Pattern of acute MI admissions in India during COVID-19 era: A Cardiological Society of India study - Rationale and design.

BACKGROUND: COVID-19 pandemic has affected around 20million patients worldwide and 2.0 million cases from India. The lockdown was employed to delay the pandemic. However, it had an unintentional impact on acute cardiovascular care, especially acute myocardial infarction (AMI). Observational studies have shown a decrease in hospital admissions for AMI in several developed countries during the pandemic period. We aimed to evaluate the impact of COVID-19 on the AMI admissions patterns across India. METHODS: In this multicentric, retrospective, cross-sectional study, we included all AMI cases admitted to participating hospitals during the study period 15th March to 15th June 2020 and compared them using a historical control of all cases of AMI admitted during the corresponding period in the year 2019. Major objective of the study is to analyze the changes inthe number of hospital admissions for AMI in hospitals across India. In addition, we intend to evaluate the impact of COVID-19 on the weekly AMI admission rates, and other performance measures like rates of thrombolysis/primary percutaneous interventions (PCI), window period, door to balloon time, and door to needle time. Other objectives include evaluation of changes in the major complications and mortality rates of AMI and its predictors during COVID-19 pandemic. CONCLUSIONS: This CSI-AMI study will provide scientific evidence about the impact of COVID-19 on AMI care in India. Based on this study, we may be able to suggest appropriate changes to the existing MI guidelines and to educate the public regarding emergency care for AMI during COVID-19 pandemic.

Large Submitral Aneurysm Compressing Left Main Coronary Artery: Rare Presentation of a Rare Disease.

Submitral left ventricular aneurysm is a rare cardiac anomaly that was first reported from African countries and initially termed as "annular left ventricular aneurysm". Submitral aneurysm (SMA) causes out-pouching of the left ventricular wall, adjacent to the posterior leaflet of the mitral valve. Generally, SMA opens into left ventricle (LV) with a wide mouth and not into left atrium (LA). We report a case of Submitral Aneurysm with two openings: one into LV and the other into LA. This case also highlights the compression of coronary arteries by the submitral aneurysm. Large SMA can cause compression of left main coronary artery rarely. Having a knowledge of this point can help the clinician. SMA generally have an opening in LV but in this case SMA has two openings (One in LV and another in LA). This knowledge can help in proper surgical management.

Ruptured pseudo-aneurysm of the mitral-aortic intervalvular fibrosa - A 3D transesophageal echocardiographic depiction.

Pseudo-aneurysm of the mitral-aortic intervalvular fibrosa (MAIVF) is a rare complication of native or prosthetic valve endocarditis. Good imaging is the key to successful diagnosis of this rare entity. This report describes a pseudo - aneurysm of the MAIVF rupturing into left atrium in a patient with double valve replacement with special reference to 3-dimensional transesophageal echocardiographic imaging. .