Pub Date : 2024-03-21DOI: 10.9734/ca/2024/v13i1400
M. Njie, P. M. Mulendelé, A. Mahi, A. A. Timimi, S. Hayar, A. Assklou, S. Arous, A. Drighil, R. Habbal
Ventricular septal rupture (VSR) is an uncommon but well-recognized mechanical complication of acute myocardial infarction (MI). Mortality without intervention is 70% in intrahospital at 30 days, and 90% at one year due to cardiogenic shock. Transthoracic echocardiography (TTE) is the choice tool in the diagnosis and evaluation of VSR. We report an original case of a 72-year-old patient diagnosed with myocardial infarction of the inferior wall of the left ventricle, complicated by the rupture of its basal segment aneurysm extending to the right ventricle. After which standard drug treatment was prescribed. Inferior wall myocardial infarction complicated with VSR at its basal segment is a rare mechanical complication of MI and this clinical case shows a rare location of VSR compared to forms described in the literatures. On the third day, the patient died from refractory cardiogenic shock, and neurological complications which could have been prevented by surgery. Treatment of VSR secondary to MI is an emergency based on either an open heart surgery or percutaneous intervention inorder to reduce morbi-mortality rate.
{"title":"Myocardial Infarction Seen Tardively Complicated by Ventricular Septal Rupture Extending to the Right Ventricule: A Dilemmatic Scenario","authors":"M. Njie, P. M. Mulendelé, A. Mahi, A. A. Timimi, S. Hayar, A. Assklou, S. Arous, A. Drighil, R. Habbal","doi":"10.9734/ca/2024/v13i1400","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1400","url":null,"abstract":"Ventricular septal rupture (VSR) is an uncommon but well-recognized mechanical complication of acute myocardial infarction (MI). Mortality without intervention is 70% in intrahospital at 30 days, and 90% at one year due to cardiogenic shock. Transthoracic echocardiography (TTE) is the choice tool in the diagnosis and evaluation of VSR. We report an original case of a 72-year-old patient diagnosed with myocardial infarction of the inferior wall of the left ventricle, complicated by the rupture of its basal segment aneurysm extending to the right ventricle. After which standard drug treatment was prescribed. Inferior wall myocardial infarction complicated with VSR at its basal segment is a rare mechanical complication of MI and this clinical case shows a rare location of VSR compared to forms described in the literatures. On the third day, the patient died from refractory cardiogenic shock, and neurological complications which could have been prevented by surgery. Treatment of VSR secondary to MI is an emergency based on either an open heart surgery or percutaneous intervention inorder to reduce morbi-mortality rate.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221714","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: Cardiac magnetic resonance (CMR) imaging combines the assessment of both the functional and structural aspects of the heart in order to identify the existence, timing, and intensity of ischemic heart disease by analyzing the function of the myocardium and the movement of the heart wall. This study aimed to investigate whether preoperative myocardial fibrosis, measured by CMR imaging, may be used to predict the incidence of rhythm disturbances in the early postoperative phase after coronary artery bypass grafting (CABG) surgery. Methods: Two groups of 92 patients who had CABG procedures performed were studied in this retrospective observational single site cohort study: There were 43 patients in Group A who had atrial or ventricular arrhythmia, and 49 patients in Group B who did not. Results: There was no correlation between arrhythmia and non-arrhythmia group and age, sex, body mass index, risk factor, CMR timing before surgery, cross clamp time, bypass time, left ventricular end-diastolic volume index (LV EDVI), LV end-systolic volume index (ESVI), stroke volume index (SVI), LV ejection fraction (EF) and territory of scar and were positive correlation between both groups and scar (P <0.001). Scar% was an independent predictor of occurrence of rhythm disturbance (P=0.002) while LV EDVI, LV EF, LV ESVI, SVI, and presence of scar were not. Group A had a statistically significantly lower LV-EF% and lower LV-SVI compared to Group B. Group A had a higher scar percentage compared with group B and this was statistically significant (P <0.001). Rhythm disturbance occurred more often in patients with a scar percentage >14.8% {P=0.0002 and area under ROC curve (AUC)=0.708}. Conclusions: CMR has evolved as a gold standard non-invasive imaging tool in cardiovascular medicine. Preoperative CMR imaging may be a promising tool for predicting postoperative cardiac arrhythmia after CABG. Our study showed that preoperative myocardial scarring >14.8%, as determined by CMR imaging, was predictive of early postoperative arrhythmia in patients undergoing CABG.
{"title":"Correlation between Pre-Operative Myocardial Fibrosis and Early Post CABG Dysrhythmia","authors":"Mohamed Moustafa Abdelfattah AlFrargy, S. Romeih, Inas Elsayed Deraz, Samia Mahmoud Sharaf El-Din","doi":"10.9734/ca/2024/v13i1398","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1398","url":null,"abstract":"Background: Cardiac magnetic resonance (CMR) imaging combines the assessment of both the functional and structural aspects of the heart in order to identify the existence, timing, and intensity of ischemic heart disease by analyzing the function of the myocardium and the movement of the heart wall. This study aimed to investigate whether preoperative myocardial fibrosis, measured by CMR imaging, may be used to predict the incidence of rhythm disturbances in the early postoperative phase after coronary artery bypass grafting (CABG) surgery. \u0000Methods: Two groups of 92 patients who had CABG procedures performed were studied in this retrospective observational single site cohort study: There were 43 patients in Group A who had atrial or ventricular arrhythmia, and 49 patients in Group B who did not. \u0000Results: There was no correlation between arrhythmia and non-arrhythmia group and age, sex, body mass index, risk factor, CMR timing before surgery, cross clamp time, bypass time, left ventricular end-diastolic volume index (LV EDVI), LV end-systolic volume index (ESVI), stroke volume index (SVI), LV ejection fraction (EF) and territory of scar and were positive correlation between both groups and scar (P <0.001). Scar% was an independent predictor of occurrence of rhythm disturbance (P=0.002) while LV EDVI, LV EF, LV ESVI, SVI, and presence of scar were not. Group A had a statistically significantly lower LV-EF% and lower LV-SVI compared to Group B. Group A had a higher scar percentage compared with group B and this was statistically significant (P <0.001). Rhythm disturbance occurred more often in patients with a scar percentage >14.8% {P=0.0002 and area under ROC curve (AUC)=0.708}. \u0000Conclusions: CMR has evolved as a gold standard non-invasive imaging tool in cardiovascular medicine. Preoperative CMR imaging may be a promising tool for predicting postoperative cardiac arrhythmia after CABG. Our study showed that preoperative myocardial scarring >14.8%, as determined by CMR imaging, was predictive of early postoperative arrhythmia in patients undergoing CABG.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"165 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256836","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}
Meadows syndrome is a rare entity, defined as systolic heart failure occurring peripartum in the absence of underlying heart disease. Thromboembolic manifestations can complicate this syndrome but are rarely revealing. We report the case of a 30-year-old patient, without a history of cardiac, multiparous, who presented 3 months after delivery, acute dyspnea. Distal pulmonary embolism was objectified by pulmonary angiography. But the final diagnosis after an analysis of clinical, ultrasound and etiological data was peripartum cardiomyopathy complicated by embolism pulmonary. The evolution under medical treatment was hardly favorable with a worsening of systolic function complicated by a new episode of bilateral proximal pulmonary embolism after 1 month in a context of covid 19 infection.
{"title":"Pulmonary Embolism Revealing Meadows Syndrome: Case Study","authors":"A-Hamad, Y-Eshak, E-Cheikh, O-Diawara, A.Aityahya, M-El Jamili, S.Elkarimi, M-Elhataoui","doi":"10.9734/ca/2024/v13i1399","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1399","url":null,"abstract":"Meadows syndrome is a rare entity, defined as systolic heart failure occurring peripartum in the absence of underlying heart disease. Thromboembolic manifestations can complicate this syndrome but are rarely revealing. We report the case of a 30-year-old patient, without a history of cardiac, multiparous, who presented 3 months after delivery, acute dyspnea. Distal pulmonary embolism was objectified by pulmonary angiography. But the final diagnosis after an analysis of clinical, ultrasound and etiological data was peripartum cardiomyopathy complicated by embolism pulmonary. The evolution under medical treatment was hardly favorable with a worsening of systolic function complicated by a new episode of bilateral proximal pulmonary embolism after 1 month in a context of covid 19 infection.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"214 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256152","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 : 2024-01-25DOI: 10.9734/ca/2024/v13i1393
Dalia Sobhy Khalil, S. S. Khalil, Mohammed Ahmed Elbarbary, M. Ashmawy
Background: PCI necessitates the usage of iodinated contrast agent which in some cases is accompanied by CIN and the potential for worse outcomes. The current study aimed to use the CHA2DS2-VASc score with its simple and available components as a predictor of risk of developing CIN in NSTEMI cases who will undergo PCI. Methods: This single center observational study was conducted on 200 cases diagnosed with NSTEMI who were subjected to primary PCI. The basic level of serum Cr was detected at time of admission followed by monitoring for 48 h, and seven days following the approach to detect the occurrence of CIN. Electrocardiogram (ECG) and transthoracic echocardiography are assessed to all patients. Results: At cut off ≥2 (area under curve (AUC)=0.649), CHA2DS2-VASc could be used as a predictor for post-PCI CIN with sensitivity and specificity, PPV, NPV and accuracy of 77.6%, 52.3%, 34.5%, 87.8% and 58.5% respectively. There was a statistically significant correlation between occurrence of CIN and all the studied factors (female sex, HTN, DM, anemia, CHF, hemoglobin (HBG), pre-existing renal disease, previous stroke, pre-creatinine, 48hrs and 7 days post-creatinine, pre glomerular filtration rate (GFR) and cha2ds-vasc score and dehydration) with exception of age and vascular disease (p>0.05) being non-significant. Contrast volume, CHA2DS VASC score, metformin use, eGFR after 48h and ACEI /ARB II antagonists ’inhibitor use were significant independent predictors for CIN. Conclusions: In NSTEMI cases who are subjected to PCI, CHADS2 VASC score ≥ 2 is accompanied by a high risk for CIN and in hospital morbidity and mortality. CHA2DS2-VASC score is considered a useful novel, easy, and reliable method to anticipate CIN in NSTEMI cases undergoing urgent P.
{"title":"Value of CHA2DS2-VASC Score as Predictor of Contrast-Induced Nephropathy in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention","authors":"Dalia Sobhy Khalil, S. S. Khalil, Mohammed Ahmed Elbarbary, M. Ashmawy","doi":"10.9734/ca/2024/v13i1393","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1393","url":null,"abstract":"Background: PCI necessitates the usage of iodinated contrast agent which in some cases is accompanied by CIN and the potential for worse outcomes. The current study aimed to use the CHA2DS2-VASc score with its simple and available components as a predictor of risk of developing CIN in NSTEMI cases who will undergo PCI. \u0000Methods: This single center observational study was conducted on 200 cases diagnosed with NSTEMI who were subjected to primary PCI. The basic level of serum Cr was detected at time of admission followed by monitoring for 48 h, and seven days following the approach to detect the occurrence of CIN. Electrocardiogram (ECG) and transthoracic echocardiography are assessed to all patients. \u0000Results: At cut off ≥2 (area under curve (AUC)=0.649), CHA2DS2-VASc could be used as a predictor for post-PCI CIN with sensitivity and specificity, PPV, NPV and accuracy of 77.6%, 52.3%, 34.5%, 87.8% and 58.5% respectively. There was a statistically significant correlation between occurrence of CIN and all the studied factors (female sex, HTN, DM, anemia, CHF, hemoglobin (HBG), pre-existing renal disease, previous stroke, pre-creatinine, 48hrs and 7 days post-creatinine, pre glomerular filtration rate (GFR) and cha2ds-vasc score and dehydration) with exception of age and vascular disease (p>0.05) being non-significant. Contrast volume, CHA2DS VASC score, metformin use, eGFR after 48h and ACEI /ARB II antagonists ’inhibitor use were significant independent predictors for CIN. \u0000Conclusions: In NSTEMI cases who are subjected to PCI, CHADS2 VASC score ≥ 2 is accompanied by a high risk for CIN and in hospital morbidity and mortality. CHA2DS2-VASC score is considered a useful novel, easy, and reliable method to anticipate CIN in NSTEMI cases undergoing urgent P.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"16 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595797","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 : 2024-01-24DOI: 10.9734/ca/2024/v13i1392
Saad Wageh Abo EL Ata, Magdy Mohamed Al Masry, Sahr Abd Allah EL Shedoudy, Mohamed Bayoumi Nassar
Background: Palpitations are the second-most common cause of primary healthcare referrals to cardiologists and are linked to long-term morbidity. Despite the absence of a significant underlying cause, a considerable number of patients report fear and anxiety. The purpose of this study was to assess individuals who were evaluated for palpitation in order to ascertain the diagnostic yield of 24 or 48 hours of Holter monitoring. Methods: 105 participants participated in this prospective observational cross-sectional research, children and adults, with palpitations, dizziness and syncope, with Holter monitoring 24 or 48 hours. Every patient had a thorough medical history, clinical evaluation, and physical assessment, Resting Electrocardiography (ECG), Transthoracic Echocardiography, and Holter monitoring. Patients were further subdivided into two groups: Positive Holter group and Negative Holter group. Results: Symptoms among positive Holter response showed that 48.6% had palpitations, 34.2% had dizziness and 13.3% had syncope. Higher age, increased frequency of danger factors (Diabetes mellitus, Hypertension, Ischemic heart disease, cardiomyopathy), symptoms (Palpitations, Dizziness, Syncope), Premature ventricular contractions and lower Ejection fraction was observed in patients with positive Holter response compared to patients with negative Holter response. There was no significant association with sex, smoking, Atrial fibrillation, regular sinus rhythm, and premature atrial contractions (P ≤ 0.05). Conclusions: Holter Monitoring retains its value, despite the appearance of new investigations and considered the first line for assessment of palpitations as it is widespread and not expensive. It has a good outcome if the patient’s symptoms are suggestive for arrhythmia, syncope and dizziness.
{"title":"The Diagnostic Significance of the Holter Monitoring in the Evaluation of Palpitation at Tanta University Hospitals","authors":"Saad Wageh Abo EL Ata, Magdy Mohamed Al Masry, Sahr Abd Allah EL Shedoudy, Mohamed Bayoumi Nassar","doi":"10.9734/ca/2024/v13i1392","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1392","url":null,"abstract":"Background: Palpitations are the second-most common cause of primary healthcare referrals to cardiologists and are linked to long-term morbidity. Despite the absence of a significant underlying cause, a considerable number of patients report fear and anxiety. The purpose of this study was to assess individuals who were evaluated for palpitation in order to ascertain the diagnostic yield of 24 or 48 hours of Holter monitoring. \u0000Methods: 105 participants participated in this prospective observational cross-sectional research, children and adults, with palpitations, dizziness and syncope, with Holter monitoring 24 or 48 hours. Every patient had a thorough medical history, clinical evaluation, and physical assessment, Resting Electrocardiography (ECG), Transthoracic Echocardiography, and Holter monitoring. Patients were further subdivided into two groups: Positive Holter group and Negative Holter group. \u0000Results: Symptoms among positive Holter response showed that 48.6% had palpitations, 34.2% had dizziness and 13.3% had syncope. Higher age, increased frequency of danger factors (Diabetes mellitus, Hypertension, Ischemic heart disease, cardiomyopathy), symptoms (Palpitations, Dizziness, Syncope), Premature ventricular contractions and lower Ejection fraction was observed in patients with positive Holter response compared to patients with negative Holter response. There was no significant association with sex, smoking, Atrial fibrillation, regular sinus rhythm, and premature atrial contractions (P ≤ 0.05). \u0000Conclusions: Holter Monitoring retains its value, despite the appearance of new investigations and considered the first line for assessment of palpitations as it is widespread and not expensive. It has a good outcome if the patient’s symptoms are suggestive for arrhythmia, syncope and dizziness.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"54 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139602115","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 : 2024-01-23DOI: 10.9734/ca/2024/v13i1390
Eslam Elhelw, U. Hamza, Tamer Mansour Ayed, Amr Abdellateef, Mostafa Elhelali
Background: The great saphenous vein (GSV) remains the most commonly used conduit worldwide for the majority of coronary artery bypass surgery (CABG) procedures, despite concerns regarding the long-term patency of arterial revascularization. Therefore, our aim is to assess and demonstrate the impact of harvesting techniques on patient quality of life and early post-operative outcomes. Methods: This prospective, single-blinded randomized controlled study enrolled patients with ischemic heart disease indicated for CABG. The study was conducted at the Cardiothoracic and Vascular Surgery Center (CVSC) at Mansoura University, Mansoura, and El-Galaa Military Hospital, Cairo, involving 32 patients. Patients were categorized into two groups: Group I comprised sixteen patients where the GSV was harvested using the open vein harvesting technique (OVH), and Group II included sixteen patients where the GSV was harvested using the endoscopic vein harvesting technique (EVH). Results: Multivariate regression analysis evaluating the effect of the endoscopic technique revealed a significant correlation with postoperative outcomes, particularly in terms of leg wound complications assessed by the ASEPSIS score (p < 0.001) and the prediction of postoperative NRS values for leg pain (p 0.001). Additionally, the impact on patients' quality of life across all subclinical categories was assessed using the Euro-Qol 5D (p < 0.001). Conclusion: EVH presents itself as a viable minimally invasive alternative to traditional OVH techniques. It offers greater patient comfort, improved cosmetic satisfaction, a reduced incidence of postoperative leg wound complications, and lower levels of pain. Moreover, there is a statistically significant association between performing EVH techniques and enhanced quality of life, as well as a decrease in total ASEPSIS scores.
{"title":"Early Results of Endoscopic Versus Open Saphenous Vein Harvesting in Coronary Artery Bypass Grafting: A Single Blinded Randomized Controlled Trial","authors":"Eslam Elhelw, U. Hamza, Tamer Mansour Ayed, Amr Abdellateef, Mostafa Elhelali","doi":"10.9734/ca/2024/v13i1390","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1390","url":null,"abstract":"Background: The great saphenous vein (GSV) remains the most commonly used conduit worldwide for the majority of coronary artery bypass surgery (CABG) procedures, despite concerns regarding the long-term patency of arterial revascularization. Therefore, our aim is to assess and demonstrate the impact of harvesting techniques on patient quality of life and early post-operative outcomes. \u0000Methods: This prospective, single-blinded randomized controlled study enrolled patients with ischemic heart disease indicated for CABG. The study was conducted at the Cardiothoracic and Vascular Surgery Center (CVSC) at Mansoura University, Mansoura, and El-Galaa Military Hospital, Cairo, involving 32 patients. Patients were categorized into two groups: Group I comprised sixteen patients where the GSV was harvested using the open vein harvesting technique (OVH), and Group II included sixteen patients where the GSV was harvested using the endoscopic vein harvesting technique (EVH). \u0000Results: Multivariate regression analysis evaluating the effect of the endoscopic technique revealed a significant correlation with postoperative outcomes, particularly in terms of leg wound complications assessed by the ASEPSIS score (p < 0.001) and the prediction of postoperative NRS values for leg pain (p 0.001). Additionally, the impact on patients' quality of life across all subclinical categories was assessed using the Euro-Qol 5D (p < 0.001). \u0000Conclusion: EVH presents itself as a viable minimally invasive alternative to traditional OVH techniques. It offers greater patient comfort, improved cosmetic satisfaction, a reduced incidence of postoperative leg wound complications, and lower levels of pain. Moreover, there is a statistically significant association between performing EVH techniques and enhanced quality of life, as well as a decrease in total ASEPSIS scores.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"15 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139603080","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 : 2024-01-19DOI: 10.9734/ca/2024/v13i1389
Safia Ouarrak, Abdalani Badr, O. Esther, Njie Malick, Mulendele Mayanga Patrick, Alaa Altimimi, E. Benouna, Abdenasser Drighil, R. Habbal
This case report details the clinical presentation, diagnosis, and multidisciplinary management of a 68-year-old man with cardiac thyrotoxicosis mimicking an acute coronary syndrome (ACS). The patient presented with persistent anginal chest pain, systemic symptoms, and electrocardiographic abnormalities suggestive of ACS. Despite presenting with persistent chest pain and ACS-like symptoms, a thorough examination, including the calculation of the thyrotoxicosis storm (StPRM) score, revealed thyrotoxicosis-induced dilated cardiomyopathy, challenging the initial diagnosis. This specific scoring for thyrotoxicosis severity played a crucial role in accurately identifying the thyrotoxic crisis. The case highlights the intricate relationship between thyroid dysfunction and cardiovascular manifestations, emphasizing the need for a multidisciplinary approach. Management included standard ACS protocols, careful titration of antithyroid medications, and the transition from intravenous to oral heart failure medications. Follow-up assessments demonstrated the success of personalized treatment strategies, with the normalization of thyroid function and complete resolution of the patient's symptoms. Nevertheless, the enduring impairment of left ventricular function following treatment prompts intriguing inquiries into the lasting impact of cardiac thyrotoxicosis on myocardial recovery. However, the persistence of impaired left ventricular function post-treatment raises intriguing questions about the lingering effects of cardiac thyrotoxicosis on myocardial recovery. This case underscores the importance of considering diverse cardiac presentations in hyperthyroid patients and the effectiveness of individualized management approaches in navigating the complexities of thyroid-cardiac interactions.
{"title":"Cardiac Thyrotoxicosis Mimicking an Acute Coronary Syndrome","authors":"Safia Ouarrak, Abdalani Badr, O. Esther, Njie Malick, Mulendele Mayanga Patrick, Alaa Altimimi, E. Benouna, Abdenasser Drighil, R. Habbal","doi":"10.9734/ca/2024/v13i1389","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1389","url":null,"abstract":"This case report details the clinical presentation, diagnosis, and multidisciplinary management of a 68-year-old man with cardiac thyrotoxicosis mimicking an acute coronary syndrome (ACS). The patient presented with persistent anginal chest pain, systemic symptoms, and electrocardiographic abnormalities suggestive of ACS. Despite presenting with persistent chest pain and ACS-like symptoms, a thorough examination, including the calculation of the thyrotoxicosis storm (StPRM) score, revealed thyrotoxicosis-induced dilated cardiomyopathy, challenging the initial diagnosis. This specific scoring for thyrotoxicosis severity played a crucial role in accurately identifying the thyrotoxic crisis. The case highlights the intricate relationship between thyroid dysfunction and cardiovascular manifestations, emphasizing the need for a multidisciplinary approach. Management included standard ACS protocols, careful titration of antithyroid medications, and the transition from intravenous to oral heart failure medications. Follow-up assessments demonstrated the success of personalized treatment strategies, with the normalization of thyroid function and complete resolution of the patient's symptoms. Nevertheless, the enduring impairment of left ventricular function following treatment prompts intriguing inquiries into the lasting impact of cardiac thyrotoxicosis on myocardial recovery. However, the persistence of impaired left ventricular function post-treatment raises intriguing questions about the lingering effects of cardiac thyrotoxicosis on myocardial recovery. This case underscores the importance of considering diverse cardiac presentations in hyperthyroid patients and the effectiveness of individualized management approaches in navigating the complexities of thyroid-cardiac interactions.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613602","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 : 2024-01-15DOI: 10.9734/ca/2024/v13i1388
Charfo M, Afendi L, Belmalyani R, Errami A, Haboub M., Drighil A
Infective endocarditis is a relatively rare disease which, despite today's advances in diagnosis and treatment, is still associated with a high morbidity and mortality rate. Staphylococci and streptococci head the list of causative organisms. Few cases of Streptococcus gordonii endocarditis have been reported in the literature. We report the case of a 34-year-old man with no previous history of S. gordonii IE, responsible for multiple systemic embolisms in addition to valvular lesions.
{"title":"Streptococcus gordonii: A Rare Cause of Infective Endocarditis with High Embolic Potential Revealed by Febrile Ischemic Stroke","authors":"Charfo M, Afendi L, Belmalyani R, Errami A, Haboub M., Drighil A","doi":"10.9734/ca/2024/v13i1388","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1388","url":null,"abstract":"Infective endocarditis is a relatively rare disease which, despite today's advances in diagnosis and treatment, is still associated with a high morbidity and mortality rate. Staphylococci and streptococci head the list of causative organisms. Few cases of Streptococcus gordonii endocarditis have been reported in the literature. \u0000We report the case of a 34-year-old man with no previous history of S. gordonii IE, responsible for multiple systemic embolisms in addition to valvular lesions.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"22 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139528837","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 : 2024-01-09DOI: 10.9734/ca/2024/v13i1387
Rifat Ara Nisu, Faisal Ahmed Nadvi, A. A. Ankhi, Sabnam Roy Suma, Israt Jahan Papiya, Ankita Bose
In the realm of health research, hyperlipidemia is a condition that has lately become prevalent and is a serious issue. Elevated lipid levels in an individual's body are the primary indicator of hyperlipidemia, a condition defined by increased levels of low-density lipoprotein (LDL), total cholesterol, triglycerides, and high lipoprotein levels. Several pharmacological agents are accessible for the treatment of hyperlipidemia. Nevertheless, human beings throughout the globe also thrive on nature-derived therapeutic items. Coccinia grandis is a noteworthy plant known for its antihyperlipidemic properties among them. In this study, we provided a high-fat diet for the experimental rats to generate hyperlipidemia conditions in this rat model. As per our research methodology, Coccnia grandis was administered to all the rats in the treatment group at three (low, medium and high) distinct dosages. It is eventually revealed that Coccnia grandis may successfully lower (p<0.05) the hyperlipidemic state in both medium and high dosages. Elevated and unusual Triglyceride and Total Cholesterol were observed to be restored following Coccnia grandis medication. However, in the case of HDL and LDL, no substantial drop was detected. A considerable restoration was noted similarly in both instances of SGPT and SGOT. These findings show that our plant has components with antihyperlipidemic action, however the concentrations did not meet the necessary threshold. So, additional investigations are needed to examine the chemical structure and the quantities of the molecule as well as find out about genetic alterations.
{"title":"An Evaluation of Anti-hyperlipidemic Activity of Ethanolic Extract of Coccinia grandis Leaves in High Fat Induced Rodent Model","authors":"Rifat Ara Nisu, Faisal Ahmed Nadvi, A. A. Ankhi, Sabnam Roy Suma, Israt Jahan Papiya, Ankita Bose","doi":"10.9734/ca/2024/v13i1387","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1387","url":null,"abstract":"In the realm of health research, hyperlipidemia is a condition that has lately become prevalent and is a serious issue. Elevated lipid levels in an individual's body are the primary indicator of hyperlipidemia, a condition defined by increased levels of low-density lipoprotein (LDL), total cholesterol, triglycerides, and high lipoprotein levels. Several pharmacological agents are accessible for the treatment of hyperlipidemia. Nevertheless, human beings throughout the globe also thrive on nature-derived therapeutic items. Coccinia grandis is a noteworthy plant known for its antihyperlipidemic properties among them. In this study, we provided a high-fat diet for the experimental rats to generate hyperlipidemia conditions in this rat model. As per our research methodology, Coccnia grandis was administered to all the rats in the treatment group at three (low, medium and high) distinct dosages. It is eventually revealed that Coccnia grandis may successfully lower (p<0.05) the hyperlipidemic state in both medium and high dosages. Elevated and unusual Triglyceride and Total Cholesterol were observed to be restored following Coccnia grandis medication. However, in the case of HDL and LDL, no substantial drop was detected. A considerable restoration was noted similarly in both instances of SGPT and SGOT. These findings show that our plant has components with antihyperlipidemic action, however the concentrations did not meet the necessary threshold. So, additional investigations are needed to examine the chemical structure and the quantities of the molecule as well as find out about genetic alterations.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"45 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534925","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 : 2024-01-03DOI: 10.9734/ca/2024/v13i1385
Sofia Bezza, M. I. Rhoujjati, M. Eljamili, S. Karimi, M. Elhattaoui
Double-chambered right ventricle (DCRV) is an uncommon congenital heart condition characterized by a progressive obstruction in the right ventricular outflow tract. This obstruction is caused by anomalous muscles or fibrous tissues that divide the right ventricle into two cavities: a proximal high-pressure chamber (anatomically lower) and a distal low-pressure chamber (anatomically higher). We present a case of a middle-aged man with a medical history of recurrent symptomatic dyspnea. Upon presentation, there were no signs of congestive cardiac failure. The diagnosis was confirmed using transthoracic two-dimensional (2-D) echocardiography and Transesophageal echocardiography (TEE) for more precise characterization. The primary objective of this case report is to highlight the rarity of this congenital heart disease, particularly in adults.
{"title":"Isolated Double-Chambered Right Ventricle: A Rare Congenital Heart Disease","authors":"Sofia Bezza, M. I. Rhoujjati, M. Eljamili, S. Karimi, M. Elhattaoui","doi":"10.9734/ca/2024/v13i1385","DOIUrl":"https://doi.org/10.9734/ca/2024/v13i1385","url":null,"abstract":"Double-chambered right ventricle (DCRV) is an uncommon congenital heart condition characterized by a progressive obstruction in the right ventricular outflow tract. This obstruction is caused by anomalous muscles or fibrous tissues that divide the right ventricle into two cavities: a proximal high-pressure chamber (anatomically lower) and a distal low-pressure chamber (anatomically higher). We present a case of a middle-aged man with a medical history of recurrent symptomatic dyspnea. Upon presentation, there were no signs of congestive cardiac failure. The diagnosis was confirmed using transthoracic two-dimensional (2-D) echocardiography and Transesophageal echocardiography (TEE) for more precise characterization. The primary objective of this case report is to highlight the rarity of this congenital heart disease, particularly in adults.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"120 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387781","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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