were noted in STEMI group with eight in-hospital deaths and three during 30-day follow-up period. Killips class III and IV and higher grace score (>150) were predictors of in-hospital mortality. Chronic kidney disease, ischemic mitral regurgitation, LV clot, and in-hospital cardiac arrest were associated with higher risk., (Copyright © 2016. Published by Elsevier B.V.)

Reel syndrome is an uncommon condition in which a patient's subconscious, inadvertent, or deliberate external manipulation of their cardiac pacemaker results in the movement of the transducer wires along its transverse axis. We report a clinical case of a 67 year old lady with permanent pacemaker presenting with pacemaker malfunction and was detected with reel syndrome.