Background: Left main coronary artery intervention is getting common throughout the world. Data in our local population are still lacking. Our aim was to study the short-term outcomes after revascularization of left main coronary artery (LMCA) at a tertiary care Centre at public sector hospital in Pakistan. Methodology: In this descriptive study conducted at Peshawar Institute of Cardiology, we enrolled consecutive patients who underwent LMCA intervention from January 2021 till November 2021. Direct patients’ interviews, reviewing charts and records were used for in-hospital outcomes and telephonic and physical follow up were used to document three months outcome. Results were expressed as means, standard deviations and percentages for different variables. Results: Total number of patients in the study were 68. The mean age was 61 ± 11.7 years, 73.5% (50 cases) were males. Six patients (8.8%) were in cardiogenic shock and five of them were put on mechanical ventilation. Thirty-two (47.1%) patients had presentation as acute coronary syndrome (ACS) within the last seven days. Mean follow up time was 170 ± 71 days. Mortality in-hospital was 5.8%, at the mean follow up it was 8.8%. Conclusion: Comparable short-term outcomes of left main coronary artery PCI, to national and international data can be achieved in a public sector hospital in our country where resources are scarce. Hence LMCA PCI is an acceptable alternative to CABG in suitable patients.
{"title":"Short term Outcomes of left main coronary artery Percutaneous Coronary Intervention A large tertiary care dedicated Cardiac Centre experience.","authors":"A. Ullah, M. Ishaq, Rafiullah Jan, A. Raza","doi":"10.58889/pjcvi.3.24.30","DOIUrl":"https://doi.org/10.58889/pjcvi.3.24.30","url":null,"abstract":"Background: Left main coronary artery intervention is getting common throughout the world. Data in our local population are still lacking. Our aim was to study the short-term outcomes after revascularization of left main coronary artery (LMCA) at a tertiary care Centre at public sector hospital in Pakistan. \u0000Methodology: In this descriptive study conducted at Peshawar Institute of Cardiology, we enrolled consecutive patients who underwent LMCA intervention from January 2021 till November 2021. Direct patients’ interviews, reviewing charts and records were used for in-hospital outcomes and telephonic and physical follow up were used to document three months outcome. Results were expressed as means, standard deviations and percentages for different variables. \u0000Results: Total number of patients in the study were 68. The mean age was 61 ± 11.7 years, 73.5% (50 cases) were males. Six patients (8.8%) were in cardiogenic shock and five of them were put on mechanical ventilation. Thirty-two (47.1%) patients had presentation as acute coronary syndrome (ACS) within the last seven days. Mean follow up time was 170 ± 71 days. Mortality in-hospital was 5.8%, at the mean follow up it was 8.8%. \u0000Conclusion: Comparable short-term outcomes of left main coronary artery PCI, to national and international data can be achieved in a public sector hospital in our country where resources are scarce. Hence LMCA PCI is an acceptable alternative to CABG in suitable patients.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126718143","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}
Classical symptoms of ischemic heart disease include exertional chest pain associated diaphoresis, palpitations or shortness of breath. Yet, it can also present unusually with symptoms ranging from epigastric discomfort, fatigue and vomiting. A 48 years old male presented to the hospital with severe retrosternal chest pain for 6 hours duration. ECG showed acute anterior wall STEMI. Primary PCI to LAD was performed successfully. He had been complaining of intractable hiccups for the past one year for which he had been seen in gastroenterology clinics multiple times with no relief in hiccups. After we performed primary PCI to LAD, he had complete resolution of hiccups. He is still under regular follow up with us for the past 4 months with no active complaints of hiccups. This case conclude that Intractable hiccups can be the only symptomatic manifestation of coronary artery disease (CAD) in some patients. Therefore, a high suspicion of CAD should be kept in mind especially in patients with risk factors for CAD.
{"title":"Chronic ischemia in Left anterior descending artery territory presenting as intractable hiccups: An unusual symptom of coronary artery disease.","authors":"S. Khan, A. Khan, Syed Abid Habib","doi":"10.58889/pjcvi.3.77.79","DOIUrl":"https://doi.org/10.58889/pjcvi.3.77.79","url":null,"abstract":"Classical symptoms of ischemic heart disease include exertional chest pain associated diaphoresis, palpitations or shortness of breath. Yet, it can also present unusually with symptoms ranging from epigastric discomfort, fatigue and vomiting. A 48 years old male presented to the hospital with severe retrosternal chest pain for 6 hours duration. ECG showed acute anterior wall STEMI. Primary PCI to LAD was performed successfully. He had been complaining of intractable hiccups for the past one year for which he had been seen in gastroenterology clinics multiple times with no relief in hiccups. After we performed primary PCI to LAD, he had complete resolution of hiccups. He is still under regular follow up with us for the past 4 months with no active complaints of hiccups. This case conclude that Intractable hiccups can be the only symptomatic manifestation of coronary artery disease (CAD) in some patients. Therefore, a high suspicion of CAD should be kept in mind especially in patients with risk factors for CAD. \u0000 ","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"529 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114090913","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}
Hannah Hameed, Tara Anne John, M. Tahirkheli, Bruce Cannon, Julie Ellen White, Hussnain Zafar, M. Baig, Zarrar Sani, A. Chohan, A. Weitzel, Humza Razaq, A. Siddiqi, Mehak Ali, Ilsa Rizvi, Arslan Ahmad, Bireera Muzaffar, Sakina Batool, Riyan Imtiaz Karamat, Qasim Manzoor Amjad, A. Karim, N. Tahirkheli
Since its introduction, Bentall procedure has remained the standard of care for management of ascending aortic aneurysms with associated aortic valve pathologies. It involves replacement of aortic root, ascending aorta and the aortic valve, using a hybrid vascular graft with built in valves. The openings of the main coronary arteries are then rejoined with the graft. The procedure has satisfactory long term survival rate. However, there are some complications including graft infection, stroke from dislodged plaques and coronary insufficiency due to kinking of the reconnected main coronary arteries. Here, we report a rare and life-threatening complication following Bentall procedure. A 76-year-old female developed left main stenosis following Bentall procedure, successfully treated with percutaneous coronary intervention (PCI). We discuss various etiologies and treatment options for this complication. We recommend routine surveillance with coronary angiography at six months post Bentall.
{"title":"Left Main Coronary Artery Stenosis following Bentall Procedure: A case report.","authors":"Hannah Hameed, Tara Anne John, M. Tahirkheli, Bruce Cannon, Julie Ellen White, Hussnain Zafar, M. Baig, Zarrar Sani, A. Chohan, A. Weitzel, Humza Razaq, A. Siddiqi, Mehak Ali, Ilsa Rizvi, Arslan Ahmad, Bireera Muzaffar, Sakina Batool, Riyan Imtiaz Karamat, Qasim Manzoor Amjad, A. Karim, N. Tahirkheli","doi":"10.58889/pjcvi.3.60.64","DOIUrl":"https://doi.org/10.58889/pjcvi.3.60.64","url":null,"abstract":"Since its introduction, Bentall procedure has remained the standard of care for management of ascending aortic aneurysms with associated aortic valve pathologies. It involves replacement of aortic root, ascending aorta and the aortic valve, using a hybrid vascular graft with built in valves. The openings of the main coronary arteries are then rejoined with the graft. The procedure has satisfactory long term survival rate. However, there are some complications including graft infection, stroke from dislodged plaques and coronary insufficiency due to kinking of the reconnected main coronary arteries. \u0000Here, we report a rare and life-threatening complication following Bentall procedure. A 76-year-old female developed left main stenosis following Bentall procedure, successfully treated with percutaneous coronary intervention (PCI). We discuss various etiologies and treatment options for this complication. We recommend routine surveillance with coronary angiography at six months post Bentall.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115195057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Khan, A. Khan, Jasia Bukhari, Muhammad Idrees Khan, Imad Uddin
Background: Currently, patients with coronary artery disease are advised to use coronary stenting as their primary revascularization method. This study aims to compare outcome of MACE after DEB Vs DES in treatment of patients within stent restenosis (ISR) presented with chest pain. Methodology: The current study was Quasi experimental study carried out at the Department of Cardiology, MTI-HMC Peshawar for duration of six months from 21 April 2021 to 21 Nov 2021. In this study, 94 patients in DEB group and 94 patients in DES group were followed for 06 months to look for development of MACE. All data was collected through a well-defined proforma. Data was entered on computer software SPSS version 22. Results: In DEB group, 52 (55.3%) male patients and 42 (44.7%) female patients were recorded whereas in DES group, 57 (60.6%) male patients while 37 (39.4%) female patients were recorded. In DEB group, 15 (16.0%) patients were recorded with MACE whereas in DES group, 38 (40.4%) patients were recorded with MACE. Conclusion: Our study showed that DEB is superior to DES in the management of in-stent restenosis and results in fewer major adverse cardiovascular events (MACE), so DEB may be considered as a treatment option for CAD patients admitted to our setting in in order to reduce mortality and morbidity associated to restenosis in such patients.
背景:目前，建议冠状动脉疾病患者使用冠状动脉支架植入术作为其主要的血运重建方法。本研究旨在比较DEB与DES治疗支架再狭窄(ISR)患者胸痛的效果。方法学:目前的研究是在MTI-HMC白沙瓦心脏病学系进行的准实验研究，为期六个月，从2021年4月21日至2021年11月21日。本研究对DEB组94例患者和DES组94例患者进行随访，随访时间为06个月，观察MACE的发展情况。所有数据都是通过定义明确的形式收集的。数据在计算机软件SPSS version 22中输入。结果:DEB组男性52例(55.3%)，女性42例(44.7%);DES组男性57例(60.6%)，女性37例(39.4%)。DEB组有15例(16.0%)患者发生MACE, DES组有38例(40.4%)患者发生MACE。结论:我们的研究表明，DEB在处理支架内再狭窄方面优于DES，并且导致更少的主要不良心血管事件(MACE)，因此DEB可以作为我们收治的CAD患者的治疗选择，以降低此类患者与再狭窄相关的死亡率和发病率。
{"title":"Comparative outcomes of MACE after Drug eluting balloon Vs. Drug Eluting Stent in treatment of in-stent restenosis (ISR) patients presented with acute coronary syndrome.","authors":"S. Khan, A. Khan, Jasia Bukhari, Muhammad Idrees Khan, Imad Uddin","doi":"10.58889/pjcvi.3.31.36","DOIUrl":"https://doi.org/10.58889/pjcvi.3.31.36","url":null,"abstract":"Background: Currently, patients with coronary artery disease are advised to use coronary stenting as their primary revascularization method. This study aims to compare outcome of MACE after DEB Vs DES in treatment of patients within stent restenosis (ISR) presented with chest pain. \u0000Methodology: The current study was Quasi experimental study carried out at the Department of Cardiology, MTI-HMC Peshawar for duration of six months from 21 April 2021 to 21 Nov 2021. In this study, 94 patients in DEB group and 94 patients in DES group were followed for 06 months to look for development of MACE. All data was collected through a well-defined proforma. Data was entered on computer software SPSS version 22. \u0000Results: In DEB group, 52 (55.3%) male patients and 42 (44.7%) female patients were recorded whereas in DES group, 57 (60.6%) male patients while 37 (39.4%) female patients were recorded. In DEB group, 15 (16.0%) patients were recorded with MACE whereas in DES group, 38 (40.4%) patients were recorded with MACE. \u0000Conclusion: Our study showed that DEB is superior to DES in the management of in-stent restenosis and results in fewer major adverse cardiovascular events (MACE), so DEB may be considered as a treatment option for CAD patients admitted to our setting in in order to reduce mortality and morbidity associated to restenosis in such patients.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126836303","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}
Coronary artery spasm is a relatively uncommon cause of ST segment elevation myocardial infarction. However, the clinical presentation and electrocardiographic findings are remarkably similar to STEMI secondary to plaque rupture. Recurrent presentation with coronary vasospasm as STEMI presents a unique clinical dilemma especially if they present to different centers where the previous history is not well known. Management in the acute settings continue to pose significant challenges in these acutely unwell patients. We describe and explore a similar clinical situation in which a patient with severe recurrent STEMI presentations was found to have coronary artery vasospasms. The case was twice misinterpreted as having plaque rupture STEMI leading to percutaneous coronary intervention and then further difficulties in long term management in view of need for long term antiplatelet and suspected association of eosinophilia with coronary vasospasm which in turn can be caused by Aspirin.
{"title":"Recurrent coronary spasm presenting as acute STEMI; To stent or not to stent?","authors":"A. Ullah, F. Keshavarzi, D. Fraser","doi":"10.58889/pjcvi.3.69.76","DOIUrl":"https://doi.org/10.58889/pjcvi.3.69.76","url":null,"abstract":"Coronary artery spasm is a relatively uncommon cause of ST segment elevation myocardial infarction. However, the clinical presentation and electrocardiographic findings are remarkably similar to STEMI secondary to plaque rupture. \u0000Recurrent presentation with coronary vasospasm as STEMI presents a unique clinical dilemma especially if they present to different centers where the previous history is not well known. Management in the acute settings continue to pose significant challenges in these acutely unwell patients. \u0000We describe and explore a similar clinical situation in which a patient with severe recurrent STEMI presentations was found to have coronary artery vasospasms. \u0000The case was twice misinterpreted as having plaque rupture STEMI leading to percutaneous coronary intervention and then further difficulties in long term management in view of need for long term antiplatelet and suspected association of eosinophilia with coronary vasospasm which in turn can be caused by Aspirin.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117125356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Ullah, N. Malik, D. Fraser, A. Raza, F. Ordoubadi, M. Omar
Stress cardiomyopathy (SCM), also known as Takatsubo cardiomyopathy or broken heart syndrome has been well documented in literature since its first description. With more awareness of the condition and increasing evidence base, the reported incidence of SCM has steadily increased over years and currently estimated at 1-2 % of the patients presenting with acute coronary syndrome. There are different criteria proposed for diagnosis of stress cardiomyopathy and this address more or less the same clinical questions while diagnosing this not so uncommon condition. Despite extensive research , there has been a lack of understanding on the exact mechanism and causative factors leading to SCM. We report a variety of cases where a different trigger appears to have been responsible for causation of SCM. It would seem that irrespective of the original trigger, the final clinical picture and course remains identical. These further strengths the idea that the condition is mediated by a common neurocardiovacular pathway in susceptible individuals. Further exploration of these mechanisms would be crucial to improve our strategies to try to prevent and effectively manage this potentially disabling condition.
{"title":"Stress cardiomyopathy: Same pathology caused by variety of triggers.","authors":"A. Ullah, N. Malik, D. Fraser, A. Raza, F. Ordoubadi, M. Omar","doi":"10.58889/pjcvi.3.7.16","DOIUrl":"https://doi.org/10.58889/pjcvi.3.7.16","url":null,"abstract":"Stress cardiomyopathy (SCM), also known as Takatsubo cardiomyopathy or broken heart syndrome has been well documented in literature since its first description. With more awareness of the condition and increasing evidence base, the reported incidence of SCM has steadily increased over years and currently estimated at 1-2 % of the patients presenting with acute coronary syndrome. \u0000There are different criteria proposed for diagnosis of stress cardiomyopathy and this address more or less the same clinical questions while diagnosing this not so uncommon condition. \u0000Despite extensive research , there has been a lack of understanding on the exact mechanism and causative factors leading to SCM. We report a variety of cases where a different trigger appears to have been responsible for causation of SCM. It would seem that irrespective of the original trigger, the final clinical picture and course remains identical. These further strengths the idea that the condition is mediated by a common neurocardiovacular pathway in susceptible individuals. Further exploration of these mechanisms would be crucial to improve our strategies to try to prevent and effectively manage this potentially disabling condition.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133509693","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}
Rheumatic mitral stenosis (MS) incidence and severity rates have decreased in the developed world, but the condition is still very common in many nations. Since its invention, percutaneous mitral balloon valvuloplasty has transformed the therapy of mitral stenosis, shown promising short- and long-term outcomes, and taken the role of surgical mitral commissurotomy as the preferred method of managing rheumatic mitral stenosis in suitable patients. The morphologic characteristics of the valve leaflets and sub valvular structures can be used to predict the possibility of hemodynamic benefit and the danger of complications with balloon valvuloplasty. The results will be less than ideal if the valves are hard, thickened, and extensively calcified. We presented the retrospective data of approximately 500 patients from March 2001 to June 2006 in this paper.
{"title":"History of PTMC at National Institute of Cardiovascular Diseases Karachi.","authors":"Khan Shah Zaman","doi":"10.58889/pjcvi.3.1.6","DOIUrl":"https://doi.org/10.58889/pjcvi.3.1.6","url":null,"abstract":"Rheumatic mitral stenosis (MS) incidence and severity rates have decreased in the developed world, but the condition is still very common in many nations. Since its invention, percutaneous mitral balloon valvuloplasty has transformed the therapy of mitral stenosis, shown promising short- and long-term outcomes, and taken the role of surgical mitral commissurotomy as the preferred method of managing rheumatic mitral stenosis in suitable patients. The morphologic characteristics of the valve leaflets and sub valvular structures can be used to predict the possibility of hemodynamic benefit and the danger of complications with balloon valvuloplasty. The results will be less than ideal if the valves are hard, thickened, and extensively calcified. We presented the retrospective data of approximately 500 patients from March 2001 to June 2006 in this paper.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122005062","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}
Coronary artery disease (CAD) accounts for more than two-thirds of these deaths. It is indicated per the latest information that one in four Pakistani adults over 40 has CAD. The stable coronary disease has a relatively low annual mortality, while acute myocardial infarction (MI) carries a high mortality and morbidity. Though recent advancements in coronary interventions have however revolutionized the management of acute myocardial infarction, resulting in a significant reduction of cardiovascular morbidity and mortality in the developed world but in Pakistan, the majority of ST-elevation myocardial infarction (STEMI) patients still remain sub-optimally managed. Urban areas are relatively better equipped, but this does not necessarily translate into universal access to quality and timely cardiac care. There is not only substantial variation in accessibility and practices amongst cardiac healthcare facilities between rural and urban areas but also amongst major city hospitals. Such variations clearly indicate an urgent need for a nationwide standardized STEMI management program to ensure that everyone with an acute STEMI will have speedy access to quality and standard acute care without being economically burdened.
{"title":"STEMI Pakistan; A National Heart Attack Management Program.","authors":"Salman S Nishtar","doi":"10.58889/pjcvi.3.17.23","DOIUrl":"https://doi.org/10.58889/pjcvi.3.17.23","url":null,"abstract":"Coronary artery disease (CAD) accounts for more than two-thirds of these deaths. It is indicated per the latest information that one in four Pakistani adults over 40 has CAD. \u0000The stable coronary disease has a relatively low annual mortality, while acute myocardial infarction (MI) carries a high mortality and morbidity. Though recent advancements in coronary interventions have however revolutionized the management of acute myocardial infarction, resulting in a significant reduction of cardiovascular morbidity and mortality in the developed world but in Pakistan, the majority of ST-elevation myocardial infarction (STEMI) patients still remain sub-optimally managed. Urban areas are relatively better equipped, but this does not necessarily translate into universal access to quality and timely cardiac care. There is not only substantial variation in accessibility and practices amongst cardiac healthcare facilities between rural and urban areas but also amongst major city hospitals. Such variations clearly indicate an urgent need for a nationwide standardized STEMI management program to ensure that everyone with an acute STEMI will have speedy access to quality and standard acute care without being economically burdened.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131335349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pericardial effusion is not an uncommon finding in cardiology practice and the clinical picture depends on various factors including size of the effusion, etiology and speed of accumulation. Significant hemodynamic abnormalities, including cardiac arrest, can result from pericardial tamponade. We report a case of pericardial tamponade in a patient precipitated by added pressure from a transthoracic echo probe. Hemodynamic changes occurred unexpectedly during acquisition of subcostal echo images. The patient was promptly resuscitated and urgent pericardiocentesis was performed. Soon after the pericardiocentesis, hemodynamic indicators improved, and the patient achieved a satisfactory clinical recovery.
{"title":"rare case of pericardial tamponade during Transthoracic Echocardiogram.","authors":"A. Ullah, Colin Cunningham","doi":"10.58889/pjcvi.3.65.68","DOIUrl":"https://doi.org/10.58889/pjcvi.3.65.68","url":null,"abstract":"Pericardial effusion is not an uncommon finding in cardiology practice and the clinical picture depends on various factors including size of the effusion, etiology and speed of accumulation. Significant hemodynamic abnormalities, including cardiac arrest, can result from pericardial tamponade. We report a case of pericardial tamponade in a patient precipitated by added pressure from a transthoracic echo probe. Hemodynamic changes occurred unexpectedly during acquisition of subcostal echo images. The patient was promptly resuscitated and urgent pericardiocentesis was performed. Soon after the pericardiocentesis, hemodynamic indicators improved, and the patient achieved a satisfactory clinical recovery.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114310892","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: ACS presents as wide range of clinical ailments that requires prompt treatment to avoid unforeseen circumstances. As noninvasive strategy, TIMI risk assessment is a widely accepted tool for risk stratification of ACS patient to initiate timely management. Purpose of the present study is to determine the association of TIMI score in predicting the severity of coronary artery disease in ACS. Methodology: A cross-sectional study was conducted in specialized tertiary care cardiac hospital on 255 patients from January 2021 to June 2021. For all patients, TIMI score calculated based on all the seven variables. Confidentiality of the participants was maintained. Ethical approval was obtained from review board of concerned hospital. Data was analyzed on SPSS version 23.0. One way ANOVA was used to compare categorical variables. Chi square test used to reveal difference in proportion to three TIMI groups. Results: Finding show that ST segment deviation was evident in 51.5% patients. Out of 37 patients in group-III with ST segment changes, 91.8% were found of having significant CAD. Results show that in group-III, 54.1% had significant three vessel CAD compared to 17.6% group-II & 7.5% group-I patients. Also, p-value of <0.001 depict significant association between TIMI score and severity of CAD. Conclusion: A significant association from this study gives a notion that TIMI score is valuable tool in clinical setting to make urgent decision regarding the management of CAD. Also, it was concluded from current study that patients with higher TIMI score had additional risk of three vessel CAD and left main vessel CAD in patients with ACS.
{"title":"Correlation of TIMI score with severity of coronary artery disease in acute coronary syndrome","authors":"Ahmad Q. Hasan, A. Iqbal, S. Tawab, I. Hussain","doi":"10.58889/pjcvi.3.52.59","DOIUrl":"https://doi.org/10.58889/pjcvi.3.52.59","url":null,"abstract":"Background: ACS presents as wide range of clinical ailments that requires prompt treatment to avoid unforeseen circumstances. As noninvasive strategy, TIMI risk assessment is a widely accepted tool for risk stratification of ACS patient to initiate timely management. Purpose of the present study is to determine the association of TIMI score in predicting the severity of coronary artery disease in ACS. \u0000Methodology: A cross-sectional study was conducted in specialized tertiary care cardiac hospital on 255 patients from January 2021 to June 2021. For all patients, TIMI score calculated based on all the seven variables. Confidentiality of the participants was maintained. Ethical approval was obtained from review board of concerned hospital. Data was analyzed on SPSS version 23.0. One way ANOVA was used to compare categorical variables. Chi square test used to reveal difference in proportion to three TIMI groups. \u0000Results: Finding show that ST segment deviation was evident in 51.5% patients. Out of 37 patients in group-III with ST segment changes, 91.8% were found of having significant CAD. Results show that in group-III, 54.1% had significant three vessel CAD compared to 17.6% group-II & 7.5% group-I patients. Also, p-value of <0.001 depict significant association between TIMI score and severity of CAD. \u0000Conclusion: A significant association from this study gives a notion that TIMI score is valuable tool in clinical setting to make urgent decision regarding the management of CAD. Also, it was concluded from current study that patients with higher TIMI score had additional risk of three vessel CAD and left main vessel CAD in patients with ACS.","PeriodicalId":438573,"journal":{"name":"Pakistan Journal of Cardiovascular Intervention","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124306512","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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