O. Shafe, J. Moosavi, A. Alizadehasl, H. Pouraliakbar, B. Naghavi, Sepehr Jamalkhani, Sajjad Rezaei, K. Rezaei-Kalantari, Melody Farrashi, M. Naghshbandi, Parham Rabiei, M. Maleki, H. Talakoob, Maryam Salehi, M. Malakouti, Parham Sadeghipour
Background: Pulmonary embolism (PE) is a major public health concern, with a considerable mortality rate. In the present study, we have evaluated the impact of registry implementation on PE management. Methods: In the present single-center study, composed of two distinct cohorts, we have evaluated the impact of registry implementation (prospective arm-September 2015 to August 2018) on patient management and survival, and compared it with the same duration when no registry was implied (retrospective arm-September 2012 to August 2015). Results: One hundred and seventy and 182 patients were recruited in the prospective and retrospective arms, respectively. Guideline-recommended risk stratification was significantly overlooked before the introduction of PE registry (100% vs. 45.6% prospective and retrospective arms, respectively [P < 0.001]). A trend toward higher administration of thrombolytic therapy was noted in patients admitted during the registry time (20 [64.5%] vs. 3 [37.5%], P = 0.166). The registry had also significant impact on length of hospital stay (6.72 ± 4.39 days versus 9.35 ± 5.55, P = 0.001, in prospective and retrospective arms, respectively). No significant difference was detected on the 6-month all-cause mortality. However, re-venous thromboembolism was significantly reduced during registry time (2 [1.2%) vs. 22 [12.2%], P < 0.001). Finally, significantly more patients underwent guideline-recommended follow-up during the registry time (107 [72.3%] vs. 30 [16.5%], P < 0.001). Conclusion: Our study showed the implementation of registry had significant effect on PE-related outcome and might have direct impact on burden of pulmonary emboli on the healthcare system.
{"title":"Impact of registry implementation on the management and survival of patients with pulmonary embolism","authors":"O. Shafe, J. Moosavi, A. Alizadehasl, H. Pouraliakbar, B. Naghavi, Sepehr Jamalkhani, Sajjad Rezaei, K. Rezaei-Kalantari, Melody Farrashi, M. Naghshbandi, Parham Rabiei, M. Maleki, H. Talakoob, Maryam Salehi, M. Malakouti, Parham Sadeghipour","doi":"10.4103/rcm.rcm_4_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_4_21","url":null,"abstract":"Background: Pulmonary embolism (PE) is a major public health concern, with a considerable mortality rate. In the present study, we have evaluated the impact of registry implementation on PE management. Methods: In the present single-center study, composed of two distinct cohorts, we have evaluated the impact of registry implementation (prospective arm-September 2015 to August 2018) on patient management and survival, and compared it with the same duration when no registry was implied (retrospective arm-September 2012 to August 2015). Results: One hundred and seventy and 182 patients were recruited in the prospective and retrospective arms, respectively. Guideline-recommended risk stratification was significantly overlooked before the introduction of PE registry (100% vs. 45.6% prospective and retrospective arms, respectively [P < 0.001]). A trend toward higher administration of thrombolytic therapy was noted in patients admitted during the registry time (20 [64.5%] vs. 3 [37.5%], P = 0.166). The registry had also significant impact on length of hospital stay (6.72 ± 4.39 days versus 9.35 ± 5.55, P = 0.001, in prospective and retrospective arms, respectively). No significant difference was detected on the 6-month all-cause mortality. However, re-venous thromboembolism was significantly reduced during registry time (2 [1.2%) vs. 22 [12.2%], P < 0.001). Finally, significantly more patients underwent guideline-recommended follow-up during the registry time (107 [72.3%] vs. 30 [16.5%], P < 0.001). Conclusion: Our study showed the implementation of registry had significant effect on PE-related outcome and might have direct impact on burden of pulmonary emboli on the healthcare system.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"40 - 44"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45359602","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. Taghavi, Parham Sadeghipour, S. Amini, Samira Arami, N. Naderi, A. Amin, H. Pouraliakbar, A. Alizadehasl, O. Shafe, J. Moosavi, A. Ghavidel, B. Mohebbi, Ziae Totonchi, R. Azarfarin, H. Sadeghi, M. Mirdamadi, H. Malek, K. Rezaei-Kalantari
Introduction: We herein present the preliminary results of our center's chronic thromboembolic pulmonary hypertension (CTEPH) registry of the tertiary outcomes of patients diagnosed with CTEPH and treated with pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA), or medical treatment. Methods: The present retrospective cross-sectional study was conducted on patients who received treatment for CTEPH in Rajaie Cardiovascular Medical and Research Center over the past four years, from 2016 to 2020. The data were obtained from routine hospital admission and outpatient visit records. The patients were divided into PEA, BPA, and medical treatment groups, and the outcomes and complications of the procedures were reported. Results: Twenty-eight patients, at a median age of 40 (33–59) years were included in our study and were followed for approximately 20.0 (16.2–23.7) months. PEA was performed on 13 (46%) patients, BPA on 10 (35%), and medical therapy only on 5 (17%). Death occurred in 4 (30%) patients after surgery, and 10 (77%) had a surgical complication. There were no deaths or recorded complications in the other two groups, but the rates of postprocedural pulmonary hypertension (30% vs. 91%; P = 0.006) and rehospitalization (7% vs. 73%; P < 0.001) were significantly lower in the operated patients. The 1-year survival rate among the entire study population was 85.7%. Conclusions: The possibility of CTEPH incidence, especially in high-risk patients with dyspnea, should always be borne in mind given its large morbidity and mortality rate and its chances of curability with early diagnosis and proper treatment.
在此，我们报告了本中心慢性血栓栓塞性肺动脉高压(CTEPH)患者的三级结局登记的初步结果，这些患者被诊断为CTEPH并接受肺动脉内膜切除术(PEA)、球囊肺血管成形术(BPA)或药物治疗。方法:回顾性横断面研究2016 - 2020年4年间Rajaie心血管医学研究中心接受CTEPH治疗的患者。数据来自常规住院和门诊就诊记录。将患者分为PEA组、BPA组和药物治疗组，并报告手术结果和并发症。结果:我们的研究纳入了28例患者，中位年龄为40(33-59)岁，随访时间约20.0(16.2-23.7)个月。PEA治疗13例(46%)，BPA治疗10例(35%)，药物治疗5例(17%)。术后死亡4例(30%)，手术并发症10例(77%)。其他两组无死亡或并发症，但术后肺动脉高压发生率(30% vs 91%;P = 0.006)和再住院(7% vs. 73%;P < 0.001)明显低于手术组。整个研究人群的1年生存率为85.7%。结论:考虑到CTEPH的高发病率和死亡率，以及早期诊断和适当治疗的治愈机会，应始终牢记其发生的可能性，特别是在呼吸困难的高危患者中。
{"title":"The preliminary diagnostic and therapeutic outcomes of chronic thromboembolic pulmonary hypertension registry rajaie cardiovascular medical and research center","authors":"S. Taghavi, Parham Sadeghipour, S. Amini, Samira Arami, N. Naderi, A. Amin, H. Pouraliakbar, A. Alizadehasl, O. Shafe, J. Moosavi, A. Ghavidel, B. Mohebbi, Ziae Totonchi, R. Azarfarin, H. Sadeghi, M. Mirdamadi, H. Malek, K. Rezaei-Kalantari","doi":"10.4103/rcm.rcm_6_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_6_21","url":null,"abstract":"Introduction: We herein present the preliminary results of our center's chronic thromboembolic pulmonary hypertension (CTEPH) registry of the tertiary outcomes of patients diagnosed with CTEPH and treated with pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA), or medical treatment. Methods: The present retrospective cross-sectional study was conducted on patients who received treatment for CTEPH in Rajaie Cardiovascular Medical and Research Center over the past four years, from 2016 to 2020. The data were obtained from routine hospital admission and outpatient visit records. The patients were divided into PEA, BPA, and medical treatment groups, and the outcomes and complications of the procedures were reported. Results: Twenty-eight patients, at a median age of 40 (33–59) years were included in our study and were followed for approximately 20.0 (16.2–23.7) months. PEA was performed on 13 (46%) patients, BPA on 10 (35%), and medical therapy only on 5 (17%). Death occurred in 4 (30%) patients after surgery, and 10 (77%) had a surgical complication. There were no deaths or recorded complications in the other two groups, but the rates of postprocedural pulmonary hypertension (30% vs. 91%; P = 0.006) and rehospitalization (7% vs. 73%; P < 0.001) were significantly lower in the operated patients. The 1-year survival rate among the entire study population was 85.7%. Conclusions: The possibility of CTEPH incidence, especially in high-risk patients with dyspnea, should always be borne in mind given its large morbidity and mortality rate and its chances of curability with early diagnosis and proper treatment.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"29 - 36"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46187978","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}
Z. Khajali, N. Naderi, M. Mirtajaddini, N. Rezaeian
Marfan syndrome is a connective tissue disorder which involves various systems such as the cardiovascular system. One of the cardiovascular manifestations of Marfan syndrome is ventricular dysfunction. In this report, a case of Marfan syndrome was presented who suffered from acute heart failure due to Coronavirus disease 2019 (COVID-19). We discussed about several reasons of heart failure in this case and we suggested that COVID-19 related cardiovascular complications may be more prevalent in Marfan syndrome.
{"title":"Does myocardial injury rapidly progress in marfan syndrome following COVID-19?","authors":"Z. Khajali, N. Naderi, M. Mirtajaddini, N. Rezaeian","doi":"10.4103/rcm.rcm_10_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_10_21","url":null,"abstract":"Marfan syndrome is a connective tissue disorder which involves various systems such as the cardiovascular system. One of the cardiovascular manifestations of Marfan syndrome is ventricular dysfunction. In this report, a case of Marfan syndrome was presented who suffered from acute heart failure due to Coronavirus disease 2019 (COVID-19). We discussed about several reasons of heart failure in this case and we suggested that COVID-19 related cardiovascular complications may be more prevalent in Marfan syndrome.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"59 - 61"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48735725","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: Refractory periods are measured by the extrastimulus technique, whereby a single extrastimulus is introduced at progressively shorter coupling intervals until a response is no longer elicited. Purpose: As refractoriness of cardiac tissues depends on prior cycle length, refractory periods should be determined at a fixed cycle length within the physiologic range. The extrastimulus is delivered after a train of 8 to 10 paced complexes to allow time for reasonable stabilization of refractoriness, which is usually accomplished after the first 3 or 4 paced beats. Objectives: We conducted this study to compare the effect of 6 vs 8 stimuli in basic cycle length (BCL) in measurement of effective refractory period (ERP). Materials and Methods: During electrophysiologic study (EPS) of 100 consecutive patients, anterograde and retrograde ERP of atrioventricular node (AVN) were measured by introduction of 6 vs 8 stimuli in BCL and premature beat, then the results were compared. Results: Recorded anterograde and retrograde ERP of AVN applying 6 vs 8 stimuli in BCL were compared and no difference was detected. Conclusion: We concluded that for ERP measurement of AVN, 6 stimuli in BCL is comparable to 8 stimuli in reaching the steady state.
{"title":"The effect of basic cycle length stimuli on effective refractory period measurement","authors":"Mohammd Sadr-Ameli, Farzad Kamali, Milad Vahedinezhad, Sadaf Sadrameli","doi":"10.4103/rcm.rcm_1_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_1_21","url":null,"abstract":"Background: Refractory periods are measured by the extrastimulus technique, whereby a single extrastimulus is introduced at progressively shorter coupling intervals until a response is no longer elicited. Purpose: As refractoriness of cardiac tissues depends on prior cycle length, refractory periods should be determined at a fixed cycle length within the physiologic range. The extrastimulus is delivered after a train of 8 to 10 paced complexes to allow time for reasonable stabilization of refractoriness, which is usually accomplished after the first 3 or 4 paced beats. Objectives: We conducted this study to compare the effect of 6 vs 8 stimuli in basic cycle length (BCL) in measurement of effective refractory period (ERP). Materials and Methods: During electrophysiologic study (EPS) of 100 consecutive patients, anterograde and retrograde ERP of atrioventricular node (AVN) were measured by introduction of 6 vs 8 stimuli in BCL and premature beat, then the results were compared. Results: Recorded anterograde and retrograde ERP of AVN applying 6 vs 8 stimuli in BCL were compared and no difference was detected. Conclusion: We concluded that for ERP measurement of AVN, 6 stimuli in BCL is comparable to 8 stimuli in reaching the steady state.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"37 - 39"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46964551","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}
A. Alizadehasl, H. Bakhshandeh, Parham Sadeghipour, B. Mohebbi, M. Baay, M. Alemzadeh-Ansari, Zahra Hosseini, Z. Norouzi, M. Maleki, F. Noohi, Yasaman Khalili, N. Naderi, H. Pouraliakbar, B. Ghadrdoost, M. Arabian, Shiva Khaleghparast, S. Boudagh
Introduction: It is crucial to define the normal ranges of echocardiographic parameters and their relationships with age, sex, race, and geographical differences given the failure of the existing literature to reflect the diversity of the world's populations. This study aimed to determine the normal ranges of echocardiographic systolic and diastolic values and the incidence of valvular heart lesions with or without rheumatic involvement in a sample of Iranian population. Methods: The Echocardiography Heart Assessment and Monitoring in Rajaie Hospital study is a population-based investigation conducted in Rajaie Cardiovascular Medical and Research Center. A total of 2229 Iranian individuals between 30 and 75 years of age without clinical cardiovascular diseases were invited through a multistage random sampling process, and they underwent two-dimensional and Doppler echocardiography. The left ventricular (LV) ejection fraction, the interventricular septal thickness, the ascending aortic size, the LV diastolic function, the valvular heart disease (VHD) severity, and rheumatic valvular involvement were assessed. Results: The study population comprised 2229 patients: 882 men (40%) and 1347 women (60%) at an age range of 39–58 years and a mean age of 48 years. The average body mass index was 28.8 kg/m2 (25.9–32 kg/m2), and the median body surface area was 1.86. Mildsystolic dysfunction was reported in 119 patients (5.7%) and moderate systolic dysfunction in 19 (0.9%). LV systolic dysfunction was significantly correlated with the male sex, age, and hypertension (P < 0.001). The mean interventricular septal thickness was 8 mm. Mild LV hypertrophy (LVH) was detected in 5.5% of all the patients and moderate LVH in 0.4%. The mean interventricular septal thickness significantly increased with age (P < 0.001), and it was higher in the men than in the women (8.2 mm [7.8–9.2] vs. 8 mm [7–8.25]; P < 0.001). Mild LVH and moderate LVH were significantly correlated with hypertension, diabetes mellitus, hyperlipidemia, chronic kidney disease, and diastolic dysfunction (P < 0.001). Diastolic dysfunction was found in 29% of the patients (28.6% mild and 0.2% moderate). Significant correlations were found between LV diastolic dysfunction and age, the female sex, diabetes mellitus, hypertension, hyperlipidemia, and hypercholesterolemia (P < 0.001). The mean ascending aortic size was 31 mm in the men and 29 mm in the women. The ascending aortic size exceeded 37 mm in 5% of the men and 3.5% of the women. The indexed ascending aortic size was 1.54 cm/m2 in the men and 1.66 cm/m2 in the women. Valvular heart lesions were diagnosed in about half of the study population. The most common findings were mild regurgitation in the mitral and tricuspid valves. Multiple valvular disorders were found in 55% of the patients. Among significant (moderate and more-than-moderate) VHDs, tricuspid regurgitation (36%), mitral regurgitation (33%), and aortic regurgitation (19%) were the most f
引言:鉴于现有文献未能反映世界人口的多样性，确定超声心动图参数的正常范围及其与年龄、性别、种族和地理差异的关系至关重要。本研究旨在确定伊朗人群中超声心动图收缩期和舒张期值的正常范围以及有或无风湿病累及的瓣膜性心脏病变的发生率。方法:拉加伊医院超声心动图心脏评估与监测研究是在拉加伊心血管医学研究中心开展的一项基于人群的调查。通过多阶段随机抽样，共邀请2229名年龄在30至75岁之间、无临床心血管疾病的伊朗人接受二维和多普勒超声心动图检查。评估左室(LV)射血分数、室间隔厚度、升主动脉大小、左室舒张功能、瓣膜性心脏病(VHD)严重程度和风湿性瓣膜受累。结果:研究人群包括2229例患者:男性882例(40%)，女性1347例(60%)，年龄39-58岁，平均年龄48岁。平均体重指数为28.8 kg/m2 (25.9 ~ 32 kg/m2)，中位体表面积为1.86。轻度收缩功能障碍119例(5.7%)，中度收缩功能障碍19例(0.9%)。左室收缩功能障碍与男性、年龄、高血压显著相关(P < 0.001)。室间隔平均厚度为8mm。5.5%的患者有轻度左室肥厚，0.4%的患者有中度左室肥厚。室间隔平均厚度随年龄增加而显著增高(P < 0.001)，且男性高于女性(8.2 mm [7.8 ~ 9.2] vs. 8 mm [7 ~ 8.25];P < 0.001)。轻度LVH和中度LVH与高血压、糖尿病、高脂血症、慢性肾病、舒张功能不全显著相关(P < 0.001)。29%的患者存在舒张功能障碍(28.6%为轻度，0.2%为中度)。左室舒张功能障碍与年龄、女性、糖尿病、高血压、高脂血症、高胆固醇血症有显著相关性(P < 0.001)。男性的平均升主动脉直径为31毫米，女性为29毫米。5%的男性和3.5%的女性升主动脉直径超过37mm。男性的指数升主动脉大小为1.54 cm/m2，女性为1.66 cm/m2。大约一半的研究人群被诊断出心脏瓣膜病变。最常见的表现是二尖瓣和三尖瓣轻度反流。55%的患者存在多重瓣膜疾病。在显著(中度和中度以上)vhd中，三尖瓣反流(36%)、二尖瓣反流(33%)和主动脉反流(19%)是最常见的vhd。31例(1.4%)患者被诊断为风湿性瓣膜受累。结论:超声心动图参数随年龄、性别、种族的不同而不同，应进行人群调整。我们建议在伊朗的不同地区进行进一步的研究，以获得足够的数据，以创建关于超声心动图参数的适用指南。
{"title":"Normal values of echocardiographic parameters and incidence of valvular heart findings in 2229 iranian peaple: Results from the “HAMRAH survey”","authors":"A. Alizadehasl, H. Bakhshandeh, Parham Sadeghipour, B. Mohebbi, M. Baay, M. Alemzadeh-Ansari, Zahra Hosseini, Z. Norouzi, M. Maleki, F. Noohi, Yasaman Khalili, N. Naderi, H. Pouraliakbar, B. Ghadrdoost, M. Arabian, Shiva Khaleghparast, S. Boudagh","doi":"10.4103/rcm.rcm_18_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_18_21","url":null,"abstract":"Introduction: It is crucial to define the normal ranges of echocardiographic parameters and their relationships with age, sex, race, and geographical differences given the failure of the existing literature to reflect the diversity of the world's populations. This study aimed to determine the normal ranges of echocardiographic systolic and diastolic values and the incidence of valvular heart lesions with or without rheumatic involvement in a sample of Iranian population. Methods: The Echocardiography Heart Assessment and Monitoring in Rajaie Hospital study is a population-based investigation conducted in Rajaie Cardiovascular Medical and Research Center. A total of 2229 Iranian individuals between 30 and 75 years of age without clinical cardiovascular diseases were invited through a multistage random sampling process, and they underwent two-dimensional and Doppler echocardiography. The left ventricular (LV) ejection fraction, the interventricular septal thickness, the ascending aortic size, the LV diastolic function, the valvular heart disease (VHD) severity, and rheumatic valvular involvement were assessed. Results: The study population comprised 2229 patients: 882 men (40%) and 1347 women (60%) at an age range of 39–58 years and a mean age of 48 years. The average body mass index was 28.8 kg/m2 (25.9–32 kg/m2), and the median body surface area was 1.86. Mildsystolic dysfunction was reported in 119 patients (5.7%) and moderate systolic dysfunction in 19 (0.9%). LV systolic dysfunction was significantly correlated with the male sex, age, and hypertension (P < 0.001). The mean interventricular septal thickness was 8 mm. Mild LV hypertrophy (LVH) was detected in 5.5% of all the patients and moderate LVH in 0.4%. The mean interventricular septal thickness significantly increased with age (P < 0.001), and it was higher in the men than in the women (8.2 mm [7.8–9.2] vs. 8 mm [7–8.25]; P < 0.001). Mild LVH and moderate LVH were significantly correlated with hypertension, diabetes mellitus, hyperlipidemia, chronic kidney disease, and diastolic dysfunction (P < 0.001). Diastolic dysfunction was found in 29% of the patients (28.6% mild and 0.2% moderate). Significant correlations were found between LV diastolic dysfunction and age, the female sex, diabetes mellitus, hypertension, hyperlipidemia, and hypercholesterolemia (P < 0.001). The mean ascending aortic size was 31 mm in the men and 29 mm in the women. The ascending aortic size exceeded 37 mm in 5% of the men and 3.5% of the women. The indexed ascending aortic size was 1.54 cm/m2 in the men and 1.66 cm/m2 in the women. Valvular heart lesions were diagnosed in about half of the study population. The most common findings were mild regurgitation in the mitral and tricuspid valves. Multiple valvular disorders were found in 55% of the patients. Among significant (moderate and more-than-moderate) VHDs, tricuspid regurgitation (36%), mitral regurgitation (33%), and aortic regurgitation (19%) were the most f","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"45 - 53"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42716818","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}
Pardha Sivakoti, G. Harsha, Praveen Nagula, Srinivas Ravi
Amyloidosis is a clinical disorder caused by extracellular deposition of insoluble fibrils with beta-pleated sheet configuration. The protein misfolding abnormalities result in amyloid fibrils and may manifest as primary, secondary, familial, or senile amyloidosis. Amyloid deposition can occur in multiple organs (e.g. heart, liver, kidney, skin, eyes, lungs, and nervous system), resulting in a variety of clinical manifestations. Cardiac involvement is a progressive disorder resulting in early death due to congestive heart failure and arrhythmias. We report a rare case of cardiac amyloidosis presenting as recurrent pericardial effusion with features of restrictive cardiomyopathy.
{"title":"Unveiling the diagnosis of cardiac amyloidosis in a patient with large pericardial effusion and tamponade","authors":"Pardha Sivakoti, G. Harsha, Praveen Nagula, Srinivas Ravi","doi":"10.4103/rcm.rcm_3_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_3_21","url":null,"abstract":"Amyloidosis is a clinical disorder caused by extracellular deposition of insoluble fibrils with beta-pleated sheet configuration. The protein misfolding abnormalities result in amyloid fibrils and may manifest as primary, secondary, familial, or senile amyloidosis. Amyloid deposition can occur in multiple organs (e.g. heart, liver, kidney, skin, eyes, lungs, and nervous system), resulting in a variety of clinical manifestations. Cardiac involvement is a progressive disorder resulting in early death due to congestive heart failure and arrhythmias. We report a rare case of cardiac amyloidosis presenting as recurrent pericardial effusion with features of restrictive cardiomyopathy.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"65 - 67"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47923472","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}
Tutan Das, D. Das, D. Acharya, S. Singh, J. Gupta, Subhash R. Pramanik
We present an extreme rare case of acute pulmonary embolism in an 83-year-old male presenting as acute inferior wall ST-elevated myocardial infarction with right ventricular infarction (RVMI) in electrocardiogram (ECG). Acute pulmonary embolism presenting as acute inferior wall ST-elevation myocardial infarction with RVMI has not been described in the world literature so far. Our case is unique and first to describe the presentation of acute pulmonary embolism in the form of inferior wall ST-elevated myocardial infarction with evidence of RVMI in the ECG. It is of utmost important for the treating cardiologist and critical care physician to differentiate the same as treatment modalities of both conditions varies markedly and wrong therapeutic measures can land up in a catastrophe.
{"title":"Acute provoked pulmonary embolism masquerading as inferior wall myocardial infarction with right ventricular infarction","authors":"Tutan Das, D. Das, D. Acharya, S. Singh, J. Gupta, Subhash R. Pramanik","doi":"10.4103/rcm.rcm_32_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_32_21","url":null,"abstract":"We present an extreme rare case of acute pulmonary embolism in an 83-year-old male presenting as acute inferior wall ST-elevated myocardial infarction with right ventricular infarction (RVMI) in electrocardiogram (ECG). Acute pulmonary embolism presenting as acute inferior wall ST-elevation myocardial infarction with RVMI has not been described in the world literature so far. Our case is unique and first to describe the presentation of acute pulmonary embolism in the form of inferior wall ST-elevated myocardial infarction with evidence of RVMI in the ECG. It is of utmost important for the treating cardiologist and critical care physician to differentiate the same as treatment modalities of both conditions varies markedly and wrong therapeutic measures can land up in a catastrophe.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"68 - 71"},"PeriodicalIF":0.3,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49245585","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}
Objective: The objective was to study the role of 12-lead electrocardiogram (ECG) changes in predicting the association of severe stenosis of other coronary arteries along with infarct-related artery in patients who presented with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: We studied the admission ECG, clinical records, and coronary angiography of 201 patients with STEMI who underwent primary PCI within the first 12 h of symptoms. Patients with first episode of STEMI and coronary angiogram showing coronary artery disease between January 2015 and July 2016 were included in this study. Results: Most of the patients in this study were males (82.1%). The mean age of the patients was 55.20 ± 11.79 years. Diabetic mellitus (37.8%), hypertension (37%), and smoking (49.7%) were the main risk factors. This study had 117 (58.2%) patients of anterior wall myocardial infarction (MI) (Group I) while inferior wall MI was present in 84 (41.8%) patients (Group II). In Group I, 83 (70.9%) patients had single-vessel disease (SVD) while 34 (29.1%) patients had multivessel disease (MVD). The presence of ST-segment depression ≥0.1 mV in leads I, aVL, and V6 significantly correlated with the presence of MVD (P = 0.001, 0.001, and 0.001, respectively). In Group II, 39 (51.3%) patients had SVD while 37 (48.7%) patients had MVD. The presence of ST-segment depression in leads aVL, V5, and V6 significantly correlated with the presence of MVD (P = 0.049, 0.001, and 0.001, respectively). Conclusion: The presence of ST-segment depression of ≥0.1 mv in leads I, aVL, and V6 on admission ECG in the setting of acute anterior wall STEMI and in leads aVL, V5, and V6 on admission ECG in the setting of acute inferior wall STEMI was associated with MVD.
{"title":"Electrocardiogram predictors of multivessel disease in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention","authors":"A. Sharma, Tarun Kumar, M. Dhaka","doi":"10.4103/rcm.rcm_42_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_42_20","url":null,"abstract":"Objective: The objective was to study the role of 12-lead electrocardiogram (ECG) changes in predicting the association of severe stenosis of other coronary arteries along with infarct-related artery in patients who presented with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: We studied the admission ECG, clinical records, and coronary angiography of 201 patients with STEMI who underwent primary PCI within the first 12 h of symptoms. Patients with first episode of STEMI and coronary angiogram showing coronary artery disease between January 2015 and July 2016 were included in this study. Results: Most of the patients in this study were males (82.1%). The mean age of the patients was 55.20 ± 11.79 years. Diabetic mellitus (37.8%), hypertension (37%), and smoking (49.7%) were the main risk factors. This study had 117 (58.2%) patients of anterior wall myocardial infarction (MI) (Group I) while inferior wall MI was present in 84 (41.8%) patients (Group II). In Group I, 83 (70.9%) patients had single-vessel disease (SVD) while 34 (29.1%) patients had multivessel disease (MVD). The presence of ST-segment depression ≥0.1 mV in leads I, aVL, and V6 significantly correlated with the presence of MVD (P = 0.001, 0.001, and 0.001, respectively). In Group II, 39 (51.3%) patients had SVD while 37 (48.7%) patients had MVD. The presence of ST-segment depression in leads aVL, V5, and V6 significantly correlated with the presence of MVD (P = 0.049, 0.001, and 0.001, respectively). Conclusion: The presence of ST-segment depression of ≥0.1 mv in leads I, aVL, and V6 on admission ECG in the setting of acute anterior wall STEMI and in leads aVL, V5, and V6 on admission ECG in the setting of acute inferior wall STEMI was associated with MVD.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"1 - 6"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44093998","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}
A. Fakhrabadi, M. Zanganehfar, S. Saedi, M. Maleki, M. Ansari, H. Pouraliakbar
Spontaneous coronary artery dissection (SCAD) is a well-documented cause of acute coronary syndrome and could have life-threatening consequences. We report the case of young female with a prior history of cardiac surgery due to congenital aortic stenosis presenting with multi-vessel SCAD. She was successfully managed with medical treatment.
{"title":"Multi-vessel coronary artery dissection in a patient with congenital aortopathy","authors":"A. Fakhrabadi, M. Zanganehfar, S. Saedi, M. Maleki, M. Ansari, H. Pouraliakbar","doi":"10.4103/rcm.rcm_46_20","DOIUrl":"https://doi.org/10.4103/rcm.rcm_46_20","url":null,"abstract":"Spontaneous coronary artery dissection (SCAD) is a well-documented cause of acute coronary syndrome and could have life-threatening consequences. We report the case of young female with a prior history of cardiac surgery due to congenital aortic stenosis presenting with multi-vessel SCAD. She was successfully managed with medical treatment.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"23 - 25"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48305870","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}
R. Salehi, M. Mirtajaddini, M. Chenaghlou, Leili Faridi
Cardiac myxomas are the most common primary cardiac tumors, with an estimated incidence of 0.5 per million individuals annually. Although surgical resection is curative however, postoperative tumor recurrence has been reported, especially in familial and complex type of myxoma. Literature reviews reveal only a few cases of recurrence in sporadic cardiac myxoma. Herein we have reported a case of sporadic cardiac myxoma, with multiple recurrences after surgical resection. The possibility of repeated recurrence of cardiac myxomas demonstrates the importance of regular echocardiographic surveillance after surgical resection in order to detection of recurrence even in non-familial and non-syndromic cases. Further evaluations, including genetic analysis of patients with recurrent cardiac myxomas, are warranted to investigate the exact nature of these tumors.
{"title":"Multiple recurrences in a nonfamilial cardiac myxoma","authors":"R. Salehi, M. Mirtajaddini, M. Chenaghlou, Leili Faridi","doi":"10.4103/rcm.rcm_7_21","DOIUrl":"https://doi.org/10.4103/rcm.rcm_7_21","url":null,"abstract":"Cardiac myxomas are the most common primary cardiac tumors, with an estimated incidence of 0.5 per million individuals annually. Although surgical resection is curative however, postoperative tumor recurrence has been reported, especially in familial and complex type of myxoma. Literature reviews reveal only a few cases of recurrence in sporadic cardiac myxoma. Herein we have reported a case of sporadic cardiac myxoma, with multiple recurrences after surgical resection. The possibility of repeated recurrence of cardiac myxomas demonstrates the importance of regular echocardiographic surveillance after surgical resection in order to detection of recurrence even in non-familial and non-syndromic cases. Further evaluations, including genetic analysis of patients with recurrent cardiac myxomas, are warranted to investigate the exact nature of these tumors.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":"10 1","pages":"26 - 28"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42792359","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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