Reader Login
| Users Online: 4319
Home
|
About us
|
Editorial board
|
Search
|
Ahead of print
|
Current Issue
|
Archives
|
Submit article
|
Instructions
|
Subscribe
|
Advertise
|
Contact us
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Access statistics : Table of Contents
2021| April-June | Volume 22 | Issue 2
Online since
August 19, 2021
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Viewed
PDF
Cited
ORIGINAL ARTICLES
Clinical characteristics and prognosis of young middle Eastern adults with ST-elevation myocardial infarction: One-year follow-up
Omar Sami Obeidat, Hanna Makhamreh, Ra'ad Zaid Al-Muhaisen, Layan R Obeidat, Farah I Kitana, Justin Z Amarin, Mahmoud Ahmed Ebada, Mhd Anas Murad, Tuqa Alhameedi, Dania Haj-Yasin, Ayman Hammoudeh
April-June 2021, 22(2):88-95
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_67_20
Aims:
Few studies have investigated premature ST-elevation myocardial infarction (STEMI) in the Middle East. We aimed to compare the clinical characteristics and one-year prognosis of young (<45 years) and older (≥45 years) Middle Eastern adults with STEMI.
Methods and Material:
A total of 706 patients with STEMI, who were prospectively enrolled in the First Jordanian Percutaneous Coronary Intervention Registry, were stratified into two groups (<45 or ≥45 years). Baseline clinical variables and one-year major adverse cardiovascular events (MACE) were evaluated.
Results:
Young patients (<45 years) comprised 17.4% of STEMI patients (123 of 706). Compared with older patients (≥45 years), young patients were mostly male (96% vs 82%, P<0.001), smokers (86% vs 49%, P<0.001) and less likely to have multi-vessel disease (26% vs 44%, P=0.001). Anterior STEMI was the most common diagnosis and left anterior descending artery was the most common culprit vessel in both groups. There were no significant differences between the younger and older patients in in-hospital (20% vs 19%, P=0.12) and one-year MACE (24% vs 26%, P=0.68). However, none (0%) of the young died during one-year follow-up while 21 (4%) of the older patients died (P=0.036).
Conclusions:
Young adult patients in the Middle East with STEMI are more likely to be smoking men with multiple risk factors and single vessel disease by angiography. Although, younger patients had similar one-year MACE to older patients, their mortality rate appears to be better. A larger study is warranted to investigate this vulnerable group of patients to prevent future events.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
2,088
64
-
Morphological cardiac alterations in liver cirrhosis: An autopsy study
Banushree Chandrasekhar Srinivasamurthy, Sanjay P Saravanan, Fremingston K Marak, Prakash Manivel, Ramachandra V Bhat, Dharanya Mathiyazhagan
April-June 2021, 22(2):96-101
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_14_21
Background:
Cirrhosis can cause various cardiac complications and severely affect the prognosis of the patient suffering from cirrhosis. Anatomical, morphological variations in the heart of patients with liver cirrhosis in the absence of known cardiac disease has not been well described. There is a paucity of studies in the literature on cardiac alterations in cirrhosis. Early detection of known cardiac alterations can further help in improving the quality of life.
Materials and Methods:
A cross-sectional descriptive study was conducted in the departments of pathology and forensic medicine of our institution. An autopsy-based prospective study of forty consecutive patients with final diagnosis of liver cirrhosis were included. Patients with a known history of cardiac disease/anomaly were excluded from the study. Macroscopic and microscopic changes in the heart and coronaries were noted and statistically analyzed.
Results:
Analysis of the hearts on gross examination showed cardiomegaly in 31 patients (77.5%). All cases had left ventricular hypertrophy. Endocardial thickening was seen in 22 patients (55%). Calcified mitral valve was seen in 9 patients (22.5%). On microscopy, apart from hypertrophy, the pathological changes like interstitial oedema (47.5%), fibrosis (45%), cardiac muscle disarray (87.5%), fatty infiltrate (10%), pericarditis (5%), and severe coronary artery atherosclerosis (17.5%) were seen in the patients.
Conclusion:
Knowledge about the involvement of the heart in liver cirrhosis is essential for both the physician and the surgeons to prevent adverse outcomes during liver transplantation and can further help in improving the quality of life of the patient.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,951
46
-
The effect of early aggressive diuresis on hospital length of stay in acute congestive heart failure
Muhammad Butt, Ahmad Jabri, Hany Messeh, Abdullah Ahmed, Anas Alameh, Faris Haddadin, Andin Mullis, Claude S Elayi
April-June 2021, 22(2):108-114
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_24_20
Background:
Diuresis is the mainstay of treatment during hospitalization for patients admitted with congestive heart failure (CHF). Hospital length of stay (LOS) is considered an important patient outcome for CHF patients; previous studies comparing higher rates of diuresis (aggressive) versus relatively lower rates (nonaggressive) on patient outcomes have shown contradicting results. In fact, no specific guidelines to direct diuretic therapy exist. This investigation was designed to study the effect of early aggressive diuresis on hospital LOS.
Methods:
Data from 194 CHF patients (admitted to the hospital for 1 year) were collected and analyzed in a retrospective cohort study design. Patients were divided into two cohorts based on urine output achieved in the first 24 h of admission; the aggressive diuresis cohort (urine output ≥2400 mL) comprised of 29 subjects while the nonaggressive diuresis cohort (urine output ≤2400 mL) had 165 subjects. The primary endpoint was LOS.
Results:
Median LOS for the aggressive diuresis cohort was 4 days (95% confidence interval [CI]: 2.95–5.06) as compared to 5 days (95% CI 4.40–5.60) for the nonaggressive diuresis cohort; log-rank test showed no significant differences between the hospitalized proportions between the two cohorts over time (
P
= 0.67).
Conclusion:
Hospital LOS for CHF patients treated with early aggressive diuresis was not significantly different compared to patients treated with nonaggressive diuresis.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,901
45
-
The variability of anginal radiation
Nasser Hayat, Mohamed Ali, Remya Pushparajan Subha, Hadeel Toufiq, Jadaan Al-Saddah
April-June 2021, 22(2):85-87
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_35_20
Aims:
The goal of this study was whether we could clinically anticipate the extent of CAD and whether we could determine the frequency of less common angina radiation in the population of stable angina group. We hypothesized that the extent of angina radiation (AR) may be related to ischemic burden.
Methods:
One hundred (100) consecutive patients referred for coronary arteriography were divided into 2 groups according to anginal radiation. The patients were divided into 2 broad categories. Those whose anginal discomfort limited to chest and back were assigned to group 1. If the anginal radiation was more widespread, then those patients were placed in group 2.
Results:
Forty-four (44) patients who had AR limited to chest and back radiation were classified to group 1. Fifty-six (56) were in more extensive radiation and were classified as group 2. In group 2, there were 15 patients whose AR extended to lower jaw, wrists or head. We labeled these 15 patients as remote radiation. Although group 1 and 2 differed clinically, no differences existed in the distribution of CAD. However, the 15 patients with remote AR had high sensitivity for multi-vessel CAD; but specificity was only 50%.
Conclusions:
Extensive radiation of anginal discomfort does not necessarily reflect diffuse disease of coronary vessels. However, if anginal discomfort reaches the lower jaw, wrists and head, it carries high sensitivity (93%) for multi vessel CAD. The radiation to remote sites constitute 15% of patients referred for coronary arteriography.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,842
50
-
CASE REPORTS
Electrocardiogram artifact in catheterizaton laboratory setting mimicking ventricular fibrillation: Stay vigilant
Mohamed Salah Abdelghani, Ahmad M Salem, Ammar Chapra, Fahd Alkindi
April-June 2021, 22(2):134-136
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_221_20
Electrocardiogram (ECG) is a reliable tool in the initial diagnostic workup of patients presenting to the Emergency Department (ED). However, it is not totally free of interference from artifacts due to various causes such as positional changes during capture, muscle contractions, limb tremors, etc., Such artifacts can have disastrous complications if they mimic arrhythmias and are treated as such. This case report describes two such patients in the catheterization laboratory (Cath lab) setting who developed ECG changes mimicking ventricular fibrillation. The first patient was shivering upon arrival to the Cath lab and developed ECG changes that were initially thought to be ventricular fibrillation. The patient received 2 DC shocks as a consequence. The ECG changes reflected artifacts caused by shivering and muscle activity. The second patient had similar changes induced by triggering the contrast injector during his coronary angiogram. These cases highlight the importance of staying vigilant for causes of artifacts in asymptomatic, hemodynamically stable patients, especially in Cath lab areas, where rapid management response is expected for optimal patient care.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,667
43
-
ORIGINAL ARTICLES
Comparison of long-term complications of using amplatzer ductal occluder and ventricular septal defect occluder for transcatheter ventricular septal defect closure
Mehdi Ghaderian, Negin Salemi
April-June 2021, 22(2):102-107
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_166_20
Background:
Ventricular Septal Defect (VSD) is the most common type of congenital heart disease and perimembranous type is the commonest form of these defects. Trans-catheter management of these defects is a challenging procedure.
Objectives:
The purpose of this study was to compare of Trans-catheter closure of perimembranous ventricular septal defect (PMVSD) using Amplatzer Ductal Occluder (ADO) and VSD occluder and their complications and follow-up.
Patients and Methods:
Between 2013 and April 2019, 69 patients underwent percutaneous closure of PMVSD using ADO (29 patients) and VSD occluder (40 patients). After obtaining the size of VSD from the ventriculogram at least 2 mm larger than the orifice diameter of VSD at the right ventricular side was chosen. The devices were positioned after verification of the proper device position by echocardiography, aortogram and left ventriculography.
Results:
The mean age of patients were 9.07 ± 7.73 years, mean weight 26.12 ±16.25 kg. The mean defect size of the right ventricular orifice and device sizes were 5.54 ± 1.83 mm 7.72 ± 1.94 mm respectively. Small residual shunts were seen at the completion of the procedure, but they disappeared during follow-up in all but one patient. Two patients had mild AI before the procedure in ADO group that disappeared during the follow-up. The mean follow-up period was 3.3 ± 1.7 years (range 1 to 6 years). Complete atrioventricular block (CAVB) was seen in one patient (VSD occluder) during the procedure that disappeared after the retrieval of the device. Major complication or death was not observed in our study.
Conclusions:
Trans-catheter closures of PMVSD with ADO or VSD occluder had similar effects in these patients and are safe and effective treatment associated with excellent success and closure rates. Long-term follow-up in a large number of patients is warranted.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,650
41
-
HISTORY OF MEDICINE
Evolution of surgical repair of patent ductus arteriosus - A historical timeline
Mohsin Yahya Murshid, Ahmed Abdelrahman Elassal
April-June 2021, 22(2):160-164
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_8_21
Congenital cardiac surgery is one of the most challenging and fascinating branches of modern medicine which continues to advance in areas and improving outcomes, post-operative and pre-operative care. Patent Ductus Arteriosus was the first congenital heart lesion to be successfully corrected surgically. The landmark surgery was performed by Dr. Robert E. Gross in 1938 and opened up the possibility of subsequent surgical correction of various other lesions, which were considered to be untreatable previously. The first successful surgical closure of persistent ductus arteriosus (PDA) was preceded by years of work and contributed by various surgeons, physicians, and anatomists, dating all the way back to the 1st century. They are all worthy of recognition and praise. This article covers the important events related to PDA lesions including its first identification, followed by its description in various texts and sources over the course of time, failed attempts at surgical correction, and disputes regarding credits. These contributions to the branch cannot be overstated and serves as an inspiration to cardiac surgeons all over the world and to students, interns, and newly graduated doctors as well, who would one day like to be part of this fascinating branch.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,580
42
-
ORIGINAL ARTICLES
Thrombolysis in acute pulmonary embolism: Are we overdoing it?
Refai Showkathali, Radhapriya Yalamanchi, Balasubramaniam Ramakrishnan, Abraham Oomman, Aruna Sivaprakash, Pramod Kumar
April-June 2021, 22(2):115-120
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_68_20
PMID
:7
Aim and Methods:
We aimed to study the clinical data and outcome of patients admitted in our center with acute pulmonary embolism (PE) over a 5-year period from May 2013 to April 2018. The main outcome data included were: in - hospital bleeding, in - hospital right ventricular (RV) function improvement, pulmonary arterial hypertension improvement, duration of hospital stay, and 30- and 90-day mortality.
Results:
A total of 114 (69 m, 55 f) patients with the mean age of 55 ± 15 years were included. Patients who had involvement of central pulmonary trunk called as “Central PE” group (
n
= 82) and others as “Peripheral PE” group (
n
= 32). There were more women in the peripheral PE group (53.1% vs. 34.1%,
P
= 0.05), while RBBB (22% vs. 3.1%,
P
= 0.02) and RV dysfunction (59.8% vs. 25%,
P
= 0.002) were noted more in the central PE group. Systemic thrombolysis was done in 53 patients (49 central, 4 peripheral), of which only 3 had hypotension and 28 patients were in the Intermediate-high risk group. The overall inhospital, 30-day, and 90-day mortalities were 3.6, 13.2, and 22.8%, respectively. Bleeding was significantly higher in the thrombolysis group compared to the nonthrombolysis group (18.9% vs. 0,
P
= 0.0003). However, improvement in pulmonary hypertension was noted more in thrombolysis group compared to nonthrombolytic group (49% vs. 21.2%,
P
= 0.01).
Conclusion:
This retrospective data from a tertiary center in South India showed that short- and mid-term mortality of patients with PE still remains high. The high nonguideline use of thrombolysis has been reflected in the increased bleeding noted in our study.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,530
40
-
CASE REPORTS
Not all postmyocardial infarction ventricular septal rupture need immediate surgery: Role of cardiogenic shock classification
Mohammed Azizul Hasan Khandaker, Prashanth Panduranga
April-June 2021, 22(2):141-145
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_138_20
A 56-year-old man presented with acute anterior ST elevation myocardial infarction. Initially he was thrombolysed at a peripheral hospital and a transthoracic echocardiography revealed multiple (2-3 mm) apical muscular ventricular septal defects suggesting ventricular septal rupture (VSR), with the largest measuring 10mm with left to right shunt and max gradient was 74 mmHg. His left ventricular ejection fraction was 45%. A coronary angiogram revealed tight proximal (95%) and mid segments (80%) stenosis in the left anterior descending artery (LAD) but diffusely diseased distally. Another significant stenosis (80%) was present at the ostium of the right posterior descending artery (r-PDA). He was in Society for Cardiovascular Angiography and Intervention (SCAI) cardiogenic shock Stage B, hence cardiac surgeons advised conservative medical treatment in order to stabilize the infarct area with view of good surgical outcome. Although, there was a dilemma between the surgeon and the cardiologist regarding timing VSR closure, classification of shock stages helped to delay surgery. Eventually, he was taken for surgery at the 18
th
day of admission with a graft to r-PDA rather to LAD (due to difficult visualization) and repair of VSR with Gortex patch. In conclusion, in all patients with post MI VSR, SCAI shock stages classification has to be applied in determining the timing of surgery.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,524
41
-
Unprotected left main primary PCI via distal transradial access in the setting of STEMI-related cardiogenic shock
Marcos Danillo Peixoto Oliveira, Ednelson Cunha Navarro, Glenda Alves de Sá, Adriano Caixeta
April-June 2021, 22(2):146-149
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_185_20
Despite all well-known benefits of transradial access, patients presenting with cardiogenic shock are usually submitted to coronary angiography and percutaneous coronary intervention via traditional transfemoral access, mainly due to challenge puncture of radial artery in the setting of hemodynamic instability. We report a challenging case of STEMI-related cardiogenic shock requiring primary PCI of an occluded and unprotected left main, safety, and successfully performed via right distal trans radial access in the anatomical snuffbox.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,508
44
-
Chronic total occlusion recanalization concurrent to culprit primary percutaneous coronary intervention via distal transradial access: Maximizing revascularization through minimalist approach
Marcos Danillo Peixoto Oliveira, Ednelson Cunha Navarro, Glenda Alves de Sá, Alen Cleber Monteiro, Adriano Caixeta
April-June 2021, 22(2):150-153
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_209_20
For ST-segment elevation myocardial infarction (STEMI) patients with multi-vessel coronary disease, complete revascularization is superior to culprit-only percutaneous coronary intervention (PCI). Chronic total occlusion represents the most challenging setting for PCI. Distal transradial access (dTRA) has advantages such as faster hemostasis and risk of proximal radial artery occlusion. We report a case of nonculprit coronary total occlusion recanalization concurrent to culprit primary PCI via dTRA in the setting of STEMI.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,504
48
-
Acute myocardial infarction attributed to coronary artery embolism in a patient with atrial fibrillation secondary to thyrotoxicosis - An underrecognized entity: A case report and literature review
Hossam Abed, Sundus Sardar, Mohamed Salah Abdelghani, Walid Khaleed Abdullatef, Abdul Rahman Arabi
April-June 2021, 22(2):137-140
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_202_20
Nonatherosclerotic causes of acute myocardial infarction (MI) are infrequent, with atrial fibrillation as the most common etiology in cases of embolic MI. This entity, however, along with other causes of coronary embolus remains underappreciated as a probable cause of acute coronary syndromes.
[1]
Our case delineates a rare presentation of STEMI due to cardioembolic origin secondary to atrial fibrillation in a patient with thyrotoxicosis, previously undiagnosed to have an abnormal cardiac rhythm.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,498
46
-
REVIEW ARTICLES
Clinical evidences and pathophysiology of cardiac arrhythmia in the era of Coronavirus Disease-2019
Adel Khalifa Sultan Hamad
April-June 2021, 22(2):121-126
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_15_21
The coronavirus disease-2019 (COVID-19) is primarily caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been a challenge to the clinician. Epidemiological studies unveiled the involvement of the cardiovascular system during the course of SARS-CoV-2 infection. The cardiac complications in patients with COVID-19 include myocarditis, heart failure, acute coronary syndrome, and cardiac arrhythmia. The pathophysiological states of the disease and multiple concurrent medications (unfamiliar to the clinicians) lead to a significant threat to arrhythmia. This review article hopes to elucidate the mechanisms of arrhythmias in COVID-19.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,466
44
-
CASE REPORTS
Twenty years' follow-up of a family with Marfan syndrome: A case series
Niloufar Valizadeh, Niloofar Rafatpanah, Farbod Hatami, Mohammad Hossein Davari, Toba Kazemi
April-June 2021, 22(2):154-157
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_88_20
Marfan syndrome is a rare connective tissue disorder manifesting with cardiovascular pathologies which are also the leading cause of death. Herein, we present the past 20 years follow up of a family with 17 members afflicted with Marfan syndrome. 3 members of the family were deceased and none were due to cardiovascular events. We assume to some extent traumas are a neglected cause for a part of mortality in Marfan syndrome.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,444
47
-
REVIEW ARTICLES
Atherosclerosis, ischemia, and anticancer drugs
Shailesh Singh, Katyayni Singh
April-June 2021, 22(2):127-133
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_45_20
The heart is affected by cardiotoxicity of anticancer drugs. Myocardium, pericardium and endocardium can be affected. Besides these coronary arteries can be affected by accelerated atherosclerosis. Various pathogenic mechanisms have been proposed that underlie the ischemic complications of anticancer drugs. In this review we discuss the atherosclerotic and ischemic complications of anticancer drugs.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,445
39
-
A PICTURE IS WORTH A THOUSAND WORDS
Expanding hematoma at the start of transcatheter aortic valve implantation procedure
Mohammad Alkhalil, Richard Edwards
April-June 2021, 22(2):158-159
DOI
:10.4103/HEARTVIEWS.HEARTVIEWS_220_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,334
39
-
Feedback
Subscribe
Sitemap
|
What's New
|
Feedback
|
Disclaimer
|
Privacy Notice
© Heart Views | Published by Wolters Kluwer -
Medknow
Online since 10
th
June, 2010