Unusual and very rare presentation of wrist pain in a man with acute anterior myocardial infarction, a case report and literature of review.

BACKGROUND: As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain. CASE REPORT: A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35-40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI. DISCUSSION: In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis.

Association of Genotypes of ANGPTL3 with Vitamin D and Calcium Concentration in Cardiovascular Disease.

One of the leading causes of mortality worldwide is cardiovascular disease, which is influenced by some variables, including calcium and vitamin D. This study aimed to assess the relationship between Angiopoietin-Like 3 (ANGPTL3) gene polymorphisms with vitamin D and calcium levels in cardiovascular disease (CVD) patients. In this research, 1002 people participated. Participants' anthropometric parameters, and FBG, calcium, and vitamin D were assessed. Blood samples were used to extract DNA. Taqman®-based polymerase chain reaction (PCR) was used to conduct genetic analysis for the rs10789117 and rs17458195. Statistical analysis was applied to determine differences across subgroups and the relationship between polymorphisms and disease. Age, body mass index (BMI), fasting Blood Sugar (FBG), phenylalanine ammonia-lyase (PAL), and smoking history were significantly correlated with CVD. Vitamin D was statistically associated with rs10789117 and rs17458195 in non-CVD individuals. In the moderate group, individuals with the C allele in rs10789117 showed a tenfold increase in vitamin D deficiency compared to those with the A allele. However, in rs11207997, individuals with the T allele had 5 to 6 times higher vitamin D deficiency than those with the C allele in all groups. This research demonstrates the relationship between some ANGPTL3 gene polymorphisms and complement levels in CVD patients. It may be concluded that individuals carrying these variants would likely benefit from using vitamin D and calcium supplements to avoid CVD.

Unrepaired tetralogy of Fallot in a 71 years old woman: A case report and review of the literature.

Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease (CHD) in infants. The four components that constitute ToF are an overriding aorta over the crest of the interventricular septum, obstruction in the right ventricular outflow tract, right ventricular hypertrophy, and a typically large non-restricted ventricular septal defect. ToF may also be associated with other extracardiac abnormalities, including patent ductus arteriosus or multiple aortopulmonary collateral arteries, which can impact the patient's survival. Patients with unoperated ToF rarely reach adulthood, and it is extremely rare to discover undiagnosed ToF in individuals over 60 years old. In this report, we describe an unusual case of a woman with unrepaired ToF who survived until the age of 71. She was fairly asymptomatic until the 7th decade of her life and complained only of dyspnea on exertion. The patient declined corrective cardiac surgery and preferred conservative management.

The relationship between a plant-based diet and mental health: Evidence from a cross-sectional multicentric community trial (LIPOKAP study).

BACKGROUND: Dietary patterns emphasizing plant foods might be neuroprotective and exert health benefits on mental health. However, there is a paucity of evidence on the association between a plant-based dietary index and mental health measures. OBJECTIVE: This study sought to examine the association between plant-based dietary indices, depression and anxiety in a large multicentric sample of Iranian adults. METHODS: This cross-sectional study was performed in a sample of 2,033 participants. A validated food frequency questionnaire was used to evaluate dietary intakes of participants. Three versions of PDI including an overall PDI, a healthy PDI (hPDI), and an unhealthy PDI (uPDI) were created. The presence of anxiety and depression was examined via a validated Iranian version of the Hospital Anxiety and Depression Scale (HADS). RESULTS: PDI and hPDI were not associated to depression and anxiety after adjustment for potential covariates (age, sex, energy, marital status, physical activity level and smoking). However, in the crude model, the highest consumption of uPDI approximately doubled the risk of depression (OR= 2.07, 95% CI: 1.49, 2.87; P<0.0001) and increased the risk of anxiety by almost 50% (OR= 1.56, 95% CI: 1.14, 2.14; P= 0.001). Adjustment for potential confounders just slightly changed the associations (OR for depression in the fourth quartile= 1.96; 95% CI: 1.34, 2.85, and OR for anxiety in the fourth quartile= 1.53; 95% CI: 1.07, 2.19). CONCLUSIONS: An unhealthy plant-based dietary index is associated with a higher risk of depression and anxiety, while plant-based dietary index and healthy plant-based dietary index were not associated to depression and anxiety.

Risk factors for premature myocardial infarction: a matched case-control study.

BACKGROUND: Myocardial infarction in young age is increasing. Identifying risk factors could be important for health promotion. We studied classic atherosclerotic risk factors in premature myocardial infarction. METHODS: In this matched case-control study, which was conducted from 2005 to 2007 in Birjand County, the east of Iran, atherosclerotic risk factors (hyperten-sion, family history of coronary artery diseases, obesity, diabetes mellitus, dyslipidemia) of 98 patients affected by acute myocardial infarction aged under 50 years were compared with that of 98 healthy neighborhood controls. RESULTS: Mean levels of cholesterol, triglyceride, low-density lipoprotein, as well as systolic blood pressure and body mass index were significantly higher in cases than in controls. There was a positive association between coronary artery disease at younger age and dyslipidemia OR=2.8 [95% CI: 1.5, 5.2], smoking OR=6.4 [95% CI: 3.0, 13.5], systolic hypertension OR=3.1 [95% CI: 1.5, 6.3], family history of coronary artery diseases OR=10.9 [95% CI: 3.2, 37.9] and diabetes OR=2.5 [95% CI: 1.04, 6.2]. CONCLUSION: Smoking, systolic hypertension and dyslipidemia were the most common risk factors among patients with premature myocardial infarction.