Pub Date : 2023-05-22DOI: 10.9734/ca/2023/v12i3334
B. Maatof, I. Hazzazi, H. Nabawi, M. Eljamili, S. El karimi, M. Elhattaoui
Non-compaction cardiomyopathy (NCC) is characterized by trabeculations in either one or both ventricles. Clinical presentation is highly variable: dyspnea, palpitation, thromboembolic events, arrhythmia, or sudden cardiac death. There are currently no universally-accepted criteria for classifying and diagnosing left ventricular non-compaction (LVNC) cardiomyopathy. Transthoracic echocardiography (TTE) is the diagnostic exam of choice. The diagnosis is often missed or delayed because of a lack of knowledge about this uncommon disease. Progression of LVNC is highly variable and prognosis is very difficult to predict. We report a case of a 50-year-old female patient with a history of total thyroidectomy under hormonal supplementation who consults for dyspnea and paroxysmal palpitations revealing an isolated LVNC. This case emphasizes the importance of imaging techniques, which are, TTE and cardiac magnetic resonance imaging (MRI) in early diagnosis, management, and follow-up.
{"title":"Left Ventricular Non-Compaction Cardiomyopathy: Case Report and Review of Literature","authors":"B. Maatof, I. Hazzazi, H. Nabawi, M. Eljamili, S. El karimi, M. Elhattaoui","doi":"10.9734/ca/2023/v12i3334","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3334","url":null,"abstract":"Non-compaction cardiomyopathy (NCC) is characterized by trabeculations in either one or both ventricles. Clinical presentation is highly variable: dyspnea, palpitation, thromboembolic events, arrhythmia, or sudden cardiac death. There are currently no universally-accepted criteria for classifying and diagnosing left ventricular non-compaction (LVNC) cardiomyopathy. Transthoracic echocardiography (TTE) is the diagnostic exam of choice. The diagnosis is often missed or delayed because of a lack of knowledge about this uncommon disease. Progression of LVNC is highly variable and prognosis is very difficult to predict. \u0000We report a case of a 50-year-old female patient with a history of total thyroidectomy under hormonal supplementation who consults for dyspnea and paroxysmal palpitations revealing an isolated LVNC. \u0000This case emphasizes the importance of imaging techniques, which are, TTE and cardiac magnetic resonance imaging (MRI) in early diagnosis, management, and follow-up.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123566296","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 : 2023-05-20DOI: 10.9734/ca/2023/v12i3333
Zainab Boudhar, M. Atidi, N. Charei, M. Hattaoui
Intracardiac masses have several etiologies: tumor, infectious, thrombotic. They constitute a diagnostic challenge for the clinician. Behçet's disease is a chronic multisystemic vasculitis evolving by relapses. Intracadiac thrombosis in this disease deserves special attention because of its life-threatening nature. They often appear in the early stages of the disease, and the most frequent location is the right heart chambers. We present the case of a 23-year-old patient with an isolated mass in the right ventricle revealing an initial manifestation of Behçet's disease. The presented clinical case highlights the importance of early recognition of Behçet's disease, as well as the awareness of including this disease in the differential diagnosis of intracardiac masses in young adults.
{"title":"Cardiac Thrombosis in Behçet's Disease: A Diagnostic Challenge","authors":"Zainab Boudhar, M. Atidi, N. Charei, M. Hattaoui","doi":"10.9734/ca/2023/v12i3333","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3333","url":null,"abstract":"Intracardiac masses have several etiologies: tumor, infectious, thrombotic. They constitute a diagnostic challenge for the clinician. \u0000Behçet's disease is a chronic multisystemic vasculitis evolving by relapses. Intracadiac thrombosis in this disease deserves special attention because of its life-threatening nature. They often appear in the early stages of the disease, and the most frequent location is the right heart chambers. We present the case of a 23-year-old patient with an isolated mass in the right ventricle revealing an initial manifestation of Behçet's disease. \u0000The presented clinical case highlights the importance of early recognition of Behçet's disease, as well as the awareness of including this disease in the differential diagnosis of intracardiac masses in young adults.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122929416","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 : 2023-05-15DOI: 10.9734/ca/2023/v12i3331
Ali A. Eljazouli, A. Maaroufi, Mohamed M. Nachid, Ismail I. Benhar, R. Habbal
Learning Objectives: Learn how to identify and differentiate the shark fin EKG pattern from other EKG patterns and abnormalities. Explore the potential diagnostic and prognostic implications of the shark fin EKG pattern, including its association with increased risk of arrhythmias and sudden cardiac death. Background: The Lambda-wave ECG, also known as the Shark fin or Thombostone pattern, has been linked to ST-elevation myocardial infarction's (STEMI) hazardous implications. It is characterized by merged QRS, ST, and T waves, forming a 'triangular QRS-ST-T waveform' or 'giant R waves.' This treacherous signature poses an alarming risk, with chances of cardiogenic shock and ventricular fibrillation leading to fatality. To tackle this peril, implementing swift thrombolysis or percutaneous intervention for reperfusion is critical for successful treatment. For optimal outcomes, the preferred setting to utilize ventricular assist devices is the ICU. Misdiagnosis can happen and be seen as either wide complex tachycardia or ECG changes induced by hyperkalemia. Imperative to prevent severe complications, early detection and treatment are crucial. We are reporting three cases of this Ekg pattern.
{"title":"Deadly ECG Sign: An Aspect to Recognize in the Settings of STEMI","authors":"Ali A. Eljazouli, A. Maaroufi, Mohamed M. Nachid, Ismail I. Benhar, R. Habbal","doi":"10.9734/ca/2023/v12i3331","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3331","url":null,"abstract":"Learning Objectives: Learn how to identify and differentiate the shark fin EKG pattern from other EKG patterns and abnormalities. Explore the potential diagnostic and prognostic implications of the shark fin EKG pattern, including its association with increased risk of arrhythmias and sudden cardiac death. \u0000Background: The Lambda-wave ECG, also known as the Shark fin or Thombostone pattern, has been linked to ST-elevation myocardial infarction's (STEMI) hazardous implications. It is characterized by merged QRS, ST, and T waves, forming a 'triangular QRS-ST-T waveform' or 'giant R waves.' This treacherous signature poses an alarming risk, with chances of cardiogenic shock and ventricular fibrillation leading to fatality. To tackle this peril, implementing swift thrombolysis or percutaneous intervention for reperfusion is critical for successful treatment. For optimal outcomes, the preferred setting to utilize ventricular assist devices is the ICU. Misdiagnosis can happen and be seen as either wide complex tachycardia or ECG changes induced by hyperkalemia. Imperative to prevent severe complications, early detection and treatment are crucial. We are reporting three cases of this Ekg pattern.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130146420","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 : 2023-05-15DOI: 10.9734/ca/2023/v12i3332
A. Couissi, Y. Ettagmouti, A. Boutaleb, T. Ettachfini, R. Habbal
Chronic heart failure (HF) is a major problem of public health in Morocco with few studies exploring HF particularities in this country where the prevalence of HF is estimated to be around 2.2%. Objective: The aim of this study was to evaluate the correlation between frequency of rehospitalization in our population with age, left ventricular ejection fraction (LVEF), heart rate (HR), and QRS duration, Since the number of rehospitalizations is strongly correlated to mortality as shown by many studies. Materials and Methods: Patients with HF were enrolled in this retrospective case control study regardless of their LVEF, patients with recent (<3months) myocardial infarction were excluded. They were all examined and questioned in the heart failure unit of our hospital between the period of October 2022 and December 2022. The correlations were calculated by PEARSON index using R Statistical Software. Results: 224 patients were included. The mean patient age was 59 years (57.2-63;IC 95%) with a male predominance of 60.1 % (56.8-71; IC 95%). 35.5% and 32.2% of patients were treated for hypertension and diabetes respectively. The mean LVEF was 35.2% (33.96-36.91;IC 95%). A positive correlation was found between rehospitalization frequency and age and high heart rate (+ 0.42 p = 0,04;+0.322, p<0.005) respectively . Conversely a negative correlation was found with LVEF (-0.312, p<0.005) while there was a positive correlation with QRS duration but without significance (+0.162 , p=0.03). Conclusion: This study shows strong correlation between rehospitalization and advanced age, higher HR and lower LVEF.
慢性心力衰竭(HF)是摩洛哥公共卫生的一个主要问题，很少有研究探讨该国HF的特殊性，该国的HF患病率估计约为2.2%。目的:本研究的目的是评估我们人群中再住院次数与年龄、左心室射血分数(LVEF)、心率(HR)和QRS持续时间之间的相关性，因为许多研究表明再住院次数与死亡率密切相关。材料与方法:本研究将HF患者纳入回顾性病例对照研究，不论其LVEF大小，排除近期(<3个月)心肌梗死患者。他们均于2022年10月至2022年12月在我院心衰科接受了检查和询问。相关系数采用R统计软件PEARSON指数计算。结果:纳入224例患者。患者平均年龄59岁(57.2-63岁，IC 95%)，男性占60.1%(56.8-71岁;IC占95%)。高血压和糖尿病患者分别占35.5%和32.2%。平均LVEF为35.2% (33.96 ~ 36.91;IC为95%)。再住院次数与年龄、高心率呈正相关(+ 0.42 p = 0.04;+0.322, p<0.005)。与LVEF呈负相关(-0.312,p<0.005)，与QRS持续时间呈正相关(+0.162,p=0.03)，但无统计学意义。结论:再住院与高龄、高HR、低LVEF有较强相关性。
{"title":"Predictors of Rehospitalization in Patients with Chronic Heart Failure a Single Center Study in Moroccan Patients","authors":"A. Couissi, Y. Ettagmouti, A. Boutaleb, T. Ettachfini, R. Habbal","doi":"10.9734/ca/2023/v12i3332","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3332","url":null,"abstract":"Chronic heart failure (HF) is a major problem of public health in Morocco with few studies exploring HF particularities in this country where the prevalence of HF is estimated to be around 2.2%. \u0000Objective: The aim of this study was to evaluate the correlation between frequency of rehospitalization in our population with age, left ventricular ejection fraction (LVEF), heart rate (HR), and QRS duration, Since the number of rehospitalizations is strongly correlated to mortality as shown by many studies. \u0000Materials and Methods: Patients with HF were enrolled in this retrospective case control study regardless of their LVEF, patients with recent (<3months) myocardial infarction were excluded. They were all examined and questioned in the heart failure unit of our hospital between the period of October 2022 and December 2022. The correlations were calculated by PEARSON index using R Statistical Software. \u0000Results: 224 patients were included. The mean patient age was 59 years (57.2-63;IC 95%) with a male predominance of 60.1 % (56.8-71; IC 95%). 35.5% and 32.2% of patients were treated for hypertension and diabetes respectively. The mean LVEF was 35.2% (33.96-36.91;IC 95%). A positive correlation was found between rehospitalization frequency and age and high heart rate (+ 0.42 p = 0,04;+0.322, p<0.005) respectively . Conversely a negative correlation was found with LVEF (-0.312, p<0.005) while there was a positive correlation with QRS duration but without significance (+0.162 , p=0.03). \u0000Conclusion: This study shows strong correlation between rehospitalization and advanced age, higher HR and lower LVEF.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129003952","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 : 2023-05-04DOI: 10.9734/ca/2023/v12i3330
Mahmoud Radwan Ali Hassan, M. Elsaidy, Mai A. ELmonem Salama, Amr Fayez Alkassas
Background: Infective endocarditis (IE) is characterised by a concentration of infection inside the heart; it is caused by a bacterial or fungal infection of the endocardial surface of the heart; and it is linked with substantial morbidity and death.The aim of this research was to assess serum ferritin as an admission predictor of in-hospital prognosis in subjects with IE. Methods: This case control researchincluded60subjects diagnosed with IEon the basis of the modified duke's criteria.Subjects were allocated equally into two groups: group I: IE subjects who were further subdivided into two groups based on presence or absence of major adverse cardiovascular events (subgroup A: 19 patients who showed IE complications or major adverse cardiac events during hospitalization and subgroup B: 11 patients who showed a smooth course during hospitalization without major adverse cardiac events or IE complications) and IE subjects as well as age and sex matched 30 healthy subjects. Results: serum ferritin level were significantly increased in group I than group II (P value<0.05). Serum ferritin level was significantly increased in subgroup A than subgroup B (P value<0.001). serum ferritin can significantly predict bad outcome (P value<0.001) with AUC of 0.964 (95% CI: 0.881 – 0.995). At cut off >1200, serum ferritin can significantly predict bad outcome with 94.44% sensitivity, 92.86% specificity, 85% PPV and 97.5% NPV. Conclusions: Serum ferritin was significantly increased in IE subjects who experiencedproblems on admission as compared to IE subjects who didn’t.
{"title":"Diagnostic Use of Serum Ferritin as a Predictor of Hospital Outcome at Admission in Patients with Infective Endocarditis","authors":"Mahmoud Radwan Ali Hassan, M. Elsaidy, Mai A. ELmonem Salama, Amr Fayez Alkassas","doi":"10.9734/ca/2023/v12i3330","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3330","url":null,"abstract":"Background: Infective endocarditis (IE) is characterised by a concentration of infection inside the heart; it is caused by a bacterial or fungal infection of the endocardial surface of the heart; and it is linked with substantial morbidity and death.The aim of this research was to assess serum ferritin as an admission predictor of in-hospital prognosis in subjects with IE. \u0000Methods: This case control researchincluded60subjects diagnosed with IEon the basis of the modified duke's criteria.Subjects were allocated equally into two groups: group I: IE subjects who were further subdivided into two groups based on presence or absence of major adverse cardiovascular events (subgroup A: 19 patients who showed IE complications or major adverse cardiac events during hospitalization and subgroup B: 11 patients who showed a smooth course during hospitalization without major adverse cardiac events or IE complications) and IE subjects as well as age and sex matched 30 healthy subjects. \u0000Results: serum ferritin level were significantly increased in group I than group II (P value<0.05). Serum ferritin level was significantly increased in subgroup A than subgroup B (P value<0.001). serum ferritin can significantly predict bad outcome (P value<0.001) with AUC of 0.964 (95% CI: 0.881 – 0.995). At cut off >1200, serum ferritin can significantly predict bad outcome with 94.44% sensitivity, 92.86% specificity, 85% PPV and 97.5% NPV. \u0000Conclusions: Serum ferritin was significantly increased in IE subjects who experiencedproblems on admission as compared to IE subjects who didn’t.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122796488","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 : 2023-05-03DOI: 10.9734/ca/2023/v12i3329
Saloua El-Karimi, Joumana Elmasrioui, Y. Islah, M. Eljamili, M. Elhattaoui, O. Benfaddoul, W. Chaja, H. Jalal
Left atrial appendage (LAA) aneurysm or giant LAA is an uncommon condition. It could be discovered incidentally during echocardiography examination or in symptomatic patients presenting with tachycardia or embolic events. The giant LAA is a serious condition with a high embolic risk that can cause respiratory distress and even cardiac arrest in children. A conservative surgical approach based on resection of the LAA is recommended and is mostly safe. We report the case of a four-year-old girl presenting with a symptomatic giant LAA removed successfully. The echo-cardiographer must be aware of its appearance mimicking a pericardial effusion and focus on its possible association with other congenital lesions. There are several therapeutic strategies, all with proven efficacy and safety.
{"title":"Giant Left Atrial Appendage Aneurysm or Pericardial Effusion: A Misleading Appearance on Echocardiography and a High Risk of Rupture","authors":"Saloua El-Karimi, Joumana Elmasrioui, Y. Islah, M. Eljamili, M. Elhattaoui, O. Benfaddoul, W. Chaja, H. Jalal","doi":"10.9734/ca/2023/v12i3329","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3329","url":null,"abstract":"Left atrial appendage (LAA) aneurysm or giant LAA is an uncommon condition. It could be discovered incidentally during echocardiography examination or in symptomatic patients presenting with tachycardia or embolic events. The giant LAA is a serious condition with a high embolic risk that can cause respiratory distress and even cardiac arrest in children. A conservative surgical approach based on resection of the LAA is recommended and is mostly safe. We report the case of a four-year-old girl presenting with a symptomatic giant LAA removed successfully. The echo-cardiographer must be aware of its appearance mimicking a pericardial effusion and focus on its possible association with other congenital lesions. There are several therapeutic strategies, all with proven efficacy and safety.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134398114","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 : 2023-05-02DOI: 10.9734/ca/2023/v12i3328
Zainab Boudhar, Sana Nehame, Mohammed El-Jamili, Saloua El-Karimi, M. El-Hattaoui
Non ST elevation myocardial infarction (NSTEMI) has been the subject of numerous studies. Risk stratification is a fundamental element for the management of NSTEMI; therefore, several scores have been established in this direction, particularly prognostic markers derived from the ECG. Aims: The aim of our study is to correlate the dispersion of the QRS with the severity of coronary lesions assessed by the GENSINI score in patients admitted for NSTEMI at the University Hospital of Marrakech. Methods: A retrospective study was conducted in the cardiology department of Mohammed VI university hospital of Marrakech from January 01, 2022 to March 31, 2022. Data was derived from the hospitalization register, including 30 patients (16 women and 14 men). Age ranged from 56 to 74 years with an average of 64.6 ± 9.3. Data was analyzed by SPSS, the level of significance set at p <0.05. Results: We found, in our study, a highly significant positive correlation between QRS dispersion (considered important if >20 ms) and admission heart rate (p=0.003) as well as the level of ultrasensitive troponins (p=0.003). There is also a very significant correlation between QRS dispersion and corrected QT interval (p=0.005), Moreover, we concluded that in patients admitted for NSTEMI, the greater the dispersion of the QRS, the higher the score of GENSINI (p<0.0001). Conclusion: The dispersion of the QRS is a simple marker on the ECG that can have a predictive value in different clinical contexts, particularly in acute ischemic heart disease. Further studies are needed, however, to validate its usefulness in routine practice.
{"title":"The Correlation between QRS Dispersion and Coronary Artery Disease Severity in Patients with Non ST Elevation Myocardial Infraction","authors":"Zainab Boudhar, Sana Nehame, Mohammed El-Jamili, Saloua El-Karimi, M. El-Hattaoui","doi":"10.9734/ca/2023/v12i3328","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3328","url":null,"abstract":"Non ST elevation myocardial infarction (NSTEMI) has been the subject of numerous studies. Risk stratification is a fundamental element for the management of NSTEMI; therefore, several scores have been established in this direction, particularly prognostic markers derived from the ECG. \u0000Aims: The aim of our study is to correlate the dispersion of the QRS with the severity of coronary lesions assessed by the GENSINI score in patients admitted for NSTEMI at the University Hospital of Marrakech. \u0000Methods: A retrospective study was conducted in the cardiology department of Mohammed VI university hospital of Marrakech from January 01, 2022 to March 31, 2022. Data was derived from the hospitalization register, including 30 patients (16 women and 14 men). Age ranged from 56 to 74 years with an average of 64.6 ± 9.3. Data was analyzed by SPSS, the level of significance set at p <0.05. \u0000Results: We found, in our study, a highly significant positive correlation between QRS dispersion (considered important if >20 ms) and admission heart rate (p=0.003) as well as the level of ultrasensitive troponins (p=0.003). There is also a very significant correlation between QRS dispersion and corrected QT interval (p=0.005), Moreover, we concluded that in patients admitted for NSTEMI, the greater the dispersion of the QRS, the higher the score of GENSINI (p<0.0001). \u0000Conclusion: The dispersion of the QRS is a simple marker on the ECG that can have a predictive value in different clinical contexts, particularly in acute ischemic heart disease. Further studies are needed, however, to validate its usefulness in routine practice.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116632768","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 : 2023-04-19DOI: 10.9734/ca/2023/v12i3327
P. M. Mulendelé, M. Njie, M. Charfo, S. M. Boutar, B. E. Ovaga, M. Haboub, S. Arous, M. Benouna, A. Drighil, L. Azzouzi, R. Habbal
Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the surface electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia that results is known as «torsade de pointe». «Torsade de pointe» (TDP) is a characteristic polymorphic ventricular arrhythmia associated with delayed ventricular repolarization as evidenced on the surface electrocardiogram by QT interval prolongation. It typically occurs in self-limiting bursts, causing dizziness and syncope, but may occasionally progress to ventricular fibrillation and sudden death. This rare case report showed the potential higher risk of the occurrences of «Tdp» when levetiracetam (KEPPRA) was used in combination therapy with fluconazole, which is already a known medication with the risk of causing polymorphic ventricular arrhythmia.
{"title":"A Rare Case Report of “Torsades De Pointes” Induced by Fluconazole-Levetiracetam Combined Therapy","authors":"P. M. Mulendelé, M. Njie, M. Charfo, S. M. Boutar, B. E. Ovaga, M. Haboub, S. Arous, M. Benouna, A. Drighil, L. Azzouzi, R. Habbal","doi":"10.9734/ca/2023/v12i3327","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3327","url":null,"abstract":"Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the surface electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia that results is known as «torsade de pointe». «Torsade de pointe» (TDP) is a characteristic polymorphic ventricular arrhythmia associated with delayed ventricular repolarization as evidenced on the surface electrocardiogram by QT interval prolongation. It typically occurs in self-limiting bursts, causing dizziness and syncope, but may occasionally progress to ventricular fibrillation and sudden death. This rare case report showed the potential higher risk of the occurrences of «Tdp» when levetiracetam (KEPPRA) was used in combination therapy with fluconazole, which is already a known medication with the risk of causing polymorphic ventricular arrhythmia.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126505221","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 : 2023-04-19DOI: 10.9734/ca/2023/v12i3326
R. Zerhoudi, B. Maatof, H. Nabawi, Y. Islah, M. Eljamili, S. Karimi, M. Elhattaoui
Introduction: Coronary heart disease is the main cause of morbidity and mortality worldwide. Right ventricular (RV) infarction is often difficult to diagnose and has a poor prognosis due to rhythmic and hemodynamic complications. Objective: The study of electrical, ultrasonographic, and coronarographic features of the VD Infarction. Materials and Methods: Retrospective study of patients hospitalized in the Cardiology Department of the Mohammed VI University Hospital in Marrakech over a period of 24 months for MDI extended to the RV. Results: 120 patients were hospitalized during this period for MI with extension to the VD. Atypical clinical presentation was noted in 10% of cases. Clinical examination on admission revealed signs of right heart failure in 18% of cases, including 6% complicated by cardiogenic shock. Thrombolysis was performed in 10% of the patients, 67% of them successfully. The ECG found an isolated extension to the V3R leads in 76% of the cases and in association with a V4R overshoot in 45% of the cases, conduction disorders were noted in 28% of the cases, presented essentially by first degree auriculoventricular block. Echocardiography showed impaired LV function in 82% of cases, and longitudinal systolic dysfunction of the LV in 65%. Coronary angiography was performed in 91% of the cases, half of which underwent coronary angioplasty. The combination of both CD and IVA damage was found in 40% of the cases, and damage to the middle DC was the most common in almost half of the cases. The most frequent complications were rhythmic and conductive disorders in 38% of cases, and the evolution was fatal in 8% of cases. Conclusion: Involvement of the RV during MI is characterized by a very critical initial phase, once overcome, the overall prognosis becomes favorable in the long term.
{"title":"Electrical, Echocardiographic and Coronary Artery Characteristics of Right Ventricular Infarction: Experience of the Cardiology Department of the CHU Mohammed VI Marrakech","authors":"R. Zerhoudi, B. Maatof, H. Nabawi, Y. Islah, M. Eljamili, S. Karimi, M. Elhattaoui","doi":"10.9734/ca/2023/v12i3326","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3326","url":null,"abstract":"Introduction: Coronary heart disease is the main cause of morbidity and mortality worldwide. Right ventricular (RV) infarction is often difficult to diagnose and has a poor prognosis due to rhythmic and hemodynamic complications. \u0000Objective: The study of electrical, ultrasonographic, and coronarographic features of the VD Infarction. \u0000Materials and Methods: Retrospective study of patients hospitalized in the Cardiology Department of the Mohammed VI University Hospital in Marrakech over a period of 24 months for MDI extended to the RV. \u0000Results: 120 patients were hospitalized during this period for MI with extension to the VD. Atypical clinical presentation was noted in 10% of cases. Clinical examination on admission revealed signs of right heart failure in 18% of cases, including 6% complicated by cardiogenic shock. Thrombolysis was performed in 10% of the patients, 67% of them successfully. The ECG found an isolated extension to the V3R leads in 76% of the cases and in association with a V4R overshoot in 45% of the cases, conduction disorders were noted in 28% of the cases, presented essentially by first degree auriculoventricular block. Echocardiography showed impaired LV function in 82% of cases, and longitudinal systolic dysfunction of the LV in 65%. Coronary angiography was performed in 91% of the cases, half of which underwent coronary angioplasty. The combination of both CD and IVA damage was found in 40% of the cases, and damage to the middle DC was the most common in almost half of the cases. The most frequent complications were rhythmic and conductive disorders in 38% of cases, and the evolution was fatal in 8% of cases. \u0000Conclusion: Involvement of the RV during MI is characterized by a very critical initial phase, once overcome, the overall prognosis becomes favorable in the long term.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116721926","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 : 2023-04-18DOI: 10.9734/ca/2023/v12i3325
B. Maatof, R. Zerhoudi, H. Nabawi, M. I. Rhoujjati, M. Eljamili, S. Karimi, M. Elhattaoui
Introduction: Coronary angiography is the examination of choice in the evaluation of coronary anatomy during acute myocardial infarction, particularly of the right ventricle (RV), whose diagnosis remains difficult. The electrocardiogram reflects the pathophysiology of myocardial ischemia, thus allowing prediction of the culprit lesion. Objective: To investigate the correlation between electrical and coronary data and to judge the reproducibility of the electrocardiogram in identifying the culprit lesion in RV infarction. Materials and Methods: Retrospective study of patients hospitalized in the Cardiology Department of the Mohammed VI University Hospital in Marrakech over a period of 24 months for MDI extended to the RV. Results: During the study period, 120 patients were hospitalized for MI with RV extension. Inferior MI represented 70% of all cases of infarction extended to the RV. It is represented electrically by isolated ST-segment elevation in V3R found in 76%, as well as in association with an elevation in V4R in 45% of cases. Conduction disorders were noted in 38% of cases, presented essentially by first degree atrioventricular block, without any electrical specificity. Coronary angiography was performed in 91% of patients, half of whom underwent coronary angioplasty. A bi-truncular involvement (RC + VIA) was found in 40% of cases, the middle DC is the culprit lesion in almost half of the cases of VD infarction. The presence of an ST elevation in the isolated V3R shunt is a specific criterion of right middle coronary involvement, found in 48% of patients. Conclusion: The ECG remains an essential tool in the early prediction of the artery responsible for the infarction. Because of its complementary nature, the combination of ECG and coronary angiography is essential for a better evaluation of acute myocardial infarction.
{"title":"Is there an Electro-Angiographic Correlation in RD Infarction?","authors":"B. Maatof, R. Zerhoudi, H. Nabawi, M. I. Rhoujjati, M. Eljamili, S. Karimi, M. Elhattaoui","doi":"10.9734/ca/2023/v12i3325","DOIUrl":"https://doi.org/10.9734/ca/2023/v12i3325","url":null,"abstract":"Introduction: Coronary angiography is the examination of choice in the evaluation of coronary anatomy during acute myocardial infarction, particularly of the right ventricle (RV), whose diagnosis remains difficult. The electrocardiogram reflects the pathophysiology of myocardial ischemia, thus allowing prediction of the culprit lesion. \u0000Objective: To investigate the correlation between electrical and coronary data and to judge the reproducibility of the electrocardiogram in identifying the culprit lesion in RV infarction. \u0000Materials and Methods: Retrospective study of patients hospitalized in the Cardiology Department of the Mohammed VI University Hospital in Marrakech over a period of 24 months for MDI extended to the RV. \u0000Results: During the study period, 120 patients were hospitalized for MI with RV extension. \u0000Inferior MI represented 70% of all cases of infarction extended to the RV. It is represented electrically by isolated ST-segment elevation in V3R found in 76%, as well as in association with an elevation in V4R in 45% of cases. \u0000Conduction disorders were noted in 38% of cases, presented essentially by first degree atrioventricular block, without any electrical specificity. \u0000Coronary angiography was performed in 91% of patients, half of whom underwent coronary angioplasty. A bi-truncular involvement (RC + VIA) was found in 40% of cases, the middle DC is the culprit lesion in almost half of the cases of VD infarction. \u0000 The presence of an ST elevation in the isolated V3R shunt is a specific criterion of right middle coronary involvement, found in 48% of patients. \u0000Conclusion: The ECG remains an essential tool in the early prediction of the artery responsible for the infarction. Because of its complementary nature, the combination of ECG and coronary angiography is essential for a better evaluation of acute myocardial infarction.","PeriodicalId":431606,"journal":{"name":"Cardiology and Angiology: An International Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124275797","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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