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Articles 31 - 60 of 105
Full-Text Articles in Medicine and Health Sciences
Availability And Affordability Of Medicines And Cardiovascular Outcomes In 21 High-Income, Middle-Income And Low-Income Countries, Clara Kayei Chow, Tu Ngoc Nguyen, Simone Marschner, Rafael Diaz, Omar Rahman, Alvaro Avezum, Scott A. Lear, Koon Teo, Karen E. Yeates, Khawar Kazmi
Availability And Affordability Of Medicines And Cardiovascular Outcomes In 21 High-Income, Middle-Income And Low-Income Countries, Clara Kayei Chow, Tu Ngoc Nguyen, Simone Marschner, Rafael Diaz, Omar Rahman, Alvaro Avezum, Scott A. Lear, Koon Teo, Karen E. Yeates, Khawar Kazmi
Section of Cardiology
Objectives: We aimed to examine the relationship between access to medicine for cardiovascular disease (CVD) and major adverse cardiovascular events (MACEs) among people at high risk of CVD in high-income countries (HICs), upper and lower middle-income countries (UMICs, LMICs) and low-income countries (LICs) participating in the Prospective Urban Rural Epidemiology (PURE) study.
Methods: We defined high CVD risk as the presence of any of the following: hypertension, coronary artery disease, stroke, smoker, diabetes or age >55 years. Availability and affordability of blood pressure lowering drugs, antiplatelets and statins were obtained from pharmacies. Participants were categorised: group 1-all three drug types …
Analysis Of Covid-19 Burden, Epidemiology And Mitigation Strategies In Muslim Majority Countries, Rachel Jardine, James Wright, Zainab Samad, Zulfiqar Ahmed Bhutta
Analysis Of Covid-19 Burden, Epidemiology And Mitigation Strategies In Muslim Majority Countries, Rachel Jardine, James Wright, Zainab Samad, Zulfiqar Ahmed Bhutta
Section of Cardiology
Background: Muslim majority countries have experienced a considerable burden of COVID-19 infection. However, there has been a relative lack of research comparing COVID-19 outbreaks and responses between Muslim-majority countries.
Aims: This study aimed to analyse COVID-19 burden, epidemiology and mitigation strategies in Muslim-majority countries.
Methods: We use a mixed-methods approach to describe the course of the COVID-19 pandemic throughout the Islamic world, highlight the range of non-pharmaceutical interventions used and the speed with which they were implemented, and investigate reasons behind the differing responses between Muslim-majority countries. The number of cases and deaths per million population, and the mean time …
Cardiac Magnetic Resonance Evaluation Of Cardiac Masses In Patients With Suspicion Of Cardiac Masses On Echo Or Computed Tomography, Fateh Ali Tipoo Sultan, Syed Waqar Ahmed
Cardiac Magnetic Resonance Evaluation Of Cardiac Masses In Patients With Suspicion Of Cardiac Masses On Echo Or Computed Tomography, Fateh Ali Tipoo Sultan, Syed Waqar Ahmed
Section of Cardiology
Objectives: In recent years, cardiac magnetic resonance (CMR) imaging has emerged as an important tool in the identification and characterization of cardiac masses. No imaging data on cardiac masses are available from Pakistan. We aimed to review the clinical presentation, CMR findings, and outcome of patients referred for CMR due to suspicion of cardiac masses on echocardiogram or computed tomography (CT).
Material and methods: We reviewed all the patients referred for CMR at Aga Khan University Hospital, Karachi, from January 2011 to March 2020, with the suspicion of cardiac mass on echocardiogram and/or CT. Only those with the confirmed diagnosis …
Secondary Prevention Of Cardiovascular Diseases In India: Findings From Registries And Large Cohorts, Hasan Rehman, Ankur Kalra, Ajar Kochar, Angad S. Uberoi, Deepak L. Bhatt, Zainab Samad, Salim S. Virani
Secondary Prevention Of Cardiovascular Diseases In India: Findings From Registries And Large Cohorts, Hasan Rehman, Ankur Kalra, Ajar Kochar, Angad S. Uberoi, Deepak L. Bhatt, Zainab Samad, Salim S. Virani
Section of Cardiology
Several registries and quality improvement initiatives have focused on assessing and improving secondary prevention of CVD in India. While the Treatment and Outcomes of Acute Coronary Syndromes in India (CREATE), Indian Heart Rhythm Society-Atrial Fibrillation (IHRS-AF), and Trivandrum Heart Failure (THF) registries are limited to collecting data, the Tamil Nadu-ST-Segment Elevation Myocardial Infarction (TN-STEMI) program was aimed at examining and improving access to revascularization after an ST-elevation myocardial infarction (STEMI). The Acute Coronary Syndromes: Quality Improvement in Kerala (ACS-QUIK) study recruited hospitals from the Kerala ACS registry to assess a quality improvement kit for patients with ACS while the Practice …
Pericardiocentesis Indications And Complications: A Retrospective Observational Study In A Tertiary Care Hospital In Karachi, Pakistan, Abdul Baqi, Intisar Ahmed
Pericardiocentesis Indications And Complications: A Retrospective Observational Study In A Tertiary Care Hospital In Karachi, Pakistan, Abdul Baqi, Intisar Ahmed
Section of Cardiology
Introduction: Pericardiocentesis is crucial for the diagnosis and management of diseases responsible for significant pericardial effusions. Pericardiocentesis was performed the first time by Riolanus for cardiac tamponade. He described the process of trephination of the sternum to remove the abnormally accumulated fluid from the pericardial space. However, with the advancement of expertise in echocardiography assisted procedures, echocardiography-guided diagnostic and therapeutic pericardiocentesis is now considered standard clinical practice in the treatment of pericardial effusions.
Objectives: We aim to study different causes of pericardial effusion and indications of pericardiocentesis as well as complications associated with it in our population.
Methods: This is …
Evaluation Of Aspirin And Statin Therapy Use And Adherence In Patients With Premature Atherosclerotic Cardiovascular Disease, Dhruv Mahtta, David J. Ramsey, Mahmoud Al Rifai, Khurram Nasir, Zainab Samad, David Aguilar, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani
Evaluation Of Aspirin And Statin Therapy Use And Adherence In Patients With Premature Atherosclerotic Cardiovascular Disease, Dhruv Mahtta, David J. Ramsey, Mahmoud Al Rifai, Khurram Nasir, Zainab Samad, David Aguilar, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani
Section of Cardiology
Importance: Studies on the use of and adherence to secondary prevention therapies in patients with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD) are lacking.
Objective: To evaluate and compare aspirin use, any statin use, high-intensity statin use, and statin adherence among patients with premature or extremely premature ASCVD compared with patients with nonpremature ASCVD.
Design, setting, and participants: This multicenter cross-sectional study used the clinical and administrative data sets of the US Department of Veterans Affairs (VA) to identify adult patients with at least 1 primary care visit in the VA health care system between October 1, 2014, and …
Clinical Presentation, Cardiac Magnetic Resonance Findings, And Prognosis Of Patients With Arrhythmogenic Right Ventricular Cardiomyopathy - An Experience From Pakistan, Intisar Ahmed, Fateh Ali Tipoo Sultan
Clinical Presentation, Cardiac Magnetic Resonance Findings, And Prognosis Of Patients With Arrhythmogenic Right Ventricular Cardiomyopathy - An Experience From Pakistan, Intisar Ahmed, Fateh Ali Tipoo Sultan
Section of Cardiology
Objectives: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart-muscle disease, characterized by fibro-fatty replacement and ventricular arrhythmias, that primarily affects the right ventricle (RV). We aimed to look at the clinical presentation, cardiac magnetic resonance (CMR) imaging findings and prognosis of patients with ARVC in Pakistan.
Material and methods: It is a retrospective observational study, 17 consecutive patients with CMR and other findings consistent with ARVC, were enrolled from 2010 to 2019 at a single center.
Results: Out of 17 patients, 12 (70.6%) were male with a mean age of 33.5 ± 17.5 years. Family history of sudden cardiac …
The Frequency Of Left Atrial Thrombus On Transthoracic Echocardiogram In Patients With Mitral Stenosis, Khalil Ahmed, Aziz Rehman Memon, Hussain Liaquat Sr, Mustajab Mujtaba, Chander Parkash, Fateh Ali Tipoo Sultan, Musa Karim
The Frequency Of Left Atrial Thrombus On Transthoracic Echocardiogram In Patients With Mitral Stenosis, Khalil Ahmed, Aziz Rehman Memon, Hussain Liaquat Sr, Mustajab Mujtaba, Chander Parkash, Fateh Ali Tipoo Sultan, Musa Karim
Section of Cardiology
Background: Patients with mitral stenosis (MS) are more prone to develop left atrial (LA) thrombus. This cross-sectional study was conducted to determine the frequency of LA thrombus on transthoracic echocardiography (TTE) in patients with MS.
Methods: In this study, we included patients diagnosed with MS undergoing TTE at the echocardiography department of the National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan. The severity of MS was classified based on the mitral valve area (MVA) as follows: very severe: MVA of ≤1.0 cm2; severe: MVA of ≤1.5 cm2; and mild to moderate: MVA of >1.5 cm2 …
Changes In Ventricular Depolarisation Vectors During Exercise Caused By Regional Myocardial Ischaemia, Cameruddin Vellani, Satwat Hashmi, Sadia Mahmud, Mohammad Yusuf, Safia Awan, Khawar Kazmi
Changes In Ventricular Depolarisation Vectors During Exercise Caused By Regional Myocardial Ischaemia, Cameruddin Vellani, Satwat Hashmi, Sadia Mahmud, Mohammad Yusuf, Safia Awan, Khawar Kazmi
Section of Cardiology
Research at the Aga Khan University for several years has been directed to find a reliable, low-cost, portable, non-invasive method for identification of coronary artery disease, its location and extent. A new method has been devised to measure the magnitude and direction of cardiac electrical vectors in three perpendicular planes during physical exercise to identify reduction in myocardial excitability as the electrophysiological marker of hypoxia. This report shows that changes in electrical forces due to exercise-induced regional hypoxia serve as indicators of reversible myocardial ischaemia. Changes in the magnitude and direction of vectors at stages of the Bruce protocol were …
It’S Not Always Occam's Razor – The Case Of A Young Man With Subaortic Membrane With Superimposed Pulmonary Thromboembolism And Left Main Coronary Artery Disease, Hunaina Shahab, Abdul Baqi, Yusra Askari, Qurrat Ul Ain Aqeel, Kumail Khandwala
It’S Not Always Occam's Razor – The Case Of A Young Man With Subaortic Membrane With Superimposed Pulmonary Thromboembolism And Left Main Coronary Artery Disease, Hunaina Shahab, Abdul Baqi, Yusra Askari, Qurrat Ul Ain Aqeel, Kumail Khandwala
Section of Cardiology
Subaortic membrane (SAM) is a discrete fibromuscular structure which causes left ventricular outflow tract obstruction and leads to the symptomatology of valvular aortic stenosis. It is known to be associated with other congenital cardiac defects in around 30% of cases. However, it has not been associated with chronic pulmonary thromboembolism in the past. We present a case of a middle-aged Pakistani man who presented with dyspnea and hemoptysis. He was found to have a SAM and severe pulmonary hypertension on transthoracic echocardiogram. A coronary angiogram revealed non-obstructive left main coronary artery disease. A computed tomography (CT) scan chest was done …
Advances In Structural Heart Disease: Mitraclip For Secondary Mitral Regurgitation - A Potential Game Changer, Shahrukh Hashmani, Amammarah Yasmeen, Shayana Rukhsar Hashman
Advances In Structural Heart Disease: Mitraclip For Secondary Mitral Regurgitation - A Potential Game Changer, Shahrukh Hashmani, Amammarah Yasmeen, Shayana Rukhsar Hashman
Section of Cardiology
No abstract provided.
Severity Of Chest Pain Among Acute Myocardial Infarction Patients With Diagonal Branch Vessel Disease: A Pilot Study, Nasir Rahman, Azmina Artani, Farhala Mari Baloch, Bilal Hussain
Severity Of Chest Pain Among Acute Myocardial Infarction Patients With Diagonal Branch Vessel Disease: A Pilot Study, Nasir Rahman, Azmina Artani, Farhala Mari Baloch, Bilal Hussain
Section of Cardiology
Introduction: Acute myocardial infarction (AMI) patients present with variable clinical manifestations such as shortness of breath, nausea, etc. among which chest pain is the most common. Previous studies have reported that the clinical presentation of AMI patients with branch vessel disease is indistinguishable from epicardial coronary vessel disease. However, our experience suggests patients with branch vessel disease experience severe chest pain, especially those with a diagonal branch. Therefore, we aim to study the association of chest pain severity with isolated diagonal branch vessel disease as a culprit vessel in AMI patients.
Methods: It is a retrospective case-control design, where 10 …
Outcomes Of Left Main Percutaneous Coronary Intervention, Nasir Rahman, Bilal Hussain, Azmina Artani
Outcomes Of Left Main Percutaneous Coronary Intervention, Nasir Rahman, Bilal Hussain, Azmina Artani
Section of Cardiology
Objective: To study the outcomes of left main percutaneous coronary artery (LMCA) revascularisation.
Study Design: A descriptive study.
Place and Duration of Study: The Aga Khan University Hospital (AKUH), Karachi, from February till July 2016.
Methodology: The study included all adult patients aged 18 years or more, who underwent percutaneous LMCA revascularisation at study centre from April 2006 till April 2015. In-hospital outcomes were ascertained of patients via charts along with telephonic follow-up for outcome ascertainment at 1-year and 5-year. Results were expressed in terms of means and standard deviation for quantitative variables and percentages for qualitative variables.
Results: Of …
Hyperdominant Left Anterior Descending Artery Presenting As Anterior Wall St Segment Elevation Myocardial Infarction: A Rare Coronary Anomaly, Shahrukh Hashmani Dr., Abid Laghari
Hyperdominant Left Anterior Descending Artery Presenting As Anterior Wall St Segment Elevation Myocardial Infarction: A Rare Coronary Anomaly, Shahrukh Hashmani Dr., Abid Laghari
Section of Cardiology
We report on a 75 year-old man who presented with severe chest pain for four hours. Physical examination was unremarkable and he was haemodynamically stable. ECG done in the ED showed ST segment elevations along with Q waves in the anterior and inferior leads with T wave inversions. He was rushed to the catheterization lab where the left anterior descending (LAD) artery was 99%occluded in the proximal segment while distal left circumflex showed 50-60% lesion. He underwent primary percutaneous coronary intervention to LAD with drug eluting stent and made an uneventful recovery. The LADwas found to be wrapping around the …
Defining The Hemodynamic Response Of Hypertensive And Normotensive Subjects Through Serial Timed Blood Pressure Readings In The Clinic, Hunaina Shahab, Hamza Sohail Khan, Aysha Almas, Sohail Abrar Khan, Azmina Artani, Aamir Hameed
Defining The Hemodynamic Response Of Hypertensive And Normotensive Subjects Through Serial Timed Blood Pressure Readings In The Clinic, Hunaina Shahab, Hamza Sohail Khan, Aysha Almas, Sohail Abrar Khan, Azmina Artani, Aamir Hameed
Section of Cardiology
Background: Every third patient in the clinic is misdiagnosed due to white-coat phenomenon, necessitating needless and costly treatment. We aimed to study the hemodynamic response of the physician's visit on hypertensive and normotensive patients by investigating the trend of blood pressure (BP) before, during and 15 min after the physician-patient encounter.
Methods: A descriptive, cross-sectional study was conducted over a period of 8 months in the cardiology clinics at the Aga Khan University Hospital, Karachi. Both hypertensive and normotensive patients, aged ≥18 years, were recruited. Pregnant females or those with a history of volume loss were excluded. BP readings were …
Role Of Surgery In Spinal Metastases, Altaf Ali Laghari, Humza Faisal Siddiqui, Muhammad Shahzad Shamim
Role Of Surgery In Spinal Metastases, Altaf Ali Laghari, Humza Faisal Siddiqui, Muhammad Shahzad Shamim
Section of Cardiology
Spinal metastases constitute two-third of all cases of bone metastases. Surgical intervention in these tumours has been recommended in highly selective cases, for confirming diagnosis, stabilizing the spine, and decompressing nerves or spinal cord for alleviation of pain and preservation of function.In this article,the authors have reviewed available evidence on role of surgery in spinal metastases and have presented results of selected papers on this vast topic.
May Measurement Month 2017: An Analysis Of The Blood Pressure Screening Campaign Results In Pakistan-South Asia, Mohammad Ishaq, Feroz Memon, Thomas Beaney, Xin Xia, Elsa Kobeissi, Neil R. Poulter
May Measurement Month 2017: An Analysis Of The Blood Pressure Screening Campaign Results In Pakistan-South Asia, Mohammad Ishaq, Feroz Memon, Thomas Beaney, Xin Xia, Elsa Kobeissi, Neil R. Poulter
Section of Cardiology
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. Hypertension is a global health concern for developing countries. In Pakistan, apart from few population-based studies which evaluated the prevalence of hypertension, there is no current nationally representative study (the latest nationwide survey was conducted more than two decades ago). Pakistan Hypertension League, in accordance with the International Society of Hypertension directive under the …
Characteristics Of Traumatic Out-Of-Hospital Cardiac Arrest Patients Presenting To Major Centers In Karachi, Pakistan-A Longitudinal Cohort Study, Minaz Mawani, Muhammad Masood Kadir, Iqbal Azam Syed, Junaid Abdul Razzak
Characteristics Of Traumatic Out-Of-Hospital Cardiac Arrest Patients Presenting To Major Centers In Karachi, Pakistan-A Longitudinal Cohort Study, Minaz Mawani, Muhammad Masood Kadir, Iqbal Azam Syed, Junaid Abdul Razzak
Section of Cardiology
Background: Trauma is the leading cause of death for adults under 44 years of age. Survival after traumatic out-of-hospital cardiac arrest (OHCA) has been reported to be poor, and its epidemiology is not well defined. A few studies have reported better survival in response to pre-hospital life-saving interventions. Currently, no published data on traumatic cardiac arrests in the field exist from low- and lower middle-income countries. We aimed to explore the epidemiology and outcomes of traumatic OHCA patients from Karachi, Pakistan. We conducted a longitudinal cohort study at emergency departments (ED) of five major public and private hospitals of the …
Outcome Of Radioactive Iodine Therapy In Toxic Nodular Goiter In Pakistan, Tauseef Ahmad, Adeel Khoja, Naveed Rashid, Muhammad Areeb Ashfaq
Outcome Of Radioactive Iodine Therapy In Toxic Nodular Goiter In Pakistan, Tauseef Ahmad, Adeel Khoja, Naveed Rashid, Muhammad Areeb Ashfaq
Section of Cardiology
Objective: To determine the outcome of patients receiving radioactive iodine therapy for toxic nodular goiter coming to Aga Khan University Hospital Karachi.
Methods: A total of 89 patients who visited the outpatient department of Aga Khan University Hospital from January 2010 to August 2017 were recruited for the study. Toxic nodular goiter was diagnosed on the basis of having hot nodule on thyroid scan with low TSH and high FT4/T4. Other demographic and laboratory data were also recorded.
Results: Eighty nine patients with toxic nodular goiter received a dose range from 10 to 30mCi RAI. Six months after RAI, 36.2% …
A Curious Case Of Intermittent Left Bundle Branch Block Associated With Cough, Hunaina Shahab, Osman Faheem, Kumail Khandwala, Aamir Hameed
A Curious Case Of Intermittent Left Bundle Branch Block Associated With Cough, Hunaina Shahab, Osman Faheem, Kumail Khandwala, Aamir Hameed
Section of Cardiology
A handful of cases of voluntary control of left bundle branch block (LBBB) have been described in the literature. We report the case of a middle-aged man who was found to have LBBB on baseline electrocardiogram (ECG) which disappeared on coughing and then reappeared with the same maneuver. Subsequent myocardial perfusion scan showed reduced count in the anteroseptal region likely attributed to LBBB. It is possible that the intermittent conduction changes may be due to the alteration in the vagal tone associated with cough as reflected in the change in the PR interval on the ECG.
Sleep Fainting: A Neurocardiogenic Entity, Hunaina Shahab, Ambreen A. Sonawalla, Maryam Khan, Aman Qureshi
Sleep Fainting: A Neurocardiogenic Entity, Hunaina Shahab, Ambreen A. Sonawalla, Maryam Khan, Aman Qureshi
Section of Cardiology
Fainting is a common clinical presentation, with vagally mediated (neurocardiogenic) causes being the most common for syncope presentation to the emergency room, and for hospital admissions. Classic teaching is that upright posture is a prerequisite for vagally mediated syncope (VMS) and that syncope in the supine position has more sinister causes. We present five patients, three males and two females, with a mean age of 44.4 (range 29-67) years, who presented with VMS in the supine position (sleep fainting). Four patients also had a history of classic upright syncope. Based on their clinical features and thorough investigations, we excluded other …
Large Intra-Cardiac Fibroma Identified On Cardiac Mri - A Case Report And Review Of Literature, Khwaja Yousuf Hasan, Fateh Ali Tipoo Sultan
Large Intra-Cardiac Fibroma Identified On Cardiac Mri - A Case Report And Review Of Literature, Khwaja Yousuf Hasan, Fateh Ali Tipoo Sultan
Section of Cardiology
Primary cardiac tumours are rare. Cardiac fibroma is a benign tumour of the heart. It is fairly common among children and adolescents and is rarely encountered in adults. We present the case of a thirty-eight year old lady who presented with shortness of breath and was found to have a very large intra-cardiac mass that had cardiac magnetic resonance (CMR) features consistent with cardiac fibroma. The patient was referred for tumour resection, however could not survive the surgery.
The Post Clinic Ambulatory Blood Pressure (Pc-Abp) Study Correlates Post Clinic Blood Pressure (Pcbp) With The Gold Standard Ambulatory Blood Pressure, Hunaina Shahab, Hamza Sohail Khan, Aysha Almas, Mayera Tufail, K. Kazmi, Aamir Hameed
The Post Clinic Ambulatory Blood Pressure (Pc-Abp) Study Correlates Post Clinic Blood Pressure (Pcbp) With The Gold Standard Ambulatory Blood Pressure, Hunaina Shahab, Hamza Sohail Khan, Aysha Almas, Mayera Tufail, K. Kazmi, Aamir Hameed
Section of Cardiology
Objectives: Our previous study showed that post-clinic blood pressure (BP) taken 15 min after a physician-patient encounter was the lowest reading in a routine clinic. We aimed to validate this reading with 24 h Ambulatory Blood Pressure Monitoring (ABPM) readings. A cross-sectional study was conducted in the cardiology clinics at the Aga Khan University, Pakistan. Hypertensive patients aged ≥ 18 years, or those referred for the diagnosis of hypertension were included.
Results: Of 150 participants, 49% were males. 76% of all participants were hypertensive. Pre-clinic BP reading was measured by a nurse, in-clinic by a physician and 15 min post-clinic …
One Pulmonary Lesion, 2 Synchronous Malignancies, Masooma Aqeel, Nevin Uysal Biggs, Timothy S. Fenske, Nagarjun Rao
One Pulmonary Lesion, 2 Synchronous Malignancies, Masooma Aqeel, Nevin Uysal Biggs, Timothy S. Fenske, Nagarjun Rao
Section of Cardiology
Introduction. Mantle cell lymphoma (MCL) comprises approximately 3% to 10% of all non-Hodgkin lymphomas. Although there is an increased risk for secondary malignancies after treatment among non-Hodgkin lymphomas survivors, a synchronous diagnosis of primary lung cancer arising in conjunction with lymphoma at the same site has rarely been reported. We report an unusual case of primary lung adenocarcinoma with coexistent MCL within the same lung lesion. Case Presentation. A 55-year-old female with newly diagnosed stage IV-B MCL was referred for workup of a right upper lobe cavitary lesion detected during lymphoma staging. A whole-body positron-emission tomography-computed tomography scan …
Percutaneous Non-Stenting Approach For Distal Simultaneous Multivessel Acute Coronary Occlusions, Nasir Rahman, Bilal Hussain
Percutaneous Non-Stenting Approach For Distal Simultaneous Multivessel Acute Coronary Occlusions, Nasir Rahman, Bilal Hussain
Section of Cardiology
The occurrence of distal coronary lesions causing simultaneous occlusion of two coronary arteries in the setting of ST elevation myocardial infarction is a rare occurrence. This can occur due to simultaneous plaque rupture at more than one site or embolisation in coronary arteries. We describe a case of a middle-aged man who presented with acute inferoposterior lateral wall ST elevation myocardial infarction with simultaneous occlusion of distal left anterior descending artery and distal left circumflex artery on angiogram. The patient was treated with intracoronary streptokinase, followed by glycoprotein (GP) IIb/IIIa inhibitor and Factor X inhibitor (Rivaroxaban) with full resolution of …
Cardiac Magnetic Resonance Imaging In A Young Patient With Left Ventricular Spongiform Cardiomyopathy: A Case Report And Review Of Literature, Bilal Hussain, Fateh Ali Tipoo Sultan
Cardiac Magnetic Resonance Imaging In A Young Patient With Left Ventricular Spongiform Cardiomyopathy: A Case Report And Review Of Literature, Bilal Hussain, Fateh Ali Tipoo Sultan
Section of Cardiology
Left ventricular spongiform or non compaction cardiomyopathy is one of the rarer forms of cardiomyopathy with a reported prevalence of 0.014-0.05% in adults. It is characterized by severe left ventricular systolic dysfunction occurring secondary to the failure of the myocardium to fuse resulting in non-compacted myocardium with a trabeculated appearance of the myocardium. Initially described on the basis of 2-D echocardiography, the identification of left ventricular non compaction has now improved with the introduction of sophisticated imaging modalities such as cardiac magnetic resonance imaging that allows better visualization of the non-compacted myocardium assisting in accurate diagnosis. We report a case …
Treatment Of A Rare Vascular Complication Of Coronary Stenting In An Octagenarian, Hunaina Shahab, Bilal Hussain, Nasir Rahman, Fateh Ali Tipoo Sultan
Treatment Of A Rare Vascular Complication Of Coronary Stenting In An Octagenarian, Hunaina Shahab, Bilal Hussain, Nasir Rahman, Fateh Ali Tipoo Sultan
Section of Cardiology
The ability of drug-eluting stent (DES) to inhibit intimal proliferation has resulted in a massive increase in their usage over the years. However, it is known that the application of DES can alter the normal cascade of vascular healing, resulting in delayed endothelialisation with risk of vascular complications. Coronary artery aneurysms (CAN) are defined as more than 50% dilatation of the coronary artery compared to the reference vessel diameter with the reported incidence after percutaneous intervention (PCI) being only around 0.35 to 6.0%. Previously, CAN had been reported with the use of bare metal stent secondary to stretch, stent fracture …
Myocarditis Mimicking Acute Coronary Syndrome - The Role Of Cardiac Magnetic Resonance Imaging In The Diagnosis, Fateh Ali Tipoo Sultan, Ghurfan Adnan
Myocarditis Mimicking Acute Coronary Syndrome - The Role Of Cardiac Magnetic Resonance Imaging In The Diagnosis, Fateh Ali Tipoo Sultan, Ghurfan Adnan
Section of Cardiology
Myocarditis is an inflammatory disease of myocardium with a wide range of clinical presentations. Myocarditis may mimic acute coronary syndrome (ACS) and adequate differential diagnosis is not possible by conventional tests. Cardiac magnetic resonance (CMR) has emerged as a leading imaging modality in the diagnosis of myocarditis in such patients. Here, we report three cases of myocarditis mimicking ACS with normal coronary arteries. CMR was used for confirming the diagnosis of myocarditis in all three patients presented here.
Management Of Undernutrition And Failure To Thrive In Children With Congenital Heart Disease In Low- And Middle-Income Countries, Andrew C. Argent, Rakhi Balachandran, Balu Vaidyanathan, Amina Khan, R. Krishna Kumar
Management Of Undernutrition And Failure To Thrive In Children With Congenital Heart Disease In Low- And Middle-Income Countries, Andrew C. Argent, Rakhi Balachandran, Balu Vaidyanathan, Amina Khan, R. Krishna Kumar
Section of Cardiology
Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low- and middle-income countries. Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible. Close attention should be paid …
Caught In The Act - Migration Of A Large Right Atrial Thrombus To Pulmonary Artery During Transthoracic Echocardiography - A Case Report, Bilal Hussain, Fateh Ali Tipoo Sultan, Talha Shahzad, Sumaira Punjani
Caught In The Act - Migration Of A Large Right Atrial Thrombus To Pulmonary Artery During Transthoracic Echocardiography - A Case Report, Bilal Hussain, Fateh Ali Tipoo Sultan, Talha Shahzad, Sumaira Punjani
Section of Cardiology
In cases of pulmonary embolism, the visualization of a free-floating right heart thrombus on conventional transthoracic echocardiography is extremely rare. Even rarer is an echocardiographic recording of migration of a free-floating clot from the right heart into the pulmonary vasculature leading to pulmonary embolism. We present a unique case of an elderly man who presented with dyspnoea, in whom a routine 2-D bed side transthoracic echo recorded the live transit of a free floating thrombus from the right heart into the pulmonary artery resulting in pulmonary embolism. The patient remained haemodynamically stable and was managed with anticoagulation. Our case objectively …