Medicine and Health Sciences Commons^™

Unusual Cardiac Presentation Of Covid-19 With Significant Sinus Pauses, Tarique S. Chachar, Salman K. Slais, Abdulrahman Almadani, Adel K. Hamad

Journal of the Saudi Heart Association

There is growing evidence of cardiac complications due to corona virus disease 2019 (COVID 19). Our case is a case of a young patient with COVID-19 and symptomatic sinus pauses.

A Multiloculated Left Ventricular Thrombus, Dinkar Bhasin, Gaurav K. Arora, Anunay Gupta, Hermohander S. Isser, Sandeep Bansal

Journal of the Saudi Heart Association

No abstract provided.

Entrapment Of A Partially Degloved Stent In The Radial Artery: Is There Any Way Out?, Nooraldaem Yousif, Husam A. Noor

Journal of the Saudi Heart Association

Stent loss during percutaneous coronary intervention (PCI) is uncommon but may lead to serious adverse events. Here we describe a challenging case of stent loss in the radial artery during primary PCI. There, a long stent failed to cross the culprit lesion, and an attempt to pull back the undeployed stent into the guiding catheter resulted in eversion of the stent, partially stripping it off the stent balloon and rendering the stent irretrievable. Retrieval of the stent at all costs might have led to major complications; hence stent deployment in the radial artery bailed us out of this precarious situation.

Transfer Of Patients With St Elevation Myocardial Infarction For Primary Percutaneous Coronary Intervention During Ordinary & Pandemic Times Position Statement Of The Saudi Arabian Cardiac Intervention Society, Shukri M. Al Saif, Owayed Al Shammeri, Abdullah Alkhushail, Ramzi Almohammadi, Mohamed Kurdi

Journal of the Saudi Heart Association

Primary percutaneous coronary intervention is the most effective therapy in the management of acute ST Elevation Myocardial Infarction. Evidence recommends keeping the period from symptom onset to reperfusion to a minimum in order to preserve left ventricular function, improve outcome, and reduce mortality. The position statement describes the recommendations of the the Saudi Arabian Cardiac Intervention Society for optimal conditions and timing for the acute management of patients presenting with ST Elevation Myocardial Infarction during ordinary and pandemic times.

The Association Of Diurnal Blood Glucose Variability With Subclinical Cardiac Disease In Patients With Type 2 Diabetes Mellitus, Walid Shehab-Eldin, Ahmed Al-Ashmawy, Mahmoud Kamel, Nesrin Elhelbawy, Alaaeldin Dawood, Mostafa Elnajjar

Journal of the Saudi Heart Association

Background: The relationship between glycemic control and the risk of cardiac disease in patients with Type 2 Diabetes Mellitus (T2DM) is controversial. 1,5-Anhydroglucitol (1,5-AG) is a biomarker of Glucose Variability (GV) and has been associated with clinical cardiovascular disease. However, its association with Subclinical Cardiac Disease (SCD) is unknown. Aim of the work: Study the association between GV and SCD. Subjects and methods: A cross-sectional study was conducted on 46 asymptomatic patients with T2DM as T2DM individuals group. Another 46 non-diabetic age and sex matched subjects were included as the healthy group. 1,5-AG was measured for all subjects. M-mode echocardiography …

An Apical Mass Of The Left Ventricle After A Myocardial Infarction: Imaging Contribution, Selma Charfeddine, Wiem Feki, Imen Maaloul, Rania Hammami, Emna Daoud

Journal of the Saudi Heart Association

Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI). It can affect the left ventricular free wall, the right ventricle, or the interventricular septum.
We report a case of a 58-year-old man with an IDH following an acute anterior wall myocardial infarction detected by echocardiography and confirmed by Cardiac magnetic resonance (CMR).

Internal Medicine Point Of Care Ultrasound In The 21st Century: A ‘Focus’ On The Middle East, Arif Hussain, Irene W.Y. Ma

Journal of the Saudi Heart Association

No abstract provided.

Low-Grade Primary Leiomyosarcoma Of The Right Atrium: Promising Survival With Complete Surgical Resection, Meshaal S. Alotaibi, Shabir H. Shah, Mohammad S. Khan, Salman T. Almalki, Salman A. Faifi

Journal of the Saudi Heart Association

Primary cardiac leiomyosarcoma has an extremely low incidence with overall median survival of approximately 6 months. Here, We report the case of a 60-year-old man who underwent complete surgical excision of right atrial mass. Histologic examination revealed leiomyosarcoma. The patient made a full recovery with no evidence of recurrence at 24 months. To the best of our knowledge, this is the first reported case or primary cardiac leiomyosarcoma in the Middle East.

Percutaneous Tricuspid Valve In Failed Annuloplasty Ring And Paravalvular Leak Closure For Mechanical Aortic Valve- A Case Report, Hesham A. Naeim, Reda Abuelatta, Rifaat Alharach, Abderrahman Elhaj, Abdulaziz Alsuwayh, Mohamed Azmi

Journal of the Saudi Heart Association

Transcatheter valvular interventions are established as an alternative for surgery in selected patients in symptomatic high surgical risk patients. Tricuspid valve replacement after failed repair ring had limited experience to date. We report this case to highlight the procedure details and results.

Focused Cardiac Ultrasound Is Applicable To Internal Medicine And Critical Care But Skill Gaps Currently Limit Use, Naveed Mahmood, Mamdouh Souleymane, Rajkumar Rajendram, Amro Mt Ghazi, Mubashar Kharal, Mohammad Alqahtani

Journal of the Saudi Heart Association

Context: Coronavirus Disease 2019 (COVID-19) put a spotlight on focused cardiac ultrasound (FoCUS). However, the spectra of cardiac disease, and the resources available for investigation vary internationally. The applicability of FoCUS to internal (IM) and critical care medicine (CCM) practice in Saudi Arabia and their current use of FoCUS are unknown.

Aims: To determine the applicability of FoCUS to IM and CCM practice in Saudi Arabia and quantify the residents’ current proficiency, accreditation and use of FoCUS.

Methods: A questionnaire was distributed to the residents in IM and CCM at our institution to determine their proficiency, use of FoCUS, and …

The Role Of Microbiologic Agents In The Progression Of The Atherosclerosis: A Comprehensive Review, Ahmet Karabulut

Journal of the Saudi Heart Association

Atherosclerosis is a leading cause of disability, morbidity and mortality in the world. Atherosclerosis is accepted as a chronic progressive inflammatory disease. The inflammatory cascade in the vascular wall is well-defined. However, the predictors and contributors of the inflammatory response in atherosclerosis are not completely understood. Systemic and local inflammation, which enhance the burden of inflammation in the vascular wall, have been proposed as risk factors for the progression of atherosclerosis. Infectious micro-organisms are one of the major triggering factors for local and systemic inflammation. In this review, we aimed to emphasize the linkage between micro-organisms and the progression of …

Impact Of A Social Support Program Supervised By A Multidisciplinary Team On Psychosocial Distress And Knowledge About Heart Failure Among Heart Failure Patients, Muhammad Adil Soofi, Zainab Jafery, Faisal Alsamadi

Journal of the Saudi Heart Association

ABSTRACT:

Background: Heart failure drains significant financial resources with morbidity and mortality higher than cancer. Social support is defined as the care provided by the family members, friends and health care workers to the patients. Absence of social support and poor perceived social support will create stress, anxiety, depression and anger which further deteriorate the underlying disease and worsen quality of life. Discussion in group creates better understanding of the disease which helps the patients improving their skills in managing their condition.

Objective: To evaluate the impact of multidisciplinary team supervised social support program on components of psychosocial distress and …

Comparing Trimetazidine With Allopurinol In Prevention Of Contrast Induced Nephropathy After Coronary Angiography, Haitham Galal, Mahmoud Shehta, Sameh Attia, Islam Bastawy

Journal of the Saudi Heart Association

Objectives: Contrast-induced nephropathy is considered a serious complication following coronary angiography increasing morbidity and mortality. Various drugs have been assessed to reduce the incidence of contrast-induced nephropathy. In this study, we compared trimetazidine and allopurinol as a pharmacological measure to reduce the incidence of contrast-induced nephropathy.

Methods: One hundred and twenty patients undergoing coronary angiography with baseline creatinine clearance more than 30 ml/minute were divided into three groups, 40 patients each. Group 1 received standard parenteral intravenous hydration in the form of isotonic saline at a rate of 1 ml/kg body weight per hour started 12 hours before angiography and …

Transcatheter Aortic Valve Implantation: Bahrain Experience, Nooraldaem Yousif, Suddharsan Subbramaniyam, Babu Thevan, Mohammad Amin, Leena Sulaibikh, Nazar Bukamal, Habib Tareif, Sadananda Shivappa, Haitham Amin, Husam A. Noor

Journal of the Saudi Heart Association

STRUCTURED ABSTRACT

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that is considered a good alternative to surgical aortic valve replacement (sAVR) in selected patients. Our aim is to determine the baseline, procedural characteristics and one-year clinical outcomes of our TAVI registry.

METHODS: This study is a retrospective observational analysis of a prospectively designed cohort comprising 81 consecutive patients treated at Mohammed bin Khalifa Cardiac Centre (MKCC) who were enrolled in Bahrain TAVI registry from February 2014 to February 2019. The clinical endpoints were defined according to the updated Valve Academic Research Consortium-2 (VARC-2) consensus document.

RESULTS: …

Covid 19 Myocarditis: Myth Or Reality?, Lamyae Sasbou Md

Journal of the Saudi Heart Association

COVID 19 so far is not a known cardiotropic virus, and the term “myocarditis” should be exclusively used after EMB or autopsy proven diagnosis.

We report a case of 26-year-old man admitted for COVID 19 infection and symptoms leading to a myocarditis. We describe the workup that led to the potential diagnosis.

Diagnostic Accuracy Of Global Longitudinal Strain For Detecting Significant Coronary Artery Disease In Diabetic Patients Without Regional Wall Motion Abnormality, Oumaima Alaika, Souad Jamai, Nawal Doghmi, Mohamed Cherti

Journal of the Saudi Heart Association

Objectives:

Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this prospective study was to assess the diagnostic accuracy of global longitudinal strain (GLS) and regional longitudinal strain (RLS) parameters at rest in comparison to stress echocardiography findings for detecting significant coronary artery disease (CAD) in patients with diabetes mellitus (DM).

Methods:

We prospectively studied echocardiographic characteristics at rest with Speckle tracking echocardiography (2D STE) measures ; then stress echocardiography and coronary angiography data in 34 diabetic patients without regional wall motion abnormality (RWMA) at rest. Patients were grouped according to …

Increased Epicardial Adipose Tissue Is Associated With The Extent Of Aortic Dissection, Ahmet S. Yõlmaz

Journal of the Saudi Heart Association

Background: Epicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection.

Methods: We retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of …

Subaortic Membrane And Patent Ductus Arteriosus In Rare Association-Case Series, Hussain Moafa, Mohammed Alnasef, Obayda M. Diraneyya, Fahad Alhabshan

Journal of the Saudi Heart Association

Background: The combination of subaortic membrane (SAM) and patent ductus arteriosus is very rare. Subaortic stenosis is the second most common form of left ventricular outflow tract (LVOT) obstruction after valvular aortic stenosis. We are reporting the largest case series of SAM and PDA. Methods: We included all patients that were diagnosed with the combination of SAM and PDA at our cardiac center. We have reviewed patients echocardiographic studies, cardiac catheterizations, surgical notes and all the outpatients notes. Results: We have a total of 7 patients. The age at presentation was in the early childhood with 3 patients diagnosed in …

Ultra Long Stent In An Aberrant Right Coronary Artery, Desabandhu Vinayakumar, Jomy Vadasseril Jose

Journal of the Saudi Heart Association

The prevalence of anomalous origin of right coronary artery from the left sinus is about 0.92%. A percutaneous coronary intervention (PCI) in such a vessel is challenging especially when maneuvering long stents. We report a case of 75- year old female patient with recent acute coronary syndrome. The angiogram showed significant lesions in the left anterior descending coronary artery and the left circumflex coronary artery with an aberrant RCA originating from the left sinus close to the origin of LMCA with multiple tight lesions. The aberrant RCA was stented with a 50 mm long stent. To the best of our …

Accidental Snapping Of Right Ventricular Pacing Lead With Micra, Vivek Singh Guleria, Prafull Sharma, Prashant Bharadwaj

Journal of the Saudi Heart Association

Leadless pacemaker implantation rates are increasing worldwide. These pacemakers have to be deployed , captured and redeployed in order to achieve optimal electric parameters. Various complications occur during this procedure. We herein report a unique case, where right ventricular(RV) pacing lead of the patient was accidentally snapped during MICRA deployment in a elderly male with pocket site infection.

Effect Of Coronary Artery Bifurcation Angle On Atherosclerotic Lesion Localization Distance To The Bifurcation Site, Murat Ziyrek, Ahmet Lütfü Sertdemir, Mustafa Duran

Journal of the Saudi Heart Association

Objectives: Although percutaneous coronary interventions become a common treatment modality for coronary artery diseases, lesion localization make these procedures more complex. As the lesion localizes near to the bifurcation site, more complex PCI procedures, overqualified equipments are needed and complication risk increases. Previous studies have demonstrated the strong correlation between wide angulation and significant coronary stenosis. However, a paucity of data exists about the association between bifurcation angle and lesion localization distance. In this study we analysed the effect of coronary bifurcation angle and left main coronary artery length on the atherosclerotic lesion localization.

Methods: Patients, who underwent coronary angiography …

Hydroxychloroquine And Azithromycin As A Treatment Of Covid- 19: Electrocardiogram Variability, Amal El Ouarradi, Salma Abdeladim, Sara Oualim, Llham Bensahi, Sara Hafid, Hamza Tazi, Mahassine Elharras, Rita Aniq Filali, Abdelhamid Nailhou, El Arbi Bouaiti, Abdelhamid Moustaghfir, Mohamed Sabry

Journal of the Saudi Heart Association

During the COVID 19 pandemic, the effectiveness of the combination of hydroxychloroquine and azithromycin is widely discussed. This treatment can cause many severe cardiac side effects that makes us discuss its utility.

The aim of this study is to describe the cardiovascular effect of hydroxychloroquine and azithromycin by analyzing surface ECG in patients with COVID 19.

Methods: This observational cohort study included Moroccan patients with COVID 19 diagnosis and were hospitalized in Cheikh Khalifa International University Hospital, Casablanca, Morocco between March 26 and April 20, 2020.Patients were treated with a combination of hydroxychloroquine and azithromycin over a period of at …

Incidental Discovery Of Anomalous Left Coronary Artery Arising From The Pulmonary Artery In A Coronavirus Disease-2019 Patient: A Blessing In Disguise, Masood Ghori, Rizwan Ahmed

Journal of the Saudi Heart Association

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a serious congenital malformation. Reports about asymptomatic, incidentally discovered ALCAPA in adults are scarce. We describe a patient with no known pre-existing cardiac condition admitted to our hospital with coronavirus disease 2019 (COVID-19) and was incidentally found to have ALCAPA. To the best of our knowledge, this is the first reported case of incidentally discovered ALCAPA in a COVID-19 patient and highlights the importance of appropriate investigation of the coronary status by Multidetector Cardiac Computed Tomographic Angiography (MDCCTA) in individuals with asymptomatic left ventricular dysfunction. The presentation …

Development And Validation Of A Electrocardiographic Diagnostic Score Of Heart Failure Among Patients With Hypertension Attending A Tertiary Hospital In Ibadan, Nigeria: The Risk-Hhf Case-Control Study, Ayodipupo Sikiru Oguntade

Journal of the Saudi Heart Association

Objectives: Hypertension is the leading cause of heart failure (HF) in sub-Saharan Africa. Electrocardiography (ECG) is a cheap and easily available stratification tool for the diagnosis and prognostication of individuals with hypertension. The aim of this study was to develop an ECG-based HF diagnostic score among patients with hypertension attending a specialist cardiology clinic.

Methods:One hundred and one (101) case-control age- and sex-matched pairs were recruited. The study population were adults with a clinical diagnosis of hypertensive HF (cases) and hypertension without HF (controls). Participants underwent clinical assessment and ECG. Associations between ECG variables and HF risk were …

Discrete Left Ventricle Outflow Tract Obstruction In Children: Incidence And Predictors Of Recurrence. A Multi-Center Study, Gadah M. Alqurashi, Rema S. Almohanna, Kamal Mk Ayoub, Arwa A. Alkhuraiji, Najla A. Almasoud, Amjad R. Alsubaie, Alaa M. Althubaiti, Abdullah A. Al Sehly

Journal of the Saudi Heart Association

Objectives: The purpose of this study is to measure the incidence of recurrence of discrete subaortic stenosis (DSS) after primary resection in two major cardiac centers in Saudi Arabia and to identify risk factors associated with recurrence.

Methods: Data on 234 patients who were diagnosed with DSS and underwent surgical resection between 1999 and 2018 were retrospectively reviewed. Patient demographics as well as echocardiographic, surgical, and pathological data were compared between patients with recurrence and non-recurrence.

Results: The overall recurrence incidence after primary resection was 44.87% (N=105). Most patients were male (59%). The median age at the …

Effect Of Covid-19 Pandemic On The Cardiac Outpatients’ Perception Of Seeking Medical Advice, Sondos Samargandy, Turki A. Al Garni, Abdulrahman Almoghairi, Mohammed Alahmari, Bandar Alshehri, Mohammed Mosaad, Jamal Ahmed, Hussein Alamri, Shaza Samargandy

Journal of the Saudi Heart Association

Background:

During this unprecedented time of COVID-19 pandemic, it was noticed a decline in cardiovascular cases presentation to the Emergency rooms in many countries, raising many speculations about the reasons and its ramifications?

Objectives:

1-Identify the reasons during this pandemic that refrain patients from seeking medical care and its impact on stress level and medication adherence.

2- emphasize the new role of virtual medicine.

Methods:

A quantitative descriptive cross-section survey study of 388 patients. It has been done in the cardiac outpatient department and conducted virtually through telemedicine.

Results:

Despite this pandemic and its consensuses, the majority of cardiac outpatients …

Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash

Journal of the Saudi Heart Association

Objective: To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

Method: This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/ PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (

Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (

Conclusion: Left ventricular thrombi can be detected on cardiac viability studies …

Optimal Time Repair Of Ventricular Septal Rupture Post Myocardial Infarction, Ibrahim Shafiei, Fatemeh Jannati, Mansour Jannati

Journal of the Saudi Heart Association

Ventricular septal rupture (VSR) is an uncommon complication of myocardial infarction (MI). The mortality rate of VSR is high. The management of VSR is including the stabilization of the hemodynamic status and surgical closure of the rupture. In spite of the agreement of experts on the necessity of surgical repair, the timing of VSR repair management remains unclear. In this review article, we evaluate the optimal time repair of VSR. To collect the data, Pubmed, EMBASE, and Cochrane Central Registry databases were searched for potentially suitable studies. Search terms were including “Ventricular Septal Rupture”, “Myocardial Infarction”, “Timing”, and “MI”. According …

Epidemiological Variation Of Acute Myocardial Infarction Relevant To In-Hospital Outcomes-Tertiary Center Experience-Saudi Arabia, Sheeren Khaled, Mohammad Almalki, Ghada Shalaby, Azmat K. Niazi, Sara Ahmed, Asma Alsilami, Mohannd Alhazmi, Zeyad Bukhary, Najeeb Jaha

Journal of the Saudi Heart Association

Background: Epidemiological related differences in patients presenting with ST- elevation myocardial infarction (STEMI) have not yet been fully characterized in the Middle East countries. The aim of this study was to assess gender, ethnic and racial variation in clinical profiles, presentation and treatment strategies with relation to the in-hospital outcomes.

Method: This is a retrospective, single center study reviewing the epidemiological details of STEMI patients who were admitted to our center during the period between October 2015 and August 2019.

Result: Out of 3079 patients presented with STEMI, 498(16%) were women, 2170 (70%) were from Middle Eastern Countries and only …

Prevalence Of Cardiovascular Diseases Risk Factors Among Jordanians, Wesam Saleh Alsaud, Mohammad Tabbaa, Violet Kasabri, Maysa Suyagh, Muneer Abu Alsamen, Hussain Haddad, Anas Sheweiki

Journal of the Saudi Heart Association

Background and aims: One of the most common causes of death worldwide is cardiovascular diseases (CVDs). This study evaluated the prevalence of CVDs risk factors (RFs) and their constellation electively among the Jordanian population and assessing the most prevalent RF interplay with the rest of CVDs RFs as well as the impact of age and gender dimorphism on the frequencies of coexistence of multiple CVDs risk factors (RFs) among the Jordanian population. Methods and results: In this observational multicenter study, a total of 1449 subjects were enrolled. The mean age (± SD) was 44.35 ± 14.46 years; 796 (54.9%) of …