Myocarditis with preserved ejection fraction (MCpEF) is a subgroup of myocarditis with normal or near-normal left ventricular systolic function. Its prevalence has been reported to be low, and there are limited data about the diagnostic strategy, management, and outcome. Initial manifestation of myocarditis can be new-onset heart failure, acute coronary syndrome-like presentation, life-threatening arrhythmia, or even sudden cardiac death. Echocardiography with two-dimensional speckle-tracking mode and cardiac magnetic resonance imaging have pivotal roles in diagnosis and management of the disease. The present study is based on a research on “myocarditis preserved ejection fraction (EF)” or “ myocarditis with normal EF” mainly in PubMed, Google Scholar, and Embase databases. The search focused on the aspects of the disease which is not usually mentioned clearly. In contrast to the myocarditis as a general concept, the total number of clinical studies or case reports in the context of myocarditis with preserved EF is really low. Most treatment strategies have been based on the patient's initial presentation, and there are not enough clinical trials or long-term follow-up studies to confirm the most accurate diagnostic and therapeutic approach. In conclusion, although MCpEF has been known as a subgroup of myocarditis with specific clinical and imaging features, there are still a lot of questions about the diagnosis, management strategy, and patient prognosis which require further studies to be investigated.
{"title":"A review on myocarditis with preserved ejection fraction: Diagnosis and treatment","authors":"N. Naderi, S. Naeini, Zahra Hosseini","doi":"10.4103/rcm.rcm_40_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_40_21","url":null,"abstract":"Myocarditis with preserved ejection fraction (MCpEF) is a subgroup of myocarditis with normal or near-normal left ventricular systolic function. Its prevalence has been reported to be low, and there are limited data about the diagnostic strategy, management, and outcome. Initial manifestation of myocarditis can be new-onset heart failure, acute coronary syndrome-like presentation, life-threatening arrhythmia, or even sudden cardiac death. Echocardiography with two-dimensional speckle-tracking mode and cardiac magnetic resonance imaging have pivotal roles in diagnosis and management of the disease. The present study is based on a research on “myocarditis preserved ejection fraction (EF)” or “ myocarditis with normal EF” mainly in PubMed, Google Scholar, and Embase databases. The search focused on the aspects of the disease which is not usually mentioned clearly. In contrast to the myocarditis as a general concept, the total number of clinical studies or case reports in the context of myocarditis with preserved EF is really low. Most treatment strategies have been based on the patient's initial presentation, and there are not enough clinical trials or long-term follow-up studies to confirm the most accurate diagnostic and therapeutic approach. In conclusion, although MCpEF has been known as a subgroup of myocarditis with specific clinical and imaging features, there are still a lot of questions about the diagnosis, management strategy, and patient prognosis which require further studies to be investigated.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44768925","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}
Pub Date : 2021-09-28DOI: 10.21203/rs.3.rs-904617/v1
Reza HabibiSaravi, Touraj Assadi, G. Gholami, M. Hasani, Soheil Pourmand, R. Navaie, Fariba Ghasemihamedani
Background: Several studies have been conducted on the effects of floods on the health of the affected community. We aimed to determine the effects of floods as the most common disaster on hypertension (HTN) as one of the most common noncommunicable diseases (NCDs). Materials and Methods: Four databases including Medline, Scopus, Google Scholar, and ScienceDirect were searched with the search strategy protocol up to the end of June 2021 and with the keywords of flood and high blood pressure or hypertension. Grey literature database and websites of WHO, UNDRR, and PreventionWeb were also searched. After removing duplicate articles, abstracts of the relevant titles were reviewed, and eligible articles were included for full-text review. Finally, the study variables were extracted from selected articles. Results: The search strategy resulted in eight final relevant articles from 48,980 articles. All final articles noted meaningful effect of flood on high blood pressure. There was a positive correlation between anxiety level, property loss, financial loss, physical activity, use of alcoholic beverages, interruption of medication, and medical cares with HTN. Different studies have also reported long-term effects of flooding on blood pressure. Conclusions: The flood has significant effect on high blood pressure in affected population. However, cases of unknown HTN in the affected population should also be considered, so screening is recommended in the affected community.
{"title":"Flood and hypertension: A systematic review","authors":"Reza HabibiSaravi, Touraj Assadi, G. Gholami, M. Hasani, Soheil Pourmand, R. Navaie, Fariba Ghasemihamedani","doi":"10.21203/rs.3.rs-904617/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-904617/v1","url":null,"abstract":"Background: Several studies have been conducted on the effects of floods on the health of the affected community. We aimed to determine the effects of floods as the most common disaster on hypertension (HTN) as one of the most common noncommunicable diseases (NCDs). Materials and Methods: Four databases including Medline, Scopus, Google Scholar, and ScienceDirect were searched with the search strategy protocol up to the end of June 2021 and with the keywords of flood and high blood pressure or hypertension. Grey literature database and websites of WHO, UNDRR, and PreventionWeb were also searched. After removing duplicate articles, abstracts of the relevant titles were reviewed, and eligible articles were included for full-text review. Finally, the study variables were extracted from selected articles. Results: The search strategy resulted in eight final relevant articles from 48,980 articles. All final articles noted meaningful effect of flood on high blood pressure. There was a positive correlation between anxiety level, property loss, financial loss, physical activity, use of alcoholic beverages, interruption of medication, and medical cares with HTN. Different studies have also reported long-term effects of flooding on blood pressure. Conclusions: The flood has significant effect on high blood pressure in affected population. However, cases of unknown HTN in the affected population should also be considered, so screening is recommended in the affected community.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42362454","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}
Pericardial effusion is usually caused by infection, fluid overload states, connective tissue disorders, heart surgery, aortic dissection, and malignancy. When a patient presents with recurrent isolated pericardial effusion accompanied by a nonspecific history and negative laboratory tests, it can pose a diagnostic dilemma to the clinician. Primary malignant tumors of the pericardium are sporadic, and most primary malignant pericardial tumors are mesotheliomas. We report the case of a young adult male with recurrent pericardial effusion and no specific clinical clues enabling an early diagnosis, which later turned out to be caused by a primary angiosarcoma of the pericardium.
{"title":"Unexplained recurrent pericardial effusion in a young adult male: Think beyond tuberculosis","authors":"Anshuman Darbari, B. Kumar, A. Jose, Ajit Kumar","doi":"10.4103/rcm.rcm_39_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_39_21","url":null,"abstract":"Pericardial effusion is usually caused by infection, fluid overload states, connective tissue disorders, heart surgery, aortic dissection, and malignancy. When a patient presents with recurrent isolated pericardial effusion accompanied by a nonspecific history and negative laboratory tests, it can pose a diagnostic dilemma to the clinician. Primary malignant tumors of the pericardium are sporadic, and most primary malignant pericardial tumors are mesotheliomas. We report the case of a young adult male with recurrent pericardial effusion and no specific clinical clues enabling an early diagnosis, which later turned out to be caused by a primary angiosarcoma of the pericardium.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45241775","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}
Debasish Das, D. Acharya, Jogendra Singh, Subhash R. Pramanik, Tutan Das
We present a simple novel technique of crossing the calcium spur at right-angle bend in coronary artery by deploying a noninflated balloon over the calcium spur where the tip of the passing stent frequently hits and create difficulty in negotiation of the stent forward. When we deploy a balloon over the calcium spur, the tip of the stent does not hit the edge of the calcium spur and the stent gently slides over the hydrophilic slippery balloon forward with ease. We describe a rare case of intervention in anomalous anterior origin of right coronary artery where we were not able to pass the stent across two 90° bends which were harboring calcium spur. In spite of we adopted buddy wire and triple wire technique to make the bend straight, we were not able to move the stent forward, each time it was hitting at the edge of the calcium spur. We put a 2 mm × 10 mm noninflated semicompliant balloon each time while crossing the right-angle bend with calcium spur which covered the calcium spur and over the balloon we were easily able to slide the stent forward, deployed the stent across the lesion, and achieved distal TIMI III flow. We describe this simple novel technique of “sliding the stent over the balloon technique” to cross the calcium spur remaining at 90°-angle bend causing difficulty in forward negotiation of the stent.
{"title":"Crossing the calcium spur with “sliding over the balloon technique” in anomalous anterior origin of right coronary artery with two right-angle bends","authors":"Debasish Das, D. Acharya, Jogendra Singh, Subhash R. Pramanik, Tutan Das","doi":"10.4103/rcm.rcm_37_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_37_21","url":null,"abstract":"We present a simple novel technique of crossing the calcium spur at right-angle bend in coronary artery by deploying a noninflated balloon over the calcium spur where the tip of the passing stent frequently hits and create difficulty in negotiation of the stent forward. When we deploy a balloon over the calcium spur, the tip of the stent does not hit the edge of the calcium spur and the stent gently slides over the hydrophilic slippery balloon forward with ease. We describe a rare case of intervention in anomalous anterior origin of right coronary artery where we were not able to pass the stent across two 90° bends which were harboring calcium spur. In spite of we adopted buddy wire and triple wire technique to make the bend straight, we were not able to move the stent forward, each time it was hitting at the edge of the calcium spur. We put a 2 mm × 10 mm noninflated semicompliant balloon each time while crossing the right-angle bend with calcium spur which covered the calcium spur and over the balloon we were easily able to slide the stent forward, deployed the stent across the lesion, and achieved distal TIMI III flow. We describe this simple novel technique of “sliding the stent over the balloon technique” to cross the calcium spur remaining at 90°-angle bend causing difficulty in forward negotiation of the stent.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46860444","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}
S. Parhizgar, Milad Vahedinezhad, Tahereh Yari, Bahareh Mohajer, Zohre Maghsoudloo, Parham Sadeghipour, A. Mozayanimonfared, Z. Hosseini, M. Maleki, A. Firouzi, M. Alemzadeh-Ansari, Zahra Hosseini, A. Rashidinejad
Background: Patients' hesitation to seek medical care has seriously compromised the management of acute coronary syndrome during coronavirus disease 2019 (COVID-19) outbreak. In the present study, we have reported the rate of discharged against medical advice (DAMA) among patients referred to chest pain unit (CPU) of a tertiary cardiovascular center and compared their clinical outcomes with whom admitted or managed conservatively. Methods: Patients with modified HEART risk score ≥4 referred to the CPU were included in the present study. Population requiring CPU admission due to positive serial troponin were divided into admitted and DAMA groups. Patients with negative serial troponin were managed as outpatient (conservative treatment group). 30-day major adverse cardiac events (MACE) and all-cause mortality were compared between the study groups. Results: A modified HEART risk score (≥4) was calculated for 440 of 5490 patients visited our CPU. One hundred and one (22.9%), 80 (18.1%), and 249 (56.5%) patients were categorized as DAMA, admitted, and conservative treatment groups, respectively. Myocardial infarction was significantly higher in the DAMA versus admitted group (2 vs. 0; P ≤ 0.001). MACE and all-cause mortality were significantly higher in the DAMA group than that in the conservative treatment group (5 vs. 2; P = 0.02 and 4 vs. 2; P = 0.055, respectively). Conclusion: In the present study, we have demonstrated a considerable rate of DAMA in patients with high modified HEART risk score referring to CPU during the COVID-19 outbreak. Importantly, the DAMA group experienced a higher incidence rate of 30-day MACE and all-cause mortality compared to patients who were admitted or managed conservatively.
背景:2019冠状病毒病(COVID-19)暴发期间，患者就医犹豫严重影响了急性冠状动脉综合征的管理。在本研究中，我们报道了三级心血管中心胸痛科(CPU)患者的不遵医嘱出院率(DAMA)，并将其临床结果与入院或保守治疗的患者进行了比较。方法:采用改良心脏风险评分≥4分(CPU)的患者纳入本研究。因系列肌钙蛋白阳性而需要CPU入院的人群分为入院组和DAMA组。系列肌钙蛋白阴性患者作为门诊治疗(保守治疗组)。比较各研究组30天主要不良心脏事件(MACE)和全因死亡率。结果:5490例访问我们CPU的患者中有440例计算了改良的心脏风险评分(≥4)。DAMA组101例(22.9%)，住院组80例(18.1%)，保守组249例(56.5%)。与住院组相比，DAMA组心肌梗死发生率显著升高(2 vs 0;P≤0.001)。DAMA组的MACE和全因死亡率显著高于保守治疗组(5 vs. 2;P = 0.02, 4 vs. 2;P = 0.055)。结论:在本研究中，我们已经证明在COVID-19爆发期间，参考CPU的高修改HEART风险评分患者的DAMA发生率相当高。重要的是，与入院或保守治疗的患者相比，DAMA组经历了更高的30天MACE发生率和全因死亡率。
{"title":"Discharge against medical advice in patients with acute coronary syndrome during the COVID-19 outbreak","authors":"S. Parhizgar, Milad Vahedinezhad, Tahereh Yari, Bahareh Mohajer, Zohre Maghsoudloo, Parham Sadeghipour, A. Mozayanimonfared, Z. Hosseini, M. Maleki, A. Firouzi, M. Alemzadeh-Ansari, Zahra Hosseini, A. Rashidinejad","doi":"10.4103/rcm.rcm_23_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_23_21","url":null,"abstract":"Background: Patients' hesitation to seek medical care has seriously compromised the management of acute coronary syndrome during coronavirus disease 2019 (COVID-19) outbreak. In the present study, we have reported the rate of discharged against medical advice (DAMA) among patients referred to chest pain unit (CPU) of a tertiary cardiovascular center and compared their clinical outcomes with whom admitted or managed conservatively. Methods: Patients with modified HEART risk score ≥4 referred to the CPU were included in the present study. Population requiring CPU admission due to positive serial troponin were divided into admitted and DAMA groups. Patients with negative serial troponin were managed as outpatient (conservative treatment group). 30-day major adverse cardiac events (MACE) and all-cause mortality were compared between the study groups. Results: A modified HEART risk score (≥4) was calculated for 440 of 5490 patients visited our CPU. One hundred and one (22.9%), 80 (18.1%), and 249 (56.5%) patients were categorized as DAMA, admitted, and conservative treatment groups, respectively. Myocardial infarction was significantly higher in the DAMA versus admitted group (2 vs. 0; P ≤ 0.001). MACE and all-cause mortality were significantly higher in the DAMA group than that in the conservative treatment group (5 vs. 2; P = 0.02 and 4 vs. 2; P = 0.055, respectively). Conclusion: In the present study, we have demonstrated a considerable rate of DAMA in patients with high modified HEART risk score referring to CPU during the COVID-19 outbreak. Importantly, the DAMA group experienced a higher incidence rate of 30-day MACE and all-cause mortality compared to patients who were admitted or managed conservatively.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44020921","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}
Background: Coronavirus disease of 2019 (COVID-19) is a respiratory disease which can lead to cardiovascular complications including myocarditis, myocardial infarction, and heart failure. Electrocardiogram (ECG) may change in patients with COVID-19 with or without heart involvement. In this study, the ECG changes were evaluated in myocardial injuries due to COVID-19. Methods: This study was done on 22 COVID-19 patients with ST segment elevation in ECG and high troponin level. COVID-19 was confirmed using reverse-transcription polymerase chain reaction test. The ECG variables were evaluated by an expert cardiologist. Statistical analyses were carried out on ECG variables where the significance level of 0.05 was assigned. Results: Of 22 patients, 17 cases (77.3%) were male and 6 cases (27.3%) had a history of coronary artery disease. The most common myocardial involvement was extensive anterior type (31.8%), followed by anterior type (22.7%). Sinus rhythm was observed in 95.5% of patients and 54.5% had low voltage ECG in limb leads. No significant correlation was found between low voltage ECG and demonstrable etiologies of low voltage. Conclusion: The prevalence of low voltage ECG was significantly high in limb leads of patients with myocardial injury due to COVID-19 which was considerably greater than that of myocarditis or myocardial infarction patients.
{"title":"A novel electrocardiogram characteristic in patients with myocardial injury due to COVID-19","authors":"M. Mirtajaddini, R. Salehi, M. Chenaghlou","doi":"10.4103/rcm.rcm_21_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_21_21","url":null,"abstract":"Background: Coronavirus disease of 2019 (COVID-19) is a respiratory disease which can lead to cardiovascular complications including myocarditis, myocardial infarction, and heart failure. Electrocardiogram (ECG) may change in patients with COVID-19 with or without heart involvement. In this study, the ECG changes were evaluated in myocardial injuries due to COVID-19. Methods: This study was done on 22 COVID-19 patients with ST segment elevation in ECG and high troponin level. COVID-19 was confirmed using reverse-transcription polymerase chain reaction test. The ECG variables were evaluated by an expert cardiologist. Statistical analyses were carried out on ECG variables where the significance level of 0.05 was assigned. Results: Of 22 patients, 17 cases (77.3%) were male and 6 cases (27.3%) had a history of coronary artery disease. The most common myocardial involvement was extensive anterior type (31.8%), followed by anterior type (22.7%). Sinus rhythm was observed in 95.5% of patients and 54.5% had low voltage ECG in limb leads. No significant correlation was found between low voltage ECG and demonstrable etiologies of low voltage. Conclusion: The prevalence of low voltage ECG was significantly high in limb leads of patients with myocardial injury due to COVID-19 which was considerably greater than that of myocarditis or myocardial infarction patients.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42706663","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}
Shaikat Mondal, Himel Mondal, R. Samantaray, Debasish Das, S. Biri, Avijit Naskar, Sebabrata Jana
Background: Atherogenic index of plasma (AIP), a logarithm of ratio of triglycerides and high-density lipoprotein-cholesterol is associated with the risk of cardiovascular diseases. The cardiovascular complication in Type 2 diabetes is often assessed by the left ventricular ejection fraction (LVEF). Aim: This study aimed to observe and to find any correlation between LVEF and AIP in newly diagnosed Type 2 diabetes mellitus patients. Materials and Methods: In this cross-sectional observational study, we recruited 140 (male 81, female 59) newly diagnosed Type 2 diabetes mellitus patients from a tertiary care hospital. Plasma lipids were measured from venous blood after 12-h fasting. The LVEF was measured by echocardiography. Data were presented as mean, standard deviation, and statistically tested by Chi-square and Pearson correlation coefficient in IBM SPSS Statistics 20. Results: The mean age of the participants was 53.95 ± 11.63 years (male 53.85 ± 11.12 years, female 54.08 ± 12.39 years, unpaired t-test P = 0.91). The mean LVEF was 0.59 ± 0.06 and 0.6 ± 0.05 (unpaired t-test P = 0.17) in males and females, respectively. The AIP was 0.57 ± 0.07 and 0.57 ± 0.07 (unpaired t-test P = 0.97) in males and females, respectively. There was a negative correlation (r = −0.56, P < 0.001) between LVEF and AIP. Conclusion: Newly diagnosed type 2 diabetes mellitus patients showed a high AIP. Hence, serum lipid profile may be tested early in these patients. Patients with a higher AIP may have lower LVEF. Hence, diabetic patients with a high AIP may be screened for LVEF periodically for early detection and management of heart failure.
{"title":"Atherogenic index of plasma and left ventricular ejection fraction in newly diagnosed type 2 diabetes mellitus patients","authors":"Shaikat Mondal, Himel Mondal, R. Samantaray, Debasish Das, S. Biri, Avijit Naskar, Sebabrata Jana","doi":"10.4103/rcm.rcm_16_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_16_21","url":null,"abstract":"Background: Atherogenic index of plasma (AIP), a logarithm of ratio of triglycerides and high-density lipoprotein-cholesterol is associated with the risk of cardiovascular diseases. The cardiovascular complication in Type 2 diabetes is often assessed by the left ventricular ejection fraction (LVEF). Aim: This study aimed to observe and to find any correlation between LVEF and AIP in newly diagnosed Type 2 diabetes mellitus patients. Materials and Methods: In this cross-sectional observational study, we recruited 140 (male 81, female 59) newly diagnosed Type 2 diabetes mellitus patients from a tertiary care hospital. Plasma lipids were measured from venous blood after 12-h fasting. The LVEF was measured by echocardiography. Data were presented as mean, standard deviation, and statistically tested by Chi-square and Pearson correlation coefficient in IBM SPSS Statistics 20. Results: The mean age of the participants was 53.95 ± 11.63 years (male 53.85 ± 11.12 years, female 54.08 ± 12.39 years, unpaired t-test P = 0.91). The mean LVEF was 0.59 ± 0.06 and 0.6 ± 0.05 (unpaired t-test P = 0.17) in males and females, respectively. The AIP was 0.57 ± 0.07 and 0.57 ± 0.07 (unpaired t-test P = 0.97) in males and females, respectively. There was a negative correlation (r = −0.56, P < 0.001) between LVEF and AIP. Conclusion: Newly diagnosed type 2 diabetes mellitus patients showed a high AIP. Hence, serum lipid profile may be tested early in these patients. Patients with a higher AIP may have lower LVEF. Hence, diabetic patients with a high AIP may be screened for LVEF periodically for early detection and management of heart failure.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41331553","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}
Debasish Das, D. Acharya, Dibyasundar Mahanta, S. Singh, Tutan Das, Subhash R. Pramanik
We report a rare case of anomalous origin of right coronary artery (RCA) from the left coronary sinus with a peculiar medusa head pattern of left coronary system in an octogenarian presenting with inferior wall myocardial infarction. Although anomalous origin of RCA from the left coronary sinus is the most common anomaly to be reported, this rare association of extensive arborization of left coronary system appearing like a medusa head is not reported in literature so far. The anomalous RCA harbored critical mid-RCA lesion, but the crux of coronary intervention was that we engaged the anomalous RCA with extra back up guide catheter in place of conventionally used Judkins right guide catheter to engage the anomalous origin and accomplished the coronary intervention with buddy wire technique. Our case is unique and the first to describe the association of medusa head appearance of left coronary circulation in a case of anomalous origin of RCA from the left coronary sinus.
{"title":"Anomalous origin of the right coronary artery from the left coronary sinus with medusa head left coronaries: Plethora of left coronary circulation with paucity of right one","authors":"Debasish Das, D. Acharya, Dibyasundar Mahanta, S. Singh, Tutan Das, Subhash R. Pramanik","doi":"10.4103/rcm.rcm_42_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_42_21","url":null,"abstract":"We report a rare case of anomalous origin of right coronary artery (RCA) from the left coronary sinus with a peculiar medusa head pattern of left coronary system in an octogenarian presenting with inferior wall myocardial infarction. Although anomalous origin of RCA from the left coronary sinus is the most common anomaly to be reported, this rare association of extensive arborization of left coronary system appearing like a medusa head is not reported in literature so far. The anomalous RCA harbored critical mid-RCA lesion, but the crux of coronary intervention was that we engaged the anomalous RCA with extra back up guide catheter in place of conventionally used Judkins right guide catheter to engage the anomalous origin and accomplished the coronary intervention with buddy wire technique. Our case is unique and the first to describe the association of medusa head appearance of left coronary circulation in a case of anomalous origin of RCA from the left coronary sinus.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43520088","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}
S. Parhizgar, M. Zanganehfar, R. Kiani, H. Pouraliakbar, Raheleh Kaviani, M. Kamali, Milad Vahedinezhad, Afshin Sanavi
Infective endocarditis can cause several major complications, including valvular destruction, aneurysm formation, and aortic ring abscesses, and pseudoaneurysm formation in left ventricular outflow tract (LVOT) is quite a rare complication of infective endocarditis. Here, we present a rare case which had two simultaneous LVOT pseudoaneurysms, a bicuspid aortic valve (BAV) and abscess formation along with the presence of anerobic bacteria (Peptostreptococcus) in the tissue culture. We describe echocardiographic, computed tomography angiography findings, and the result of surgical repair. This is a unique case with 2 LVOT pseudoaneurysms, a BAV, and anerobic bacteria in the tissue culture which became complicated as a result of delayed intervention due to fear of coronavirus disease 2019.
{"title":"Two aortic root pseudoaneurysms in infective endocarditis in a patient with bicuspid aortic valve","authors":"S. Parhizgar, M. Zanganehfar, R. Kiani, H. Pouraliakbar, Raheleh Kaviani, M. Kamali, Milad Vahedinezhad, Afshin Sanavi","doi":"10.4103/rcm.rcm_13_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_13_21","url":null,"abstract":"Infective endocarditis can cause several major complications, including valvular destruction, aneurysm formation, and aortic ring abscesses, and pseudoaneurysm formation in left ventricular outflow tract (LVOT) is quite a rare complication of infective endocarditis. Here, we present a rare case which had two simultaneous LVOT pseudoaneurysms, a bicuspid aortic valve (BAV) and abscess formation along with the presence of anerobic bacteria (Peptostreptococcus) in the tissue culture. We describe echocardiographic, computed tomography angiography findings, and the result of surgical repair. This is a unique case with 2 LVOT pseudoaneurysms, a BAV, and anerobic bacteria in the tissue culture which became complicated as a result of delayed intervention due to fear of coronavirus disease 2019.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45527062","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}
N. Naderi, M. Mirtajaddini, G. Houshmand, S. Taghavi, A. Amin
Severe acute respiratory syndrome coronavirus 2 (CoV-2), the cause of CoV disease 2019 (COVID-19), can lead to multi-organ injury including cardiac involvement. Acute myocarditis is one of the serious and fatal complications of COVID-19. In this report, we introduce two cases with acute myocarditis and negative real-time polymerase chain reaction test, presented during the COVID-19 pandemic and discuss the challenge of their diagnosis and management.
{"title":"Challenge of coronavirus disease 2019-related myocarditis diagnosis in patients with negative real-time polymerase chain reaction test: A case series","authors":"N. Naderi, M. Mirtajaddini, G. Houshmand, S. Taghavi, A. Amin","doi":"10.4103/rcm.rcm_5_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_5_21","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (CoV-2), the cause of CoV disease 2019 (COVID-19), can lead to multi-organ injury including cardiac involvement. Acute myocarditis is one of the serious and fatal complications of COVID-19. In this report, we introduce two cases with acute myocarditis and negative real-time polymerase chain reaction test, presented during the COVID-19 pandemic and discuss the challenge of their diagnosis and management.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41613554","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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