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Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Screening for cardiac involvement in patients with sarcoidosis using AIIMS algorithm.

Devesh Kumar1, Karan Madan2, Priya Jagia3

  • 1Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, Room No. 20, 7th Foor, New Delhi, 110029, India.

The International Journal of Cardiovascular Imaging
|May 30, 2025
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The AIIMS screening algorithm, incorporating global longitudinal strain and biomarkers, significantly improves cardiac sarcoidosis detection compared to the standard HRS algorithm. This enhanced approach aids earlier diagnosis and potentially better patient outcomes.

Keywords:
Cardiac sarcoidosisMagnetic resonance imagingScreening

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Area of Science:

  • Cardiology
  • Immunology
  • Medical Imaging

Background:

  • Cardiac involvement in sarcoidosis negatively impacts patient prognosis.
  • Early detection and treatment are crucial for improving outcomes in cardiac sarcoidosis.
  • Current diagnostic algorithms, like the Heart Rhythm Society (HRS) screening algorithm, rely on symptoms, ECG, and conventional echocardiography.

Purpose of the Study:

  • To evaluate the efficacy of the AIIMS screening algorithm, which adds global longitudinal strain (GLS) and cardiac biomarkers (Troponin, NT-Pro-BNP) to the HRS criteria.
  • To determine if the AIIMS algorithm improves the detection rate of cardiac involvement in patients with sarcoidosis.

Main Methods:

  • A cohort of 100 patients with biopsy-proven sarcoidosis was screened.
  • Screening included assessment of cardiac symptoms, ECG, conventional echocardiography, GLS, Troponin I, and NT-Pro-BNP.
  • Patients positive on screening underwent advanced imaging (cardiac MRI or radionuclide imaging) for confirmation.

Main Results:

  • The AIIMS algorithm identified cardiac involvement in 32% of patients, a 30% increase over the HRS algorithm (24%).
  • Abnormal GLS was detected in 32% of patients.
  • Biomarkers showed elevated Troponin I in 16% and NT-Pro-BNP in 19% of patients.

Conclusions:

  • The AIIMS screening algorithm demonstrates superior detection of cardiac involvement in sarcoidosis patients.
  • Integrating GLS and biomarkers enhances diagnostic yield, potentially leading to earlier intervention.
  • Further validation in larger studies is recommended for the AIIMS algorithm.