Mojtaba Yousefzadeh, A. Asgarian, R. Ahangari, M. Vahedian, Monireh Mirzaie
Introduction: One of the unique challenges for obstetricians in pregnancy is cardiovascular changes. This study aimed to evaluate electrocardiographic (ECG) changes in mothers with COVID-19. Materials and Methods: In a retrospective study, 89 pregnant women with positive reverse transcription-polymerase chain reaction for COVID-19, between 19 and 44 years old, were selected for the study, and 12 lead ECGs were extracted and recorded from the medical documents for all cases and all parameters analyzed. Results: Of the 89 patients that met inclusion criteria, only eight patients were admitted to intensive care unit. Of all, 64 cases (71.9%) had normal ECG, three patients showed atrioventricular (AV) block (3.4%), and three patients had first-degree AV block type (PR interval >200 ms). The mean QTC interval was 428.6 ± 37.4 ms and 15 (17%) patients had long QTC intervals (QTC ≥460 ms). There was a significant relationship between antivirus treatment (P = 0.027), as well as hydroxychloroquine (HCQ) with PR interval (P = 0.002). A significant relationship was found between corticosteroids with QTC (P = 0.019) and antibiotics with QTC (P = 0.018). Conclusion: A significant association between corticosteroids usage and QTC interval as well as antiviral and HCQ treatment with PR interval. These changes during pregnancy and COVID-19 should be interpreted with caution by physicians. Understanding changes in electrocardiography can help in better and early diagnosis and management of pregnant mothers to prevent adverse outcomes.
{"title":"Electrocardiographic changes in pregnant women with COVID-19","authors":"Mojtaba Yousefzadeh, A. Asgarian, R. Ahangari, M. Vahedian, Monireh Mirzaie","doi":"10.4103/jpcs.jpcs_9_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_9_22","url":null,"abstract":"Introduction: One of the unique challenges for obstetricians in pregnancy is cardiovascular changes. This study aimed to evaluate electrocardiographic (ECG) changes in mothers with COVID-19. Materials and Methods: In a retrospective study, 89 pregnant women with positive reverse transcription-polymerase chain reaction for COVID-19, between 19 and 44 years old, were selected for the study, and 12 lead ECGs were extracted and recorded from the medical documents for all cases and all parameters analyzed. Results: Of the 89 patients that met inclusion criteria, only eight patients were admitted to intensive care unit. Of all, 64 cases (71.9%) had normal ECG, three patients showed atrioventricular (AV) block (3.4%), and three patients had first-degree AV block type (PR interval >200 ms). The mean QTC interval was 428.6 ± 37.4 ms and 15 (17%) patients had long QTC intervals (QTC ≥460 ms). There was a significant relationship between antivirus treatment (P = 0.027), as well as hydroxychloroquine (HCQ) with PR interval (P = 0.002). A significant relationship was found between corticosteroids with QTC (P = 0.019) and antibiotics with QTC (P = 0.018). Conclusion: A significant association between corticosteroids usage and QTC interval as well as antiviral and HCQ treatment with PR interval. These changes during pregnancy and COVID-19 should be interpreted with caution by physicians. Understanding changes in electrocardiography can help in better and early diagnosis and management of pregnant mothers to prevent adverse outcomes.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"17 - 21"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42986658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Kumar, Rajesh Chetiwal, Shweta Tanwar, Sudhish Gupta, Rohit Kumar
The de Winter's pattern is an electrocardiography (ECG) finding characterized by ST depression and tall prominent T-waves in precordial leads with ST elevation in lead aVR. It signifies the occlusion of proximal left anterior descending artery (LAD). Although it is considered a ST-elevation myocardial infarction (STEMI) equivalent, current guidelines recommend against the use of thrombolytic therapy in the absence of STEMI. As the question whether to use thrombolysis in such situations remains unanswered and controversial, we preferred to provide thrombolytic therapy with tenecteplase to our patient admitted with acute retrosternal chest pain with de Winter's ECG pattern so as to prevent myocardial damage and improve the patient outcome as the percutaneous coronary intervention facility was not immediately available. The thrombolysis was successful and the proximal LAD occlusion was confirmed later on coronary angiography which was treated with stent implantation. This case report tends to highlight the therapeutic dilemma while managing patients with de Winter's ECG pattern.
de Winter型是一种心电图(ECG)发现，其特征是心前导联ST段下降和高且突出的t波，aVR导联ST段升高。表示左前降支近端闭塞。虽然它被认为是st段抬高型心肌梗死(STEMI)等效，但目前的指南不建议在没有STEMI的情况下使用溶栓治疗。由于在这种情况下是否使用溶栓仍然是一个没有答案和有争议的问题，我们更倾向于对我们入院的急性胸骨后胸痛伴有de Winter心电图模式的患者提供tenecteplase溶栓治疗，以防止心肌损害，改善患者的预后，因为经皮冠状动脉介入治疗设备不能立即获得。溶栓成功，后经冠状动脉造影证实LAD近端闭塞，并行支架植入治疗。本病例报告倾向于强调在处理德温特心电图模式患者时的治疗困境。
{"title":"Thrombolysis in the de winter electrocardiography pattern: A therapeutic dilemma","authors":"Amit Kumar, Rajesh Chetiwal, Shweta Tanwar, Sudhish Gupta, Rohit Kumar","doi":"10.4103/jpcs.jpcs_4_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_4_22","url":null,"abstract":"The de Winter's pattern is an electrocardiography (ECG) finding characterized by ST depression and tall prominent T-waves in precordial leads with ST elevation in lead aVR. It signifies the occlusion of proximal left anterior descending artery (LAD). Although it is considered a ST-elevation myocardial infarction (STEMI) equivalent, current guidelines recommend against the use of thrombolytic therapy in the absence of STEMI. As the question whether to use thrombolysis in such situations remains unanswered and controversial, we preferred to provide thrombolytic therapy with tenecteplase to our patient admitted with acute retrosternal chest pain with de Winter's ECG pattern so as to prevent myocardial damage and improve the patient outcome as the percutaneous coronary intervention facility was not immediately available. The thrombolysis was successful and the proximal LAD occlusion was confirmed later on coronary angiography which was treated with stent implantation. This case report tends to highlight the therapeutic dilemma while managing patients with de Winter's ECG pattern.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"48 - 50"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43855169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Zigova, E. Petrejčíková, M. Blascáková, J. Kmec, J. Bernasovská, I. Boroňová, Martin Kmec
Cardiomyopathies are heterogeneous health conditions with the potential for atrial fibrillation. The management of patients with cardiomyopathy accompanied by atrial fibrillation is complicated by the maintenance of sinus rhythm, toxicity, or other complications. There is a lack of information about the reasons for therapy response heterogeneity or therapy failure. Our searching strategy of scientific databases declares a potentially important role of genetics in patients' management. The promising target could be the 4q25 locus and its sequence variants. Molecular-genetic analyses may shed new light on anti-atrial fibrillation therapy in cardiomyopathy patients and help reveal the genetic subtypes of cardiomyopathy patients. In this sense, the purpose of our study is to examine the evidence for genetic variation influencing the efficacy of pharmacological or invasive therapies for atrial fibrillation, especially at the 4q25 locus, in cardiomyopathy patients and declare the importance of detected genetic markers responsible for positive or negative responses to specific anti-atrial fibrillation therapies.
{"title":"Genetic targets in the management of atrial fibrillation in patients with cardiomyopathy","authors":"M. Zigova, E. Petrejčíková, M. Blascáková, J. Kmec, J. Bernasovská, I. Boroňová, Martin Kmec","doi":"10.4103/jpcs.jpcs_65_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_65_21","url":null,"abstract":"Cardiomyopathies are heterogeneous health conditions with the potential for atrial fibrillation. The management of patients with cardiomyopathy accompanied by atrial fibrillation is complicated by the maintenance of sinus rhythm, toxicity, or other complications. There is a lack of information about the reasons for therapy response heterogeneity or therapy failure. Our searching strategy of scientific databases declares a potentially important role of genetics in patients' management. The promising target could be the 4q25 locus and its sequence variants. Molecular-genetic analyses may shed new light on anti-atrial fibrillation therapy in cardiomyopathy patients and help reveal the genetic subtypes of cardiomyopathy patients. In this sense, the purpose of our study is to examine the evidence for genetic variation influencing the efficacy of pharmacological or invasive therapies for atrial fibrillation, especially at the 4q25 locus, in cardiomyopathy patients and declare the importance of detected genetic markers responsible for positive or negative responses to specific anti-atrial fibrillation therapies.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"9 - 16"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48952969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Parvathareddy, S. Maale, Praveen Nagula, Srinivas Ravi, Monica Rayapu, N. Balla
{"title":"Clinical and angiographic characteristics of coronary artery ectasia and its correlation with high-sensitivity c-reactive protein and serum uric acid","authors":"K. Parvathareddy, S. Maale, Praveen Nagula, Srinivas Ravi, Monica Rayapu, N. Balla","doi":"10.4103/jpcs.jpcs_24_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_24_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pseudoaneurysm formation between ascending aorta and main pulmonary artery following ventricular septal defect patch dehiscence","authors":"Jigisha Pujara, Guriqbal Singh, Mrugesh Prajapati, T. Gajjar, Bhavik Chimpaneri, Pavan Patel","doi":"10.4103/jpcs.jpcs_70_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_70_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Macro T-Wave alternans in recurrent orthodromic atrioventricular reentrant tachycardia","authors":"Debasish Das, Tutan Das, Subhash R. Pramanik","doi":"10.4103/jpcs.jpcs_52_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_52_21","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"68 - 69"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47633395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Lozada-Martinez, Geiro Pava-Barrios, Andres Yoli-Garrido, Anderson Leal-Buitrago, Nicolas Rodriguez-Medina
{"title":"Post-COVID-19 cardiovascular syndrome: What does the evidence tell us?","authors":"I. Lozada-Martinez, Geiro Pava-Barrios, Andres Yoli-Garrido, Anderson Leal-Buitrago, Nicolas Rodriguez-Medina","doi":"10.4103/jpcs.jpcs_69_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_69_21","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"65 - 67"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49407316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New year – A newer avenue for heart failure pharmacotherapy","authors":"Jes Jose, Iti Shri, R. Magoon, Sparsh Bhalla","doi":"10.4103/jpcs.jpcs_1_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_1_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"70 - 71"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46309537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure a multinational randomized trial (The EMPULSE Trial)","authors":"S. Sardar","doi":"10.4103/jpcs.jpcs_34_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_34_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of Indian fruits in the prevention and management of hypertension","authors":"Pankaj Prabhakar","doi":"10.4103/jpcs.jpcs_63_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_63_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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