History and Objectives: Acute myocardial infarction (AMI) is one of the most prevalent type of illness, that occurs during 24 hour period although its prevalent is higher at some hours. The present study is undertaken in order to determine the hours of occurance of acute myocardial infarction at CCU ward of Shaheed Beheshti hospital of Kashan in 1996-1997.

Materials and Methods: The present study was performed on existing data and information pertaining to diagnosis of acute myocardial infarction and item of occurance were gathered from patient’s records.

Results: The most prevalent time of occurance of the AMI was between 6am until 12pm (40.4%) and 18 to 24 (25.2%) respectively. Prevalence of AMI at Saturday was higher in the study that included 2-year period (0.53 person). Month of Esfand (0.45 person) and Mordad (0.42 person) had highest and lowest prevalence of AMI and winter (0.52 person) and summer (0.42 person) had highest and lowest prevalence of AMI among different seasons.

Conclusion: Heart patients should avoid heavy morning exercise. Health paramedics should be prepared to admit patients and provide proper treatment in the early hours of day. Further study is recommended to determine the effect of nitroglycerin and similar drug, aspirin and beta-blockers, in such a way that their serum levels are such that they will prevent AMI in the morning hours.

History and Objectives: Considering the prevalence of coronary artery atherosclerosis and its significant complications such as myocardial infarction and its high rate mortality and special involvement of the main left coronary artery devision which includes higher mortality rate and the successful by-pass surgery compared to drug treatment and assessment of relationship of risk factors regarding the presence or absence of clinical signs and the study of its condition and stenosis of LMCA and its relationship with other stenosis in different parts of left and right coronary, the present study was carried out on patients referred to Dr. Shariati hospital for coronary vessel angiography between 1990-1994.

Materials and Methods: A descriptive study was conducted on existing patients file from Dr. Shariati hospital for whom coronary angiography was performed for the past 5 years. There was no preclinical or clinical evidence of rheumatic diseases or congenital heart disease and patients who were suffering from LMCAD were selected. Personal records, clinical signs, cardiovascular risk factors and angiographic results were extracted.

Results: From the total of 1479 patients, 10% had LMCAD. 94% of the patients had clinical signs such as pain or dyspnea. The most prevalent risk factor was hyperlipidemia (in 60% of cases). Hypercholesterolemia was the most common risk factor associated with the disease (60%) and increased arterial pressure was the least prevalent associated risk factor (2.5%). The distal region narrowing in LMCA with 75% was the most frequent and in ostium it was the least frequent. The distribution of LMCA was in trunk length (11%) and 2% in middle section (6%), in proximal section (5%) and in the form of ectalic (2). The distribution of the intensity of narrowing in LMCA shows that the most frequent relates to 30% narrowing and the least rates relates to obstructions over 90%. In other words, 55% of the patients 40% have narrowing or more. In inspecting the relationship between the MCAD and narrowing in other parts, the most frequent narrowing was associated in CX-artery with 79% of the cases and in descending proximal artery in 75% of cases, in distal region with 13% and in descending posterior artery with 19% of prevalence.

Conclusion: The narrowing of coronary artery particularly in the main trunk is a common disease with high mortality rate. The characterization of angiography and its relationship with the narrowing in other parts of angiography relationship between this type of narrowing with narrowing the once in other parts of coronary artery results in identification of LMCAD.

Background: A great number of patients in our country have had valve replacement operation. Considering much problems and not being clear the rate of them in valve replaced patients in this area, this study was done in order to determine the difficulties of these people in Kashan in 2001.

Materials and Methods: In a descriptive study patients with replaced heart valve were examined. For each patient a questionnaire was completed consisting variables such as: age, sex, occupation, valve type, place and duration of valve replacement, dyspnea, hemoptysis, continuous cough, wheezing, palpitation, edema, blood pressure under 95 mm Hg, diet and nutritional habits like salt consumption, abnormal hemorrhage, contraception status, altered daily activities, and sleep difficulties like difficulty in onset of sleep, frequently and unwanted waking up during the sleep and insomnia. Using descriptive statistics, data were classified and presented. Chi square and Fischer exact tests were used for analysis.

Results: Of 140 patients with replaced heart valve, 20 cases had died and 20 people had migrated. The others were 60 women and 40 men. Seventy-five patients ranged 21 – 50 years old. Mean age was 36 years old. Two patients had biologic and 98 patients had mechanical valve. Of participants, 70 cases had at least one respiratory problem. Most common respiratory problems including dyspnea and hemoptysis were associated with Biork Shaily valve (46.6% and 36.7% respectively). Wheezing was mostly related to Sent Jude valve (28.5%). Highest rates of palpitation, edema and atrial fibrillation were observed in patients over 51(85.7, 14.3 and 90.4% respectively). Rates of sleep problems and altered daily activities were 60% and 70% respectively. Fifty-five percent of patients were not educated about care plan after surgery.

Conclusion : dyspnea, hemorrhage, hemoptysis, decreased tolerance to activity, sleep disorders, atrial fibrillation and low blood pressure were the most common problems of patients with heart valve. On the other hand, rate of these problems were higher in uneducated patients than educated ones. Therefore, paying more attention to education of patients after cardiac valve surgery, and also more studies in this field are recommended.