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Coronary Artery Involvement in Kawasaki Disease-Echocardiographic Evaluation of Cases in a Tertiary Care Hospital 川崎病累及冠状动脉的超声心动图分析
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65629
N. Fatema, J. Ferdous, Ashik Md Raihan Chowdhury, Mashiyat Mayisha Ahmad
Background: Kawasaki disease (KD) is the leading cause of childhood acquired heart disease. Cardiovascular manifestations can be prominent in the acute phase of the illness. Echocardiography is useful in recognizing these cardiac manifestations. We carried out a retrospective study by analyzing the data of Kawasaki disease patients in a tertiary care hospital.Methods: The prevalence of coronary artery dilatation and clinical outcome were documented. Clinical, laboratory, and echocardiographic findings were obtained at baseline and 1 week, 6 weeks after initial therapy with intravenous immunoglobulin in addition to high doses of Aspirin which reduces the risk of coronary artery aneurysm.Results: One hundred and forty-nine patients with mean age 3± 2 years old, 60% males with Kawasaki disease were included. One hundred and thirty-two patients had coronary involvement (left main coronary artery 36.37 %, left anterior descending artery 28.03%, right main coronary artery 24.25%, circumflex branch in 11.37%). Administration of intravenous immunoglobulin (IVIG) and aspirin has greatly reduced the incidence of coronary lesions in affected children. The initial cardiac findings developed over first few weeks of illness resolved in most of the cases in the subsequent echocardiogram studies after IVIG. The mean duration to normalization of abnormal echocardiography findings is 6±3 months.Conclusion: Coronary artery involvement is seen in most of children with Kawasaki disease. Intravenous gamma globulin and aspirin has been reported to reduce the likelihood of development of giant coronary artery aneurysms and appears to have a direct beneficial effect on abnormalities in cardiac function associated with the acute phase of Kawasaki disease.Cardiovasc j 2023; 15(2): 144-150
背景:川崎病是儿童获得性心脏病的主要病因。在疾病的急性期,心血管方面的表现很突出。超声心动图对识别这些心脏表现很有用。我们对某三级医院川崎病患者资料进行回顾性分析。方法:记录冠状动脉扩张的发生率和临床结果。临床、实验室和超声心动图结果分别在基线和1周、6周后进行,患者在服用高剂量阿司匹林的基础上静脉注射免疫球蛋白,以降低冠状动脉瘤的风险。结果:纳入川崎病患者149例,平均年龄3±2岁,男性占60%。132例冠脉受累(左冠脉主干36.37%,左前降支28.03%,右冠脉主干24.25%,旋支11.37%)。静脉注射免疫球蛋白(IVIG)和阿司匹林大大降低了受影响儿童冠状动脉病变的发生率。在大多数病例中,在IVIG后的超声心动图研究中,最初的心脏发现在疾病的最初几周内得到解决。超声心动图异常恢复正常的平均时间为6±3个月。结论:川崎病患儿冠状动脉受累多见。据报道,静脉注射丙种球蛋白和阿司匹林可降低巨大冠状动脉瘤发生的可能性,并对川崎病急性期相关的心功能异常有直接的有益作用。心血管病[j] 2023;15 (2): 144 - 150
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引用次数: 0
The Great Pioneers of Coronary Artery Bypass Surgery: Is it Necessary to Ascertain Anybody the Fatherhood of CABG? 冠状动脉搭桥术的伟大先驱:有必要确定冠状动脉搭桥术之父吗?
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65636
M. Anisuzzaman, N. Hosain, M. Kabir
Coronary bypass operation is one of the greatest achievements of medical science in the 20th century. Alexis Carrel in 1910 and Arthur Vineberg in 1945 tried to perform surgical revascularization of the diseased coronary arteries.  In the beginning of the 1950s many surgeons attempted experimentally to anastomose internal thoracic artery to the coronary arteries. Success was achieved simultaneously and independently by Vladimir Demikhov in Russia and Gordon Murray in Canada. Then the real success come of mammary-coronary bypass with tantalum ring by Robert H Goetz and with suture technique by Vasilii I Kolesov. Then autogenous great saphenous vein used by Rene G Favaloro and others and made the procedure popular worldwide. Which contribution is greater, when medicine depends on evolution and big accomplishment reached by means of the contribution of many. There comes the interesting question who should be given the credit of introducing this major surgical procedure, and along comes the ethical issue whether any single individual should be ascertained the fatherhood of CABG or any historic event at all!Cardiovasc j 2023; 15(2): 185-188
冠状动脉搭桥手术是20世纪最伟大的医学成就之一。1910年的亚历克西斯·卡雷尔和1945年的阿瑟·维因伯格试图对患病的冠状动脉进行手术重建术。在20世纪50年代初,许多外科医生尝试实验性地将胸内动脉与冠状动脉吻合。俄罗斯的弗拉基米尔·德米霍夫和加拿大的戈登·默里同时独立取得了成功。然后是Robert H Goetz的钽环乳房冠状动脉搭桥术和Vasilii I Kolesov的缝合术。随后,Rene G Favaloro等人使用自体大隐静脉,使手术在世界范围内流行起来。当医学依赖于进化和通过许多人的贡献而取得的巨大成就时,哪个贡献更大?有一个有趣的问题,谁应该被认为是引入这一重大外科手术的人,随之而来的是道德问题,是否应该确定任何一个人是CABG或任何历史事件的父亲!心血管病[j] 2023;15 (2): 185 - 188
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引用次数: 0
Pharmacoinvasive Therapy in Treating Acute STEMI Patients in Covid-19 Era 药物侵入治疗新冠肺炎时代急性STEMI患者
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65628
A. Islam, A. Reza, S. Talukder, S. Munwar, Atahar Ali, T. Ahmed, Kazi Atiqur Rahman, A. H. Bhuiyan, Aparajita Karim, P. Bala, Nighat Islam, Abeda Tasnim Reza, Tanbir Hossain, M. Z. Haque
Background: Treating acute ST segment elevated myocardial infarction (STEMI) patients by primary PCI (pPCI) has dramatically fallen globally in covid era as there is chances of potential threat of spreading COVID among the non-COVID patients. Thereby, thrombolysis of acute STEMI patient in grey zone till COVID RT PCR report to come, was the mode of treatment of acute myocardial infarction patient in our hospital. We have carried out this prospective observational study to see the outcomes of thrombolysis and subsequent intervention.Methods: STEMI patient who presented to our emergency department with chest pain and ECG and hs-Troponin-I evidenced acute STEMI, were enrolled in the study. Total 139 patients enrolled (Male:120, Female :54); average age for Male: 54 yrs., female was: 56yrs. All patients were admitted in the grey zone of CCU where thrombolysis was done.  COVID-19 patients were excluded from intervention and managed conservatively. Covid Negative patients were kept transferred to CCU green zone. On average 2.1 days after Fibrinolysis, elective PCI carried out. Data analysis from 48 patients who underwent pharmacoinvasive therapy was done.Results: Among the study population, Covid-19 positive was in 11 (7.9%) patients and Covid-19 was negative in 128 (92.1%) patients. Primary PCI was performed in 7 (5.03%) patients. Rest of the patients were managed by Pharmacoinvasive therapy. Thrombolysis by Tenecteplase (TNK) was done in 89 (64%) patients, and by Streptokinase in 25 (17.9%) patients, 18 (12.9%) patients did not receive any thrombolysis due to late presentation. Chest pain to needle time was 7.2 ±12.7hrs., thrombolysis to balloon time was 117.5 ±314.8hrs. More than 50% stenosis resolution observed in 20 (41.6%) patients, chest pain resolution within one hour of thrombolysis observed in 21 (43.8%) patients. Ten (20.8%) patients developed. Door to needle time was 30 mins. Total, 88 stents were deployed in 83 territories. CABG was recommended for 7 (5.03%) patients. Stented territory was LAD 37 (45.7%) and RCA 32 (39.5%) and LCX 12 (14.8%).Conclusion: In the era of COVID-19, in this prospective cohort study, on acute STEMI patient management, we found that Pharmacoinvasive therapy, reduced patients’ symptoms and ST resolution occurred partially.Cardiovasc j 2023; 15(2): 136-143
背景:在covid时代,由于存在在非covid患者中传播covid的潜在威胁,通过初级PCI (pPCI)治疗急性ST段抬高型心肌梗死(STEMI)患者的数量在全球范围内急剧下降。因此,在COVID RT PCR报告之前,灰色地带的急性STEMI患者的溶栓治疗是我院急性心肌梗死患者的治疗模式。我们进行了这项前瞻性观察性研究,以观察溶栓和随后干预的结果。方法:以胸痛、心电图和hs-肌钙蛋白- i向急诊科就诊的STEMI患者均为急性STEMI患者。共纳入139例患者(男性120例,女性54例);男性平均年龄:54岁。,女:56岁。所有患者均在CCU的灰色区域接受溶栓治疗。将COVID-19患者排除在干预措施之外并进行保守管理。新冠阴性患者继续转入CCU绿区。纤溶后平均2.1天,择期行PCI。对48例接受药物侵入治疗的患者进行数据分析。结果:研究人群中Covid-19阳性11例(7.9%),阴性128例(92.1%)。7例(5.03%)患者行首次PCI。其余患者采用药物侵入治疗。89例(64%)患者使用Tenecteplase (TNK)溶栓,25例(17.9%)患者使用Streptokinase溶栓,18例(12.9%)患者由于就诊较晚而未接受任何溶栓治疗。胸痛至针刺时间为7.2±12.7h。溶栓至球囊时间为117.5±314.8h。20例(41.6%)患者狭窄消退超过50%,21例(43.8%)患者溶栓后1小时胸痛消退。10例(20.8%)患者出现。从门到针的时间为30分钟。总共在83个地区部署了88个支架。推荐冠脉搭桥7例(5.03%)。支架区域为LAD 37(45.7%)、RCA 32(39.5%)和lcx12(14.8%)。结论:在COVID-19时代,在本前瞻性队列研究中,对急性STEMI患者的管理,我们发现药物侵入治疗,减轻了患者的症状,部分缓解了ST。心血管病[j] 2023;15 (2): 136 - 143
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引用次数: 0
Comparison of Urinary Sodium and Potassium Excretion between Hypertensive and Normotensive Individuals 高血压与正常血压者尿钠、钾排泄的比较
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65604
MD. Rokun Uddin, A. Islam, Muhammad Badrul Alam, Asaduzzaman Khondoker, M. Roy, Rahela Ferdous, M. Rahman
Background: Sodium and potassium intake is known to be a modifiable determinant of hypertension. Also, daily intake of these electrolytes is subject to much geographical and ethnic variation. The impact of sodium and potassium intake on blood pressure in Bangladeshi subjects in incompletely known. Our objective was to determine the relationship between urinary sodium and potassium excretion, and blood pressure in Bangladeshi subjects.Methods: Patients attending the Outpatient Department of the Department of Cardiology, SSMC & MH, who fulfilled the inclusion and exclusion criteria, were taken as study sample. Hypertensive individuals were considered as group 1 and apparently healthy individuals who did not have hypertension were considered as group 2 for the study. Estimates of 24-hour sodium and potassium excretion were made from a single spot urine specimen and were used as surrogates for intake. We assessed the relationship between sodium and potassium excretion and blood pressure.Results: The spot urinary sodium excretion was significantly higher in hypertensive group than in normotensive group (98.03 ± 71.13 mmol/L vs. 77.11 ± 41.71 mmol/L) (p=0.011). On the other hand, the spot urinary potassium excretion was lower in hypertensive group than normotensive group (33.95 ± 41.03 mmol/L vs. 39.43 ± 31.47 mmol/L), but the differences did not reach statistical significance (p=0.679). The estimated 24-hour urinary sodium excretion was higher in hypertensive group than in normotensive group (8.84 ± 3.57 gm vs. 7.67 ± 3.16 gm) and the difference was statistically significant (p = 0.015). Estimated 24-hour urinary potassium excretion was lower in hypertensive group (4.15 ± 1.37 gm) than in normotensive group (4.48 ± 1.56 gm), but the difference between 2 values did not reach statistical significance (p=0.114).Conclusion: Compared to the normotensive counterparts, sodium intake is significantly higher and potassium intake is lower in hypertensive Bangladeshi subjects.Cardiovasc j 2023; 15(2): 118-123
背景:钠和钾的摄入是高血压的一个可改变的决定因素。此外,这些电解质的每日摄入量受地理和种族差异的影响很大。钠和钾摄入对孟加拉国受试者血压的影响尚不完全清楚。我们的目的是确定孟加拉国受试者尿钠和钾排泄与血压之间的关系。方法:选取我院心内科门诊部符合纳入和排除标准的患者作为研究样本。高血压个体被认为是第1组,明显健康但没有高血压的个体被认为是第2组。估计24小时钠和钾的排泄是由一个单一的尿液标本,并作为摄入量的替代品。我们评估了钠和钾排泄与血压之间的关系。结果:高血压组尿钠点排泄量明显高于正常组(98.03±71.13 mmol/L∶77.11±41.71 mmol/L) (p=0.011)。高血压组尿钾点排泄量低于正常组(33.95±41.03 mmol/L vs. 39.43±31.47 mmol/L),但差异无统计学意义(p=0.679)。高血压组24小时尿钠排泄量高于正常组(8.84±3.57 gm∶7.67±3.16 gm),差异有统计学意义(p = 0.015)。高血压组24小时尿钾排泄量(4.15±1.37 gm)低于正常组(4.48±1.56 gm),但两者差异无统计学意义(p=0.114)。结论:孟加拉国高血压人群钠摄入量明显高于正常血压人群,钾摄入量明显低于正常血压人群。心血管病[j] 2023;15 (2): 118 - 123
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引用次数: 0
Vasilii I Kolesov: The First Series of Best Option Coronary Bypass Pioneer Vasilii I Kolesov:第一系列最佳选择冠状动脉搭桥先驱
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65637
M. Anisuzzaman, N. Hosain
Heart surgery is one of the areas of greatest achievement in 20th century medical science. As the number one killer, Ischemic heart disease (IHD) was a big hurdle in achieving health for all. In this century, cardiovascular scientists put effort to combat the disease. Vasilii Ivanovich Kolesov is the early and successful contributor among them in the field of coronary surgery. On 25 February 1964, V.I. Kolesov successfully performed the first anastomosis between the left internal thoracic artery and the left circumflex artery. This was the beginning of a new era of coronary bypass surgeries, carried out on a regular basis to re-establish coronary flow in patients with IHD. This operation, in combination with Rene G. Favaloro’s method of using the saphenous vein in coronary surgery become the most commonly performed surgical procedure in the world.Cardiovasc j 2023; 15(2): 189-194
心脏外科手术是20世纪医学科学最伟大的成就之一。作为头号杀手,缺血性心脏病(IHD)是实现全民健康的一大障碍。在本世纪,心血管科学家努力与这种疾病作斗争。Vasilii Ivanovich Kolesov是其中早期和成功的冠状动脉外科领域的贡献者。1964年2月25日,V.I. Kolesov成功地进行了左胸内动脉和左旋动脉之间的第一次吻合。这是冠状动脉搭桥手术新时代的开始,定期进行以重建IHD患者的冠状动脉血流。该手术与Rene G. Favaloro在冠状动脉手术中使用隐静脉的方法相结合,成为世界上最常用的外科手术。心血管病[j] 2023;15 (2): 189 - 194
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引用次数: 0
Young Female’s Heart was Bitten by Unknown Ghost -Isolated Cardiac Sarcoidosis: A case report 年轻女性心脏被不明鬼咬伤-分离性心脏结节病1例报告
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65634
Heru Al Amin, Rahatul Quadir, Sk Ziarat Islam, Md Shafiqur Rahman Patwary, Mohammad Shafiqullah Akbar, Md Anisul Goni Khan
Sarcoidosis is an inflammatory granulomatous disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is very rare condition which causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity.Cardiovasc j 2023; 15(2): 175-181
结节病是一种病因不明的炎性肉芽肿性疾病,可影响多个不同的器官系统。孤立性心脏结节病是一种非常罕见的疾病,可导致致命性心律失常和心力衰竭。心脏结节病的明确诊断仍然具有挑战性。多模态成像的使用在这种实体的诊断中起着关键作用。心血管病[j] 2023;15 (2): 175 - 181
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引用次数: 0
Association of Serum Vitamin D Level with Angiographic Severity of Coronary Artery Disease in Patients of Acute Myocardial Infarction 急性心肌梗死患者血清维生素D水平与冠状动脉病变血管造影严重程度的关系
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65625
Md. Mostafizur Rahman, A. Chowdhury, M. Uddin, M. Hasan, K. Islam, M. Ullah
Background: Besides conventional risk factors, a novel risk factor hypovitaminosis D may play unique role in the development of coronary artery disease. Evidences suggest that people with low serum vitamin D level  is associated  with risk of acute MI  even after adjusting for the known risk factors. This study was conducted to find out the association between serum vitamin D Level and angiographic severity of coronary artery disease in patients of acute myocardial infarction.Methods: One hundred and four patients of acute myocardial infarction undergoing coronary angiography in DMCH during May 2017 to April 2018 were the study population. The population were divided into 2 groups based on their serum vitamin D level; normal vitamin D   (>30 ng/ml)   and low vitamin D (≤30 ng/ml). Low vitamin D level again divided into 3 groups; insufficient (vitamin D 21 to 30 ng/ml), deficient (Vitamin D 10-20 ng/ml) and severely deficient having vitamin D <10 ng/ml. Coronary angiogram was done during index hospitalization. The severity of the coronary artery disease was assessed by vessel score and Gensini score.After calculation of Gensini score, 36 points was chosen as an appropriate cut-off value and patients were divided into two groups; those with a Gensini score ≤36 points was considered as having absent or mild coronary artery disease and those with a Gensini score >36 points was considered as having moderate to severe coronary artery disease. Association between serum vitamin D Level and angiographic severity of CAD was looked for. Results: Seventy seven (74.0%) of study population had vitamin D level ≤ 30 ng/ml, while 27(26.0%) patients had normal level. There was no significant association between common cardiovascular risk factors with vitamin D level. Double or triple-vessel CAD were more frequent in those with vitamin D levels ≤30 ng/ml as compared to those with normal vitamin D levels (>30 ng/ml) (P<0.05). Majority (48.1%) of patients had double vessel disease (DVD). Among them 4(8%) patients had normal serum vitamin D levels (>30 ng/ml) and 46 (92%) patients had low vitamin D (≤30 ng/ml). Mean Gensini score was found 20.8±5.1 in normal vitamin D (>30 ng/ml) and 48.3±13.3 in low vitamin D (≤30 ng/ml) (p<0.05). Moderate to severe CAD (Gensini score >36) was found in 54.1% of patients with vitamin D insufficiency (21-30 ng/dl) and 83.3% of patients with vitamin D deficiency (10-20 ng/dl) (p<0.05). Moderate negative correlation (r= -0.641; p=0.001) was found between Gensini score and serum vitamin D level of patients with acute myocardial infarction.  Conclusion: Low serum vitamin D level is associated with increasing severity of coronary artery disease, docsumented angiographically among patients of acute myocardial infarction. Low serum vitamin D levels may be an emerging, independent, and potentially modifiable cardiovascular risk factor.Cardiovasc j 2023; 15(2): 124-131
背景:除了传统的危险因素外,维生素D缺乏症可能在冠状动脉疾病的发生发展中起着独特的作用。有证据表明,即使在调整了已知的危险因素后,血清维生素D水平低的人也与急性心肌梗死的风险相关。本研究旨在探讨急性心肌梗死患者血清维生素D水平与冠状动脉病变血管造影严重程度的关系。方法:以2017年5月至2018年4月在DMCH行冠状动脉造影的急性心肌梗死患者104例为研究对象。根据血清维生素D水平将人群分为两组;正常维生素D (bb0 ~ 30ng /ml)和低维生素D(≤30ng /ml)。维生素D水平低的又分为3组;缺乏(维生素D 21至30纳克/毫升),缺乏(维生素D 10至20纳克/毫升)和严重缺乏,维生素D 36分被认为是中度至重度冠状动脉疾病。寻找血清维生素D水平与冠心病血管造影严重程度之间的关系。结果:77例(74.0%)患者维生素D水平≤30 ng/ml, 27例(26.0%)患者维生素D水平正常。常见心血管危险因素与维生素D水平之间没有显著关联。维生素D水平≤30 ng/ml的患者发生双支或三支血管CAD的频率高于维生素D水平正常(bbb30 ng/ml) (P30 ng/ml)的患者,维生素D水平低(≤30 ng/ml)的患者46例(92%)。维生素D正常者(30 ng/ml)平均Gensini评分为20.8±5.1分,维生素D不足者(21-30 ng/dl)平均Gensini评分为48.3±13.3分,维生素D不足者(10-20 ng/dl)平均Gensini评分为83.3%,维生素D不足者(10-20 ng/dl)平均Gensini评分为54.1% (p<0.05)。中度负相关(r= -0.641;急性心肌梗死患者血清维生素D水平与Gensini评分之间存在显著性差异(p=0.001)。结论:血管造影显示急性心肌梗死患者血清维生素D水平低与冠状动脉疾病严重程度增加有关。低血清维生素D水平可能是一个新兴的、独立的、潜在的可改变的心血管危险因素。心血管病[j] 2023;15 (2): 124 - 131
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引用次数: 0
Myxoma in Pediatric Patients: A Single Centre Experience 儿童黏液瘤患者:单一中心经验
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65626
M. Islam, Sakila Israt Jahan, Abu Shadat Mohammad Saem Khan, M. K. Hassan, Khondokar Shamim Shahriar Ziban Rushel
Background: Pediatric cardiac tumor is a very rare entity with an autopsy frequency 0.0017-0.28%. This study aims to analyze the characteristics and outcome of pediatric patients with myxoma.Methods: Nine Patients with myxoma treated between January 2008 & December 2019 were included into this retrospective study. The patients’ age ranged from 4 years to 11 years and weight from 10-20 kg. All patients were diagnosed by transthoracic echocardiography.Results: We did complete resection of tumor in all patients under cardiopulmonary bypass. Mean cardiopulmonary bypass time was 55 minutes & mean cross clamp time was 34 means. Mean ICU stay was 3 days. Six (66.33%) tumors found in left atrium, while 2 (22.11%) found in right atrium and 1(11.06%) in right ventricle. Histopathological report of all 9 tumors revealed myxoma. 1 patient developed left sided hemiparesis and another 1 patient developed wound infection. No mortality or recurrence in follow up period.Conclusion: Myxoma is the commonest primary cardiac tumor. Surgery of cardiac tumor can result in good early and long-term outcome.   Cardiovasc j 2023; 15(2): 132-135
背景:小儿心脏肿瘤是一种非常罕见的肿瘤,其尸检频率为0.0017-0.28%。本研究旨在分析小儿黏液瘤的特点及预后。方法:回顾性研究2008年1月至2019年12月期间治疗的9例黏液瘤患者。患者年龄4 ~ 11岁,体重10 ~ 20kg。所有患者均通过经胸超声心动图诊断。结果:所有患者均行体外循环手术,肿瘤全部切除。平均体外循环时间为55分钟,平均交叉钳夹时间为34分钟。平均ICU住院时间3天。左心房6例(66.33%),右心房2例(22.11%),右心室1例(11.06%)。9例肿瘤病理报告均为黏液瘤。1例出现左侧偏瘫,1例出现伤口感染。随访期间无死亡和复发。结论:黏液瘤是最常见的原发性心脏肿瘤。手术治疗心脏肿瘤可获得良好的早期和长期预后。心血管病[j] 2023;15 (2): 132 - 135
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引用次数: 0
Ruptured sinus of Valsalva aneurysm: A Case Report Valsalva动脉瘤窦破裂1例
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65635
Nighat Islam, S. Srivastava, R. Mehrotra, Arif Mustaqueem, P. Bala
One of the rare cardiac anomaly is Sinus of Valsalva aneurysm (SVA) that can rupture spontaneously into other cardiac chambers or the pericardial space.1 Here, we report a rare case of a right coronary sinus of Valsalva aneurysm with rupture into the Left ventricular outflow tract (LVOT).Cardiovasc j 2023; 15(2): 182-184
其中一种罕见的心脏异常是Valsalva动脉瘤窦(SVA),它可以自发破裂进入其他心腔或心包空间在此,我们报告一例罕见的右冠状动脉窦动脉瘤破裂进入左心室流出道(LVOT)。心血管病[j] 2023;15 (2): 182 - 184
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引用次数: 0
Aetiology and Clinical Profile of Giant Left Atrium – An Observational Study 巨大左心房的病因和临床特征——一项观察性研究
Pub Date : 2023-04-26 DOI: 10.3329/cardio.v15i2.65630
A K M Monwarul Islam, Abdullah AS Majumder, Mohammad Ullah, Md Toufiqur Rahman, Md Khalequzzaman, Md Kabiruzzaman, Sujit Kumar Ghosh, Shovan Rahman, Bijoy Dutta, Shahriar Azad, Tanveer Ahmad, Shahriar Kabir, AbuI Hasan Muhammad Bashar, Mezbah Uddin Ahmed
Background: The predominant cause of giant left atrium (GLA) is rheumatic mitral valvular disease. GLA is commonly defined echocardiographically by measuring the left atrial diameter (LAD). In the context of changing epidemiology of rheumatic heart disease (RHD) globally, and introduction of left atrial volume index (LAVI), the aetiology of GLA and utility of LAVI for defining GLA may be necessary. Methods: The prospective observational study was carried out at a dedicated tertiary care cardiac centre of a developing country to know the aetiology and clinical pattern of GLA over 8 years. GLA was defined echocardiographically as a left atrium (LA) having a diameter ≥80 mm in the left parasternal long-axis view. Follow-up was made over the telephone. Results: Thirty cases of GLA were diagnosed over 8 years from 2013 to 2021. Twenty two were due to rheumatic heart disease (RHD), 7 due to MVP, and 1 due to flail anterior mitral leaflet. Mean LAD was 92.13 ± 16.72 mm, and the mean LAVI was 288.77 ± 134.40 ml/m2. LA thrombus was present in 5 patients, 6 had spontaneous echo contrast (SEC) in LA, 2 had both LA thrombus and SEC. Mean follow-up was 0.99 ± 1.06 years. Out of 15 patients, 5 died, while 10 were alive. Mean survival was 1.8 ± 1.17 years, ranging from less than 1 year to 4 years. Conclusion: RHD continues to be the predominant cause of GLA; however, MVP is also important. The cut-off value of LAVI for defining GLA needs further study. Cardiovasc j 2023; 15(2): 151-158
背景:风湿性二尖瓣疾病是巨大左心房(GLA)的主要病因。GLA通常通过超声心动图测量左房直径(LAD)来定义。在全球风湿性心脏病(RHD)流行病学变化的背景下,以及引入左心房容积指数(LAVI), GLA的病因学和LAVI对GLA定义的应用可能是必要的。方法:前瞻性观察研究在一个发展中国家的专门三级保健心脏中心进行,了解GLA的病因和临床模式超过8年。超声心动图将GLA定义为左胸骨旁长轴位直径≥80 mm的左心房(LA)。后续工作是通过电话进行的。结果:2013 - 2021年8年间确诊GLA 30例。22例为风湿性心脏病(RHD), 7例为MVP, 1例为连枷二尖瓣前叶。平均LAD为92.13±16.72 mm,平均LAVI为288.77±134.40 ml/m2。5例患者出现LA血栓,6例患者出现LA自发性回声造影(SEC), 2例患者同时出现LA血栓和SEC。平均随访时间为0.99±1.06年。15名患者中,5人死亡,10人存活。平均生存期为1.8±1.17年,从不足1年到4年不等。结论:RHD仍然是GLA的主要原因;然而,MVP也很重要。lai的临界值定义GLA还需要进一步研究。心血管病[j] 2023;15 (2): 151 - 158
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Cardiovascular Journal
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