Large childhood symptomatic pericardial effusion demanding pericardio-centesis and pericardial drainage is rare and symptomatic childhood uremic pericardial effusion is even rarer. The aim of this paper is to report the rare occurrence of childhood uremic symptomatic pericardial effusion. A seven year old boy with the most extreme form of end-stage renal disease (anuric with no renal function). The patient developed large childhood symptomatic pericardial effusion which was diagnosed by echocardiography.
{"title":"Symptomatic Childhood Uremic Pericardial Effusion: An Echocardiography Image","authors":"Aamir Jalal Al-Mosawi","doi":"10.46940/shfci.02.1003","DOIUrl":"https://doi.org/10.46940/shfci.02.1003","url":null,"abstract":"Large childhood symptomatic pericardial effusion demanding pericardio-centesis and pericardial drainage is rare and symptomatic childhood uremic pericardial effusion is even rarer. The aim of this paper is to report the rare occurrence of childhood uremic symptomatic pericardial effusion. A seven year old boy with the most extreme form of end-stage renal disease (anuric with no renal function). The patient developed large childhood symptomatic pericardial effusion which was diagnosed by echocardiography.","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114276337","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: Determining the optimal revascularization strategy for patients with left main coronary artery disease (LMCAD) is a compelling topic. After the publication of two new trials, numerous meta-analyses on percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) appeared in the literature. This study set out to review the extent of published meta-analyses on PCI versus CABG in LMCAD, and stipulates the need for “quality over quantity”. Methods: A systematic search in Embase, Medline Ovid and Cochrane databases was performed to identify meta-analyses on PCI versus CABG in LMCAD. Meta-analyses that reported associations between revascularization and clinical outcomes were included. Study outcomes were reported according to descriptive statistics, without pooling study outcomes. Results: Fifty-one meta-analyses were included. Of those, 33 became available after EXCEL and NOBLE trial publication. The composite of major adverse cardiac (and cerebrovascular) events were reported in 41, and 49 reported all-cause mortality. Results varied among meta-analyses, depending on (i) randomized versus observational data, or a combination of both, (ii) methodology and effect-measures to report treatment-differences, (iii) varying sample sizes, and (iv) the year of publication. Conclusions: The number of meta-analyses on PCI versus CABG in patients with LMCAD, is disproportionate and urges the need for quality over quantity. To ensure future high-quality publications, we call on all authors, editors and reviewers to appraise the evidence already available and join forces to conduct individual patient data pooled analyses instead.
{"title":"A Critical Appraisal of a Decade of Left-Main Revascularization Meta-Analyses","authors":"C. Antonides","doi":"10.31579/2692-9759/006","DOIUrl":"https://doi.org/10.31579/2692-9759/006","url":null,"abstract":"Background: Determining the optimal revascularization strategy for patients with left main coronary artery disease (LMCAD) is a compelling topic. After the publication of two new trials, numerous meta-analyses on percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) appeared in the literature. This study set out to review the extent of published meta-analyses on PCI versus CABG in LMCAD, and stipulates the need for “quality over quantity”. Methods: A systematic search in Embase, Medline Ovid and Cochrane databases was performed to identify meta-analyses on PCI versus CABG in LMCAD. Meta-analyses that reported associations between revascularization and clinical outcomes were included. Study outcomes were reported according to descriptive statistics, without pooling study outcomes. Results: Fifty-one meta-analyses were included. Of those, 33 became available after EXCEL and NOBLE trial publication. The composite of major adverse cardiac (and cerebrovascular) events were reported in 41, and 49 reported all-cause mortality. Results varied among meta-analyses, depending on (i) randomized versus observational data, or a combination of both, (ii) methodology and effect-measures to report treatment-differences, (iii) varying sample sizes, and (iv) the year of publication. Conclusions: The number of meta-analyses on PCI versus CABG in patients with LMCAD, is disproportionate and urges the need for quality over quantity. To ensure future high-quality publications, we call on all authors, editors and reviewers to appraise the evidence already available and join forces to conduct individual patient data pooled analyses instead.","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126701785","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: Noonan syndrome is a heterogeneous congenital disorder that can occur sporadically or inherited as an autosomal dominant disorder. It is characterized by a wide spectrum of phenotypic abnormalities that vary greatly in range and severity, and two patients with Noonan syndrome may have two different characteristic features. In many patients the syndrome characterized by craniofacial abnormalities including low set ears, hypertelorism , congenital heart defect, short stature, and undescended testes. Although pulmonary stenosis is the commonly associated congenital cardiac defects, a variety of cardiac defects may occur in this syndrome. Atrial septal defect, and patent ductus arteriosus are other well-recognized cardiac defects of this syndrome. The diagnosis of Noonan syndrome is entirely clinical as there is no specific diagnostic available Materials and methods: A ten month old boy who was referred to the pediatric neuropsychiatric clinic of the Children Teaching Hospital of Baghdad Medical City because of developmental delay associated with multiple congenital abnormalities was studied. Results: The boy had growth and developmental retardation, low set ears, hypertelorism, and smooth philtrum, undescended testes. Echocardiography showed interatrial septum, small atrial septal defect and closing patent ductus arteriosus. Conclusion: Noonan syndrome was previously reported only in one girl from Iraq. The first Iraqi boy with Noonan syndrome is reported in association with unique cardiac defects. The previously reported case and the case in this deport demonstrates the variability of the phenotype of this syndrome.
{"title":"The second case of Noonan syndrome: The association with unique multiple cardiac defects","authors":"Aamir Jalal Al-Mosawi","doi":"10.31579/2692-9759/004","DOIUrl":"https://doi.org/10.31579/2692-9759/004","url":null,"abstract":"Background: Noonan syndrome is a heterogeneous congenital disorder that can occur sporadically or inherited as an autosomal dominant disorder. It is characterized by a wide spectrum of phenotypic abnormalities that vary greatly in range and severity, and two patients with Noonan syndrome may have two different characteristic features. In many patients the syndrome characterized by craniofacial abnormalities including low set ears, hypertelorism , congenital heart defect, short stature, and undescended testes. Although pulmonary stenosis is the commonly associated congenital cardiac defects, a variety of cardiac defects may occur in this syndrome. Atrial septal defect, and patent ductus arteriosus are other well-recognized cardiac defects of this syndrome. The diagnosis of Noonan syndrome is entirely clinical as there is no specific diagnostic available Materials and methods: A ten month old boy who was referred to the pediatric neuropsychiatric clinic of the Children Teaching Hospital of Baghdad Medical City because of developmental delay associated with multiple congenital abnormalities was studied. Results: The boy had growth and developmental retardation, low set ears, hypertelorism, and smooth philtrum, undescended testes. Echocardiography showed interatrial septum, small atrial septal defect and closing patent ductus arteriosus. Conclusion: Noonan syndrome was previously reported only in one girl from Iraq. The first Iraqi boy with Noonan syndrome is reported in association with unique cardiac defects. The previously reported case and the case in this deport demonstrates the variability of the phenotype of this syndrome.","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128143624","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}
37-year-old-gentleman, who was presented in three occasional times to emergency department for a fast, precordial, and rhythmic symptomatic palpitations, in which the last episode was with a duration that lasted more than an hour with instability vitally that ended in performing emergency electrical cardioversion. All these episodes were symptomatic and last hospitalization was associated with pre syncopal and syncopal attacks. With evidence of Wolff-Parkinson-White syndrome the patient was brought to Electrophysiology Lab to EP study and ablation.
{"title":"A Wolff- Parkinson- White Surprise Case","authors":"W. Vargas","doi":"10.31579/2692-9759/002","DOIUrl":"https://doi.org/10.31579/2692-9759/002","url":null,"abstract":"37-year-old-gentleman, who was presented in three occasional times to emergency department for a fast, precordial, and rhythmic symptomatic palpitations, in which the last episode was with a duration that lasted more than an hour with instability vitally that ended in performing emergency electrical cardioversion. All these episodes were symptomatic and last hospitalization was associated with pre syncopal and syncopal attacks. With evidence of Wolff-Parkinson-White syndrome the patient was brought to Electrophysiology Lab to EP study and ablation.","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131457748","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}
The care of acute coronary syndrome with persistent ST-elevation (STEMI) is a time-trial race: ‘‘time is myocardium”. The treatment relies on myocardial reperfusion by percutaneous coronary intervention (PCI) or fibrinolysis as promptly as possible. The main objective of this work was to assess the care time delays and the delaying factors during STEMI. We conducted a prospective, descriptive and analytic study over a 6 months’ time period. Were included all the patients received for STEMI. We have studied the care time delays and the delaying factors. We have compiled 50 patients. The mean age was 58.4 years and the sex-ratio M/F 2.5. The chest pain was typical in 39 patients. The mean time elapsed between the beginning of the pain and the first medical contact was 12 h 16 min. Transport (76%) and self-medication (70%) were the significant delaying factors found (p = 0.0001). The mean time elapsed between the first medical contact and the electrocardiogram was 9 h 57 min. The main factors delaying the diagnosis were the unavailability of the electrocardiogram device and the absence of electrocardiogram prescription (p = 0.001). The mean time elapsed between the electrocardiogram and the admission in the cardiology department was 3 h 02 min. The transport was the principal factor lengthening that time delay (p = 0.0001). Among the patients admitted directly in cardiology department, the mean time delay to perform the ECG was 30 min. The mean time delay of fibrinolysis was 2 h 11 min. Streptokinase shortage was the most frequent delaying factor (p = 0.001). The mean time delay between the qualifying ECG and the PCI completion was 2 h 42 min. The unavailability of the medical team was the first factor lengthening that time delay (p = 0.0001). The care time delays were lengthened enough in our context. This testifies to the lack of a codified strategy for STEMI care. It is essential to develop pre-hospital emergency medicine and sensitize the population and healthcare professionals.
急性冠状动脉综合征伴持续性st段抬高(STEMI)的护理是一场时间竞赛:“时间就是心肌”。治疗依赖于心肌再灌注经皮冠状动脉介入治疗(PCI)或纤溶。本研究的主要目的是评估STEMI期间的护理时间延迟和延迟因素。我们进行了为期6个月的前瞻性、描述性和分析性研究。纳入所有因STEMI接受治疗的患者。我们研究了护理时间延迟和延迟因素。我们收集了50例患者。平均年龄58.4岁，性别比M/F为2.5。39例患者胸痛典型。从疼痛开始到第一次就医的平均时间为12小时16分钟。转运(76%)和自我药疗(70%)是发现的显著延迟因素(p = 0.0001)。首次医疗接触到心电图的平均时间为9 h 57 min。延迟诊断的主要因素是没有心电图设备和没有心电图处方(p = 0.001)。从心电图到心内科入院的平均时间为3h 02 min。运输是延长该时间延迟的主要因素(p = 0.0001)。在心内科直接住院的患者中，平均心电图延迟时间为30 min，纤溶平均延迟时间为2 h 11 min。链激酶缺乏是最常见的延迟因素(p = 0.001)。合格心电图和PCI完成之间的平均时间延迟为2小时42分钟。医疗团队的不可用是延长时间延迟的第一个因素(p = 0.0001)。在我们的上下文中，护理时间延迟已经足够长了。这证明STEMI护理缺乏一个成文的战略。必须发展院前急救医学，提高民众和医护人员的敏感性。
{"title":"Care time Delays in Acute Coronary Syndromes with Persistent St Elevation (stem) and the Delaying Factors: Prospective STUDY About 50 Cases in the Cardiology Department of Aristide le Dante Hospital.","authors":"M. Dioum","doi":"10.31579/2692-9759/005","DOIUrl":"https://doi.org/10.31579/2692-9759/005","url":null,"abstract":"The care of acute coronary syndrome with persistent ST-elevation (STEMI) is a time-trial race: ‘‘time is myocardium”. The treatment relies on myocardial reperfusion by percutaneous coronary intervention (PCI) or fibrinolysis as promptly as possible. The main objective of this work was to assess the care time delays and the delaying factors during STEMI. We conducted a prospective, descriptive and analytic study over a 6 months’ time period. Were included all the patients received for STEMI. We have studied the care time delays and the delaying factors. We have compiled 50 patients. The mean age was 58.4 years and the sex-ratio M/F 2.5. The chest pain was typical in 39 patients. The mean time elapsed between the beginning of the pain and the first medical contact was 12 h 16 min. Transport (76%) and self-medication (70%) were the significant delaying factors found (p = 0.0001). The mean time elapsed between the first medical contact and the electrocardiogram was 9 h 57 min. The main factors delaying the diagnosis were the unavailability of the electrocardiogram device and the absence of electrocardiogram prescription (p = 0.001). The mean time elapsed between the electrocardiogram and the admission in the cardiology department was 3 h 02 min. The transport was the principal factor lengthening that time delay (p = 0.0001). Among the patients admitted directly in cardiology department, the mean time delay to perform the ECG was 30 min. The mean time delay of fibrinolysis was 2 h 11 min. Streptokinase shortage was the most frequent delaying factor (p = 0.001). The mean time delay between the qualifying ECG and the PCI completion was 2 h 42 min. The unavailability of the medical team was the first factor lengthening that time delay (p = 0.0001). The care time delays were lengthened enough in our context. This testifies to the lack of a codified strategy for STEMI care. It is essential to develop pre-hospital emergency medicine and sensitize the population and healthcare professionals.","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127366677","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}
The formation of coronary artery aneurysm (CAA) is one of the critical complications after percutaneous coronary intervention (PCI). The most common aetiologies and aggravating factors for aneurysmal dilatation are acquired, such as atherosclerosis, Kawasaki disease, Takayasu disease, connective tissue disease, trauma after percutaneous coronary intervention (PCI) and infections. Cardiac catheterization itself carries a negligible bacteremic risk. We present the case of a patient who had infective coronary artery aneurysms that developed after PCI. A 63 years old male who had ST-T MI 1 month back and underwent primary percutaneous coronary intervention with deployment of 1 Des stent in Mid left anterior polymer-based paclitaxel-eluting stent 63 years having primary PCI for LAD 1 month back in the left anterior descending artery and A large aneurysm developed MID DES. The patient had C/O high grade fever only since 3 weeks remained asymptomatic then had angina at rest for 4 days. An aneurysm was diagnosed at middle of DES on repeat coronary angiography. Intravascular ultrasound demonstrated a true aneurysm about 5.6 mm in diameter. We will review the literature and discuss the causes specially infectious aneurysm and treatment option of aneurysm with stent usually detected at the time of repeat angiography for recurrent symptoms or as apart of the routine angiographic follow up [1].
{"title":"Infectious Aneurysm Formation after Coronary Stent Implantation","authors":"K. Soomro","doi":"10.31579/2692-9759/003","DOIUrl":"https://doi.org/10.31579/2692-9759/003","url":null,"abstract":"The formation of coronary artery aneurysm (CAA) is one of the critical complications after percutaneous coronary intervention (PCI). The most common aetiologies and aggravating factors for aneurysmal dilatation are acquired, such as atherosclerosis, Kawasaki disease, Takayasu disease, connective tissue disease, trauma after percutaneous coronary intervention (PCI) and infections. Cardiac catheterization itself carries a negligible bacteremic risk. We present the case of a patient who had infective coronary artery aneurysms that developed after PCI. A 63 years old male who had ST-T MI 1 month back and underwent primary percutaneous coronary intervention with deployment of 1 Des stent in Mid left anterior polymer-based paclitaxel-eluting stent 63 years having primary PCI for LAD 1 month back in the left anterior descending artery and A large aneurysm developed MID DES. The patient had C/O high grade fever only since 3 weeks remained asymptomatic then had angina at rest for 4 days. An aneurysm was diagnosed at middle of DES on repeat coronary angiography. Intravascular ultrasound demonstrated a true aneurysm about 5.6 mm in diameter. We will review the literature and discuss the causes specially infectious aneurysm and treatment option of aneurysm with stent usually detected at the time of repeat angiography for recurrent symptoms or as apart of the routine angiographic follow up [1].","PeriodicalId":316029,"journal":{"name":"Cardiology Research and Reports","volume":"502 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124451888","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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