Introduction: Left bundle branch block (LBBB), affects septal wall thickening during systole, due to abnormal polarization pattern. However, in patients with LBBB, frequent septal perfusion defects are reported in Myocardial Perfusion SPECT even when there is no coronary stenosis on angiography. GATED Myocardial Perfusion SPECT (Single Photon Emission Tomography) is an accurate indicator and has shown high sensitivity and specificity to diagnose CAD. Septal perfusion defects in patients with LBBB is intensified during stress perfusion scintigraphy due to abnormal systolic phase in the septum, and abnormal conduction which gives a false appearance of reduced perfusion during the systolic phase. Patients and Method: Stress-rest Gated Myocardial Perfusion SPECT using Tc99m myoview was performed in 20 subjects with LBBB with probability of CAD. Visual analyses of the slice images and revision results of Gated SPECT study were done on end diastolic (ED), end systolic (ES) images, regional wall motion and wall thickness for evaluation of the perfusion of septum. Results: Visual analysis of stress-rest slices: 1) Reversible septal hypoperfusion was noted in 13 (65%) patients. 2) Fixed septal defects in 4 (20%). 3) Three patients (15%) had normal septal perfusion. Quantitative analysis of gated study: 1) Out of the 13 patients with reversible hypoperfusion, 8 (40%) show normal findings on Gated SPECT and only the remaining 5 (25 %) patients had true reversible hypoperfusion. 2) The 4 patients with fixed septal defects show normal findings on Gated SPECT Conclusion: The use of Gated myocardial perfusion scintigraphy particularly end-diastolic images can help in the evaluation of septal perfusion, wall motion and thickening and hence differentiate true perfusion defects from false patterns in cases of LBBB.

Background: Cardiovascular disease is one of the major health problems all over the world. Yemen is one of the least developed countries in the Gulf and cardiovascular diseases contribute a big economic burden. Echocardiography has revolutionized the practice of cardiology and its role as a non-invasive diagnostic tool for both congenital and acquired cardiac lesions, however complex is well established. Along with 2-D, M mode and Doppler. New echocardiographic modalities like stress Echo, tissue Doppler, harmonic imaging and contrast echocardiography are also emerging in Yemen. The aim of this study was to find the prevelance of both organic and functional mitral regurgitation (MR) by echocardiography in our population. Materials and Methods: Using Sonos 1000 & 5500 HP Echocardiography machines, all the cases of MR diagnosed over the past 6 months in Al-Thawra Modern Teaching Hospital, Sana'a, were retrospectively reviewed. Mitral regurgitation was classified as organic if the mitral apparatus was found to be abnormal, and functional in the case of MR with a normal looking mitral valve. Results: A total of thirteen hundred and thirty cases of MR were diagnosed during the study period. The mean age was 44.7 years with a standard deviation (SD) of ΁ 19.4 and the age group of 51-60 years was the dominant group making up 20.8%. Mitral regurgitation was slightly more common in males than females with 56.5% vs 43.5%. Functional MR was slightly more common than organic (51.7% vs 48.3%). Rheumatic heart disease (22.9%) was the most common cause of organic MR while Mitral valve prolapse was only found in 6.3% of this group. Hypertensive heart disease 21.7% was the most frequent etiology of functional MR. On the basis of severity, mild MR was the diagnosis in 65.5%, trivial in 15.4%, moderate in 12.9% and severe MR was found in 5.7%.

The most common tumours of the heart are metastatic in origin, but the most common primary cardiac tumour in adults is a myxoma. We present a recent classic case of myxoma and review the topic of cardiac tumours as a whole.

Using echocardiography, left ventricular function was evaluated in accordance with the diverse ultrasound methods. M-Mode and two-dimensional methods have some limitations due to the geometric assumptions to calculate the different parameters, which may cause important errors. 3-D imaging can be used for direct calculation of intracavitary volumes and global/regional ejection fraction. In the present review, the first and second scanner's generation of 3D echocardiography are illustrated. The image acquisition and reconstruction were exposed and the advantages and limitations of this technique are also reported. "Live" 3D echocardiography, which directly and more rapidly provides a free quantification of global and regional LV function, appears to be superior to other versions of real-time 3D imaging. Finally, rapid three-dimensional echocardiography allows the immediate collection of data within a few seconds, making this technique feasible in most clinical scenarios.