Cardiology Commons^™

Consensus Of The National Heart Center In Collaboration With The Saudi Arabian Cardiac Interventional Society On The Clinical Use Of Intracoronary Imaging, Mirvat Alasnag, Mognee Alameer, Ahmed Alshehri, Hind Alosaimi, Faisal Alqoofi, Hussain Alzayer, Wail Alkashkari, Adel Tash, Waqar H Ahmed

Journal of the Saudi Heart Association

Objectives: Studies show that intracoronary imaging (ICI)-guided PCI is associated with a significantly lower risk of stroke, Q-wave myocardial infarction, and death compared to angiography-guided PCI in the management of acute coronary syndromes, complex coronary lesions and left-main interventions. Despite these well-established clinical benefits, the utilization of ICI-guided PCI in Saudi Arabia remains suboptimal.

Methods: The National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) gathered national experts to develop a consensus document on how to integrate ICI-guided PCI in routine clinical practice in Saudi Arabia. The consensus was based on the nominal group technique, whereby a …

Intraoperative Remifentanil Use Reduces Atrial Fibrillation After Coronary Artery Bypass Surgery, Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa

Journal of the Saudi Heart Association

Objectives:

Atrial fibrillation after coronary artery bypass grafting is a relatively well known complication that has been observed for a long time. Though the management and drugs in the perioperative period have changed, their impact on the generation of postoperative atrial fibrillation remains unclear. Therefore, we investigated various perioperative management methods and the occurrence of postoperative atrial fibrillation.

Methods

The patients underwent off-pump coronary artery bypass grafting between January 2010 and October 2019. The study was a retrospective observational study, and we investigated the incidence of atrial fibrillation during all 5 postoperative days. Patient factors included age, sex, height, …

“Two Is Company, Three Is A Crowd” – A Case Presentation Of Cardiac Amyloidosis, Hypertrophic Cardiomyopathy Plus Coronary Heart Disease, ​Carolina Miguel Gonçalves, Mariana Carvalho, Celia Domingues, Fatima Saraiva, ​​Joao ​ ​​Morais​

Journal of the Saudi Heart Association

A 76-year-old man was referred to our appointment with complaints of exertional dyspnea. He had a medical history consisting of chronic coronary syndrome, hypertrophic cardiomyopathy, and an implantable cardioverter-defibrillator for primary prevention. A transthoracic echocardiogram revealed features suspicious for cardiac amyloidosis. Haematologic and genetic tests were negative, and scintigraphy was positive, confirming wild-type transthyretin amyloidosis, not eligible for tafamidis. Several months later with optimized medical therapy, he had two worsening heart failure events.

This clinical case highlights the importance of differential diagnosis. Our patient had both hypertrophic cardiomyopathy and transthyretin amyloidosis, a rare association that constitutes a diagnostic and treatment …

Saudi Heart Association / National Heart Center / Saudi Arabian Cardiac Interventional Society / Saudi Society For Cardiac Surgeons / Saudi Cardiac Imaging Group 2023 Tavi Guidelines, Turki Albacker, Adel Tash, Hussein Alamri, Mirvat Alasnag, Wail Alkashkari, Fawaz Almutairi, Faisal Alqoofi, Ahmed Alsaileek, Uthman Aluthman, Ghormallah Alzahrani, Mohammed Balghith, Fahd Makhdom

Journal of the Saudi Heart Association

Saudi Arabia has seen a significant improvement in its healthcare system over the past four decades resulting in an increase in life-expectancy. Transcatheter aortic valve implantation (TAVI) has spread widely in Saudi Arabia and has become a routine procedure in many centers. The expanding clinical indications and the availability of the technology have made it possible for many large and intermediate centers all over the country to commence their own TAVI programs. So, the aim of this document is to standardize TAVI practices in different Saudi Arabian centers through reasonable guidelines based on the evaluation and summarization of the best …

Spontaneous Interatrial Hematoma: Still An Unresolved Critical Conundrum, Fayaz Mohammed Khazi, Imthiaz Manoly, Nayyer R Siddiqi, Tarek Abdel Aziz, Obaid Aljassim

Journal of the Saudi Heart Association

Spontaneous interatrial hematoma is a rare clinical entity leading to the obliteration of the left atrial cavity and causing haemodynamic compromise, necessitating immediate surgical intervention. Herein, we report a patient with acute chest pain with normal coronaries and echocardiographic evidence of left atrial mass. The investigations revealed the mass to be a thrombus rather than tumour. The patient underwent surgery to remove a large thrombus completely enclosed within the interatrial septum. The septum was then repaired using a pericardial patch. No apparent etiological factor was found. Spontaneous atrial wall dissection should be considered in the differential diagnosis of acute chest …

Consensus Of National Heart Center And The Saudi Arabian Cardiac Interventional Society On The Current Landscape Of The Management Of Intracoronary Calcification In Saudi Arabia, Khaled Al-Shaibi, Mirvat Alasnag, Owayed Alshemmari, Ayman Alsaleh, Wail Alkashkari, Fawaz Almutairi, Nouf Alanazi, Mognee Alameer, Adel Tash

Journal of the Saudi Heart Association

Objectives

We aimed to develop a streamlined algorithm for the management of intracoronary calcification that includes guidance on intracoronary imaging and the appropriate selection of atherectomy devices.

Methods

National experts representing both the National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) met to develop a consensus document on the assessment and management of intracoronary calcification in Saudi Arabia. The nominal group technique was utilized; a number of statements on the assessment and management of coronary artery calcification were developed based on a systematic review of the literature. Th authors discussed the developed statements until a consensus …

Cardioprotective Efficacy Of Sevoflurane In Patients With Rheumatic Heart Disease Undergoing Heart Valve Surgery Under Cardiopulmonary Bypass, Vu Thanh Lam, Nguyen Quoc Kinh, Nguyen Minh Ly

Journal of the Saudi Heart Association

Objectives

In this study, we investigated whether cardioprotective properties of sevoflurane were expressed in patients with rheumatic heart disease undergoing heart valve surgery under cardiopulmonary bypass (CPB).

Methods

Fifty patients with rheumatic heart disease undergoing heart valve surgery under CPB were randomly assigned to receive total anesthesia with sevoflurane or propofol during surgery. Except for this, anesthetic and surgical management was the same in all patients. The primary outcomes were postoperative high-sensitive cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) release. The secondary outcomes were hemodynamic events and short-term clinical outcomes (within 30 days after surgery).

Results

The plasma …

To Evaluate Efficiency Of Various Coronary Artery Disease Risk Scores With Traditional Risk Factors In Patients Undergoing Coronary Angiography, Sharma Kamal, Panwar Jasraj, Patel Krutika, Parmar Devratsinh, Kalyani Maulik, Dhorajiya Dixit

Journal of the Saudi Heart Association

Objective:

To analyze and compare various cardiovascular disease risk scores in Western Indian patients undergoing Coronary angiogram (CAG).

Methods:

In this prospective cross-sectional study,1213 patients who underwent conventional coronary angiography; clinical risk profile and biochemical investigations were evaluated prior to undergoing CAG. Apart from the demographic information, 10-year absolute risk of having a major cardiovascular event (cardiovascular death, myocardial infarction or stroke) was calculated for each patient using various available Traditional Risk Scores (TRS). The population was divided in low, intermediate and high-risk categories for each of these scores.

Results:

Traditional cardiovascular risk factors like hypertension (41.8%) and diabetes mellitus-II …

Ultrasound-Guided Vs. Standard Coronary Access In Coronary Angiography: A Systematic Review And Meta-Analysis, Ibrahim Omer, Mohammed Bukhari, Mohammad Alsharif, Abdulrahman Alsamadani, Dinah Alahmadi, Ali Saleh Alsudais, Abdullah Abdulkareem, Hashem Alhashmi Alamir

Journal of the Saudi Heart Association

Objectives: Coronary angiography is a procedure performed during cardiac catheterization to define the coronary anatomy and determine the extent of coronary artery disease (CAD). The use of a cheap, relatively available tool like an ultrasound machine to assist in vascular access might reduce the risks associated with blind access. This study aimed to explore the efficacy and associated complications of ultrasound-guided coronary artery catheterization. Methods: This systematic review of randomized controlled trials (RCTs) was conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA) and was registered in PROSPERO (CRD42022365518). A systematic search was performed for all …

Reply To Author, Mohammed Abdullah ​ Alosaimi

Journal of the Saudi Heart Association

No abstract provided.

Concerns Regarding Sampling Methodology In "Acceptance, Awareness, Attitude, And Practices Toward Heart Transplantation: A Saudi Based Survey", Fatemeh Omidi

Journal of the Saudi Heart Association

No abstract provided.

Epicardial Pacemaker Causing Cardiac Strangulation, ​​Ian Scott ​ Kendall​, ​​Rihab ​ ​​Agouba​, Andrew Sands, ​​Frank ​ ​​Casey ​, Lars ​ Nolke ​

Journal of the Saudi Heart Association

Cardiac strangulation is a rare but potentially lethal complication of epicardial pacemaker insertion. We present the case of a 9-year-old girl who was identified as having cardiac strangulation on routine follow-up for an epicardial pacemaker inserted on day 1 of life for congenital complete heart block (CCHB). The clinical presentations and risk factors for pacemaker strangulation is then discussed

Exploring The Functionality Of Technology-Driven Cpr Training Methodologies Among Healthcare Practitioners: A Randomized Control Pilot Study, Nazrin Ahmad, Mazlinda Musa, Fairrul Kadir, Syed Sharizman, Aizuddin Hidrus, Hamidah Hassan, Rohani Mamat, Baidi Baddiri

Journal of the Saudi Heart Association

Introduction: Cardiopulmonary resuscitation training in Malaysia has evolved from traditional to modern approaches, embracing technology for better outcomes. Smartphone-based training apps offer interactive learning with simulations and real-time feedback, improving cardiopulmonary resuscitation skills anytime, anywhere. This study evaluates the effectiveness of the smart-cardiopulmonary resuscitation application for healthcare practitioners. Methods: This randomized controlled pilot study was conducted with 30 healthcare practitioners at the University of Malaysia Sabah. Participants underwent a Cardiopulmonary Resuscitation Practical formal educational training program, and data were collected using a Basic Life Support questionnaire and skills assessment checklist sourced from the American Heart Association (2020). Data analysis was …

Stepping Into The Light: Defining Culprit Lesion In Non-St Elevation Myocardial Infarction, Aditya Doni Pradana M.D., M.Sc, Arditya Damarkusuma M.D., M.Med (Clin Epi), Fiha, Hariadi Hariawan M.D., Fiha, Finasim, Dr., Fica, Fascc, Fapsic, Fscai

Journal of the Saudi Heart Association

Identifying the infarct-related artery (IRA) in a non-ST-segment-elevation acute myocardial infarction (NSTEMI) can be very challenging, particularly in a hospital that cannot perform intracoronary imaging due to certain limitations. This is because, by angiography, most patients present with multivessel coronary artery disease (CAD), diffuse disease, or non-significant CAD. We present a case of a 60-year-old female patient presented with substernal chest pain and palpitations of 6 hours duration. The first hospital contacts 12-lead electrocardiogram (ECG) showed ventricular tachycardia (VT) with unstable hemodynamics, after stabilization patient was transported to the catheterization laboratory for immediate percutaneous coronary intervention (PCI). With a clue …

Incidence, Risk Factors And Outcomes Of Acute Kidney Injury In Neonates Undergoing Open-Heart Surgeries: Single Center Experience, Faisal A. Alghamdi, Mohammed A. Bin Mahfooz, Hatim F. Almutairi, Nasser S. Alshaiban, Khaled E. Alotibi, Omar M. Kabbani, Mohamed S. Kabbani

Journal of the Saudi Heart Association

Background: Incidence and outcomes of acute kidney injury (AKI) among neonates who underwent open-heart surgery are not well highlighted in the literature. We aim to assess the incidence, risk factors, and outcome of AKI among neonates undergoing open-heart surgery. Methods: This is a retrospective cohort study between 2016 and 2021 for all neonates requiring open heart surgery. The cases were divided into 2 groups: the AKI (index) group and the non-AKI (control) group. The two groups were statistically compared for risk factors, needs for dialysis, and outcomes. Results: 100 patients fulfilled the inclusion criteria. Among them, 74 (74%) developed AKI, …

Early Outcomes Of Transcatheter Aortic Valve Implantation With Next-Generation Balloon-Expandable Myval Transcatheter Heart Valve: Single-Center Experience From Iraq, Khalid Ibrahim Amber, Ammar Jabbar Majeed

Journal of the Saudi Heart Association

Objectives: Transcatheter aortic valve implantation (TAVI) is a minimally invasive percutaneous procedure for the treatment of elderly patients with symptomatic severe aortic stenosis. The study aimed to determine immediate (in-hospital) and short-term (30-day) outcomes of TAVI with next-generation balloon-expandable Myval transcatheter heart valve (THV) at a single-centre in Iraq. Methods: During January 2019 to January 2024, a total of 100 symptomatic severe aortic stenosis patients who underwent TAVI using Myval THV at Al-Najaf Cardiac Center, Iraq were enrolled. The procedure was done under local anesthesia and conscious sedation via transfemoral approach, using balloon-expandable Myval THV. All patients were followed-up at …

A Case-Based Implementation Of Heart Failure Therapies, A Consensus Pathway By The Saudi Heart Failure Working Group, Abeer Bakhsh, Ibrahim Jelaidan, Ammar Gulzar Chaudhary, Sahar Al Amro, Kamal Alghalayini, Osama Almogbel, Maryam Alqaseer, Hanan B. Albackr, Fayez Elshaer, Fakhr Al Ayoubi

Journal of the Saudi Heart Association

The implementation of guideline-directed medical therapy (GDMT) in heart failure (HF) has many challenges in real-world clinical practice. The consensus document is written considering the variability of the clinical presentation of HF patients. HF medical therapies need frequent dose adjustment during hospital admission or when patients develop electrolyte imbalance, acute kidney injury, and other acute illnesses. The paper describes clinical scenarios and graphs that will aid the managing physicians in decision-making for HF therapy optimization.

Abdominal Congestion As A Predictor Of Worsening Renal Function In Patients With Acute Decompensated Heart Failure, Hossameldin Rezk, Ghada (Sayed) Youssef, Karim Said, Iman (Atef) Mandour, Magdy Abdelhamid

Journal of the Saudi Heart Association

Objective: Worsening renal function (WRF) is a frequent finding in patients with acute decompensated heart failure (ADHF) and is a powerful independent prognostic factor for adverse outcomes. The link between abdominal congestion and worsening renal function in such patients is not yet fully addressed. The aim of this study was to evaluate the role of abdominal congestion in the early prediction of worsening renal function in hospitalized patients with acute decompensated heart failure. Methods: This was a prospective study that enrolled 100 patients with a diagnosis of ADHF and received intravenous diuretic therapy. Intra-abdominal pressure (IAP), splenic Doppler impedance indices …

Echocardiographic Predictive Factors Of Worsening Outcome In Type 1 Cardiorenal Syndrome, Saoussen Antit, Sabrine Bousnina, Marwa Fathi, Ridha Fekih, Elhem Boussabeh, Lilia Zakhama

Journal of the Saudi Heart Association

Introduction: Type 1 cardiorenal syndrome (CRS) is defined as acute decompensated heart failure (AHF) leading to secondary acute kidney injury. Few studies have evaluated the reliability of transthoracic echocardiography (TTE) in assessing outcomes in patients with type 1 CRS. We sought to identify echocardiographic predictors of outcomes (death and rehospitalization) in patients with type 1 CRS. Methods: This was a prospective longitudinal monocentric study, conducted from December 2020 to December 2022 in the cardiology department of the Internal Security Forces Hospital in Marsa, Tunisia. 68 patients with type 1 CRS were included prospectively. Physical, biological, and echocardiographic data were collected …

The Gender Spectrum Of In-Hospital Survival Post Primary Percutaneous Coronary Intervention For St Elevation Myocardial Infarction: Exploring Age-Driven Trends, Iva Patel, Pooja Vyas, Karthik Natarajan, Kewal Kanabar, Vishal Sharma, Sharad Jain, Dinesh Joshi, Swati Dahiya, Siva Nagendra Borra

Journal of the Saudi Heart Association

Background: The study was aimed to evaluate gender difference and age & gender specific interaction of in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: This was a prospective cohort study of 1748 patients with STEMI undergoing primary PCI. The study was dichotomised according to gender to evaluate the difference in the outcome. The study was further stratified based on an age cut-off of 75 years to examine the age-specific gender relationship in survival outcomes. Independent variables for in-hospital mortality were analysed through logistic regression. Results: There were 314 (17.96%) females with …

Endothelial Dysfunction Linked To Ventricular Dysfunction In Children With Sickle Cell Disease, A 3d Speckle Tracking Study., Antoine Abdelmassih, Mervat Haroun, Rasha Abdelraouf Abdelaziz Afifi, Gehan Hussein, Manal Abdelhameed, Marina George Asaad, Heba Tarabeh, Nourhan Essam El Din Taha, Nourine Diab, Noura Shebl, Raghda Fouda, Marianne Edward Yassa, Mohamed Ghobashy, Hala Agha

Journal of the Saudi Heart Association

Background

Sickle Cell Disease (SCD) is not a hematologic disease that occurs in isolation; it results in multi-organ complications. There is growing evidence of vascular stiffness as its underlying cause.

This study aimed to investigate the relationship between endothelial stiffness and LV dysfunction in SCD patients and to explore its pathophysiology, particularly regarding the depletion of vasodilators such as Nitric Oxide (NO).

Methodology

32 patients with established criteria for SCD and 40 healthy control subjects were selected for this case-control study. Comprehensive clinical assessment and assessment of endothelial function using Brachial Flow-mediated dilation (FMD) were performed, along with serum NO …

Off-Pump Coronary Surgery Combined With Aortic Valve Replacement Under Hypothermic Circulatory Arrest Within An Unexpected Porcelain Aorta, Abdelkader Boukhmis, Khaled Khacha, Djouaher Yacine

Journal of the Saudi Heart Association

Unexpected porcelain aorta is a real challenge to safely completing aortic valve replacement combined with coronary artery surgery. This condition often leads to an aborted sternotomy in the hope of performing transcatheter procedures, the feasibility of which may be hampered by anatomical considerations. We report the case of a 71- year old man with history of hypertension, type 2 diabetes mellitus and chronic kidney disease, which was referred for severe aortic valve stenosis and severe coronary artery disease. He benefited from an anaortic off-pump coronary surgery and clampless aortic valve replacement under hypothermic circulatory arrest to overcome an unexpected porcelain …

Risk Factors For Neurological Complications And Short-Term Outcomes After Pediatric Heart Surgery: A Retrospective Analysis, ​​Muhammad ​ Shahzad, ​Yasser Abdulrhman ​ Alheraish, ​​Bushra ​ Algethami, Linah Abdulmohsen Algheryafi, Salma Kamel, Rawan Ghunaim, ​​Zohair Yousef ​ Alhalees

Journal of the Saudi Heart Association

Objective: To assess the risk factors associated with neurological complications and poor short-term outcomes following pediatric heart surgery.

Methodology: A cross-sectional study was conducted in a cardiac intensive care unit between June 2019 and June 2022. The data of all children less than 15 years old who underwent open-heart surgery and had CT brain were extracted from hospital records. The primary outcome was the incidence of CNS insult, and secondary outcomes included death after surgery, length of stay in ICU and hospital. Data analysis was performed using SPSS version 23, and a p-value less than or equal to 0.05 was …

Clinical And Procedural Characteristics Of Successful Transcatheter Device Closure Of Ostium Secundum Atrial Septal Defect In Symptomatic Children Weighing Less Than 15 Kg: A Retrospective Study Spanning One Decade From South India, Shobhit Priyanshu Joseph, Mirza Shohiab Ur Riyaz, Jesu Krupa, Shruti Irene Varghese, Gayathri Bhuvaneswaran Kartha, Oommen K. George, Paul V. George, John Jose, Viji Samuel Thomson

Journal of the Saudi Heart Association

Objectives: This retrospective study sought to determine the feasibility of transcatheter atrial septal defect device closure in patients less than 15 kg, as well as to assess complication rates and the reasons for unsuccessful device closure.

Background: In general, the risks associated with transcatheter atrial septal defect device closure are believed and reported to be relatively low, but the evidence stems from trials involving adults and older children. Current guidelines do not recommend atrial defect closure in device closure in children < 15kg, due to limited data available for feasibility and safety of device closure in this group of patients.

Methods: Retrospective review of all patients who underwent elective transcatheter closure of ostium secundum atrial septal defect between September …

Mid-Term Clinical And Hemodynamic Outcomes In Middle Age Patients Post Trifecta™ (Abbott) Aortic Valve Replacement: A Single-Center Study, Feras H. Khaliel, Mohammed Suliman Al Aboud, Suha A. Althibait, Saber Yezli, Elaf A Al Muaythir, Bandar Alamro, Domenico Galzerano

Journal of the Saudi Heart Association

Background: Trifecta™ is an externally wrapped bovine pericardial aortic valve with a favorable hemodynamic performance and acceptable rate of freedom from structural valve degeneration. However, recent reports of early Trifecta valve failure question its durability. Rheumatic valve disease in middle age population is predominant, there is no data on the Trifecta performance, durability or safety available worldwide over the middle age population, as well as there is no previous reports from Middle East region. We report on mid-term clinical and hemodynamic performance of Trifecta valve in middle age population with small aortic annuls, a single centre report. Methods: A retrospective …

Retrograde Type A　Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair, Hideki Sasaki, Yukihide Numata, Shinji Kamiya, Yoshiaki Sone, Miki Asano

Journal of the Saudi Heart Association

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

Systolic Pulmonary Artery Pressure Thresholds Predictive Of Dyspnea On Stress Doppler Echocardiography In Mitral Stenosis, Saléha Lehachi, Fadila Daimellah, Saida Khelil, Zakia Bennoui, Djohar Hannoun, Youcef Laid, Rachid Mechmeche, Mohand Said Issad

Journal of the Saudi Heart Association

Background. On Stress Doppler Echocardiography (SDE) in mitral stenosis, the systolic pulmonary artery pressure (SPAP) threshold at peak exercise recommended by the guidelines as an indication for percutaneous mitral commissurotomy (PMC) used to be 60 mmHg. However, because of the paucity of studies, that threshold has been controversial. The Europeans stopped using the value in 2007, followed by the Americans in 2014.

Objective. Determine SPAP thresholds on SDE at peak exercise and post-exercise predictive of dyspnea as an indication for PMC in mitral stenosis.

Method and results. Three hundred mitral stenosis patients with a mitral valve area (MVA) ≤ 2 …

Characteristics Of Patients Undergoing Electrophysiologic Procedures In A Tertiary Hospital In Saudi Arabia, Abdullah A. Aljammaz, Meshaal K. Alghanim, Ibraheem Altamimi, Mohammed A. Alshwieer, Albaraa Sabbagh, Abdulrahman S. Alsayed, Faisal G. Al-Zahrani, Mohammad F. Almanjomi, Sameer Qutub, Wael A. Alqarawi

Journal of the Saudi Heart Association

Introduction: The electrophysiology field has progressed rapidly over the last 2 decades. No study has examined the characteristics of patients and types of electrophysiology procedures performed in the Kingdom of Saudi Arabia. This is important given our distinctly different demographic composition and health system. As such, we sought to describe the characteristics of consecutive patients presenting for electrophysiology procedures in our tertiary care hospital.

Methods: Data was collected from the electrophysiology database at King Khalid University Hospital for procedures performed between April 2016 and November 2022. Patients’ characteristics were retrieved from the electronic medical record. Procedures were categorized into supraventricular …

Epidemiological, Bacteriological, And Evolutive Features Of Children Hospitalized For Infective Endocarditis In A Tertiary Tunisian Pediatric Department, Houda Ajmi, Rahma Herch, Hela Elghali, Dalel Ben Sliman, Mohamed Ben Rejeb, Sameh Mabrouk, Fadoua Majdoub, Salsabil Nouir, Lamia Tilouche, Abdelhalim Trabelsi, Saoussan Abroug, Jalel Chemli

Journal of the Saudi Heart Association

Background: Infective endocarditis is a rare condition in childhood, and there is limited data on this disease in Tunisia.

Objective: This study aims to analyze the epidemiological profile, bacteriological data, and prognosis of infective endocarditis in children admitted to the pediatric department of a University Hospital in Tunisia.

Methods: We conducted a comparative cross-sectional study in the pediatric department of Sahloul Teaching Hospital in Sousse, a tertiary referral hospital in Tunisia. The study included all children aged ≤ 18 years with infective endocarditis admitted to the tertiary referral center for pediatrics in Sahloul University Hospital from January 1994 to December …

Ischemic Stroke Revealing Libman-Sacks Endocarditis: A Case Report, Malak Alaoui Yazidi, Fatima Zahra Merzouk, Hajar Rabii, Hicham Benyoussef, Ilham Bensahi, Rachida Habbal

Journal of the Saudi Heart Association

Libman-Sacks endocarditis (LSE) is a characteristic but rare feature of systemic lupus erythematosus (SLE), which can be found in association with antiphospholipid syndrome (APS), exposing the patient to an increased embolism risk, particularly the occurrence of ischemic stroke. We present a case involving a 64-year-old man who was admitted for ischemic stroke accompanied by a fever. Cardiac investigation revealed mitral vegetations along with severe mitral regurgitation. The diagnosis of Libman-Sacks endocarditis associated with SLE and APS was made after a laboratory work-up showing negative blood cultures and positive antibodies. This case underlines the importance of early diagnosis for better management …