Ravi Kalra - Academia.edu (original) (raw)

Papers by Ravi Kalra

Takotsubo cardiomyopathy (TTC) is a unique heart disease that mimics the clinical presentation of... more Takotsubo cardiomyopathy (TTC) is a unique heart disease that mimics the clinical presentation of acute coronary syndrome and is seen more commonly in post-menopausal females. Here, we report a case that presents an ideal documentation of TTC depicting its characteristic clinical features and possible outcomes. TTC usually culminates in a complete reversal of both systolic and diastolic dysfunctions, however in our case of a post-COVID scenario, the persisting, rather worsening diastolic dysfunction might be a residual manifestation of COVID-19 myocarditis. Recent reports have found an increasing prevalence of TTC amidst the COVID-19 pandemic possibly as a result of the emotional and physical stress, and subsequent catecholamine surge caused by the virus in such patients. There might exist an independent association between TTC and the COVID-19 virus. Increased clinical evidence is required to establish the strength of this relationship, if any.

Medical Journal Armed Forces India

Takayasu arteritis is a well-established medical entity involving inflammatory changes in large a... more Takayasu arteritis is a well-established medical entity involving inflammatory changes in large arteries. We describe a characteristic case of Takayasu arteritis, in a young woman with significant renal artery stenosis, presenting with hypertensive urgency. Unsuccessful guide wire passage due to fibrotic septae in lumen of the left renal artery necessitated an innovative interventional approach, using an IMA-guide catheter and a UB3 coronary guidewire to cross the lesions, followed by placement of a coronary drug eluting stent, with an aim to avoid restenosis.

Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging

The Indian practitioner, 2020

Systemic lupus erythematosus is a collagen disease that frequently involves the cardiovascular sy... more Systemic lupus erythematosus is a collagen disease that frequently involves the cardiovascular system, the pericardium being the most commonly affected site. This involvement is usually pericardial effusion, majority of the time of mild degree. In a few patients, pericardial involvement may be the initial presentation of systemic lupus erythematosus. Cardiac tamponade is a rare clinical manifestation and very few cases are reported as the initial manifestation of the disease. Here, we report a patient with SLE with cardiac tamponade. Our patient presented with subacute presentation. Echocardiography showed large pericardial effusion with features suggestive of cardiac tamponade. Pericardiocentesis was done. The fluid was hemorrhagic in nature. Fluid analysis was suggestive of exudative effusion. Antinuclear antibody, U1-nRNP, nucleosomes, Sm were found to be positive. Oral prednisolone was started and slowly tapered to a maintenance dose. Azathioprine, hydroxychloroquine, torsemide ...

International Journal of Advances in Medicine, 2021

Background: Definitive diagnosis of pulmonary artery hypertension (PH) requires an elevated mean ... more Background: Definitive diagnosis of pulmonary artery hypertension (PH) requires an elevated mean pulmonary arterial pressure (MPAP) of 25 mmHg at rest measured by right heart catheterization (RHC). As it is invasive mode of investigation, it is declined by many patients, echocardiography was thought to be an acceptable substitute to assess pulmonary arterial pressures. Whether there is a correlation between these measurements is controversial. The aim of this study was to assess PH by echocardiography and its correlation with RHC.Methods: Twenty-six patients aged ≥18 years with pulmonary artery hypertension with or without tricuspid regurgitation (TR) were included in this cross-sectional study. All the patients underwent a transthoracic echocardiography evaluation and were taken for RHC study within an hour.Results: The correlation between pulmonary artery acceleration time (PAAT) and pulmonary artery systolic pressure (PASP) and PAAT and MPAP was significant in all degrees of PH. ...

Journal of Marine Medical Society, 2018

Journal of Marine Medical Society, 2019

Coarctation of the aorta (CoA) is a constriction of the thoracic aorta commonly located distal to... more Coarctation of the aorta (CoA) is a constriction of the thoracic aorta commonly located distal to the left subclavian artery. It is more common in males and is associated with Turner syndrome, bicuspid aortic valve, and ventricular septal defect. It presents as angina on exertion, lower limb claudication along diminished femoral pulses, and unequal limb blood pressure records. Balloon angioplasty with or without stenting is the preferred treatment in native coarctation or recoarctation after surgery. Here, we report four cases that were successfully managed with balloon aortoplasty for CoA.

Indian journal of biochemistry & biophysics, 2007

Myocardial infarction (MI) is a multi-factorial disease which claims many young lives. There are ... more Myocardial infarction (MI) is a multi-factorial disease which claims many young lives. There are very few Indian studies that have investigated antiphospholipid antibodies (APLs) in MI patients. APLs have been implicated in arterial thrombosis including premature coronary artery and cerebrovascular thrombosis. In the present study, the prevalence of two clinically significant APLs--anticardiolipin antibody (ACA) and lupus anticoagulants (LA) in young MI patients was studied and compared with age- and sex-matched controls. Fifty healthy blood donors and 40 young MI patients (less than 45 yrs) diagnosed according to the American Heart Association guidelines were recruited for the study. The criteria for diagnosis were presence of atleast two of three classical findings including: clinical symptoms, diagnostic ECG, and presence of one or more cardiac biomarkers out of raised CK-MB isoform and T-troponin on serial measurement. LA and ACA were tested by lupus-sensitive activated partial ...

São Paulo medical journal = Revista paulista de medicina, 2013

Arterial thrombosis may occur consequent to hereditary thrombophilia and increased lipoprotein(a)... more Arterial thrombosis may occur consequent to hereditary thrombophilia and increased lipoprotein(a) [Lp(a)] and fibrinogen. Our aim was to study the prevalence of common thrombophilia markers in 85 consecutive cases of arterial thrombosis. A retrospective study was conducted from 85 consecutive young patients treated as outpatients or admitted due to stroke or myocardial infarction at a tertiary care hospital. Eighty-five Indian patients (age < 45 years) presenting ischemic stroke (n = 48) or myocardial infarction (n = 37) and 50 controls were studied for seven thrombophilia markers including antithrombin (AT), factor V, protein C, protein S, activated protein C resistance (APC-R), fibrinogen and Lp(a). Functional assays for protein C, protein S, factor V and APC-R were performed using clotting-based methods. Semi-quantitative estimation of fibrinogen was done using Clauss's method and Lp(a) using immunoturbidimetry. Statistical analysis was done using the Epi Info 6 software. ...

Indian Journal of Clinical Cardiology

Takotsubo cardiomyopathy (TC) is a unique heart disease which mimics the clinical symptoms and fe... more Takotsubo cardiomyopathy (TC) is a unique heart disease which mimics the clinical symptoms and features of acute coronary syndrome (ACS) and is seen more commonly in postmenopausal females. In this condition, abnormal electrocardiographic findings like ST-segment elevation/depression, T wave inversion, and an abnormal/absence of Q wave, along with echocardiographic disturbances like regional wall motion abnormalities and a sudden decrease in the ejection fraction are observed. However, coronary angiography shows no coronary artery obstruction. Interestingly, the left ventricle in TC develops a characteristic appearance similar to that of a “Tako-tsubo” (Japanese pot). Such peculiar observations become important when diagnosing TC in a clinical setting. TC is often caused by a catecholamine surge due to mass sympathetic activation usually preceded by an emotional/physical trigger, however the exact etiology and mechanism of pathophysiology still remain unclear. With growing awareness...

Medical Journal Armed Forces India, 2023