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   2018| July-September  | Volume 19 | Issue 3  
    Online since March 18, 2019

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Ranolazine: Multifaceted role beyond coronary artery disease, a recent perspective
Gopal Chandra Ghosh, Raktim Kumar Ghosh, Dhrubajyoti Bandyopadhyay, Krishnarpan Chatterjee, Ashish Aneja
July-September 2018, 19(3):88-98
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_18_18  PMID:31007857
Ranolazine is a piperazine derivative approved as an antianginal. Primarily used as a second-line antianginal in stable coronary artery disease. Ranolazine blocks the late Na + current and prevents the rise of cytosolic calcium. It decreases myocardial wall tension and improves coronary blood flow. Ranolazine is effective in atrial fibrillation (AF) as an adjunct to electrical or pharmacological cardioversion. It can be used in combination with amiodarone or dronedarone. It has also been used in AF arising after coronary artery bypass grafting surgery. Role of ranolazine is also being evaluated in pulmonary arterial hypertension, diastolic dysfunction, and chemotherapy-induced cardiotoxicity. Ranolazine has some anti-glycemic effect and has shown a reduction of hemoglobin A1c in multiple trials. The antianginal effect of ranolazine has also been seen to be more in patients with diabetes compared to those without diabetes. Ranolazine is being evaluated in patients with the peripheral arterial disease with intermittent claudication and hypertrophic cardiomyopathy. Pilot studies have shown that ranolazine may be beneficial in neurological conditions with myotonia. The evidence-base on the use of ranolazine in various conditions is rapidly increasing with results of further trials eagerly awaited. Accumulating evidence may see ranolazine in routine clinical use for many conditions beyond its traditional role as an antianginal.
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Full-blown rheumatoid heart and vessels associated with rheumatoid arthritis
Hyungseop Kim, In-Cheol Kim
July-September 2018, 19(3):102-105
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_145_17  PMID:31007859
We report the case of a 54-year-old female patient with a history of rheumatoid arthritis (RA) who presented with dyspnea on exertion. Her pulsation on both arms was weak. Magnetic resonance (MR) angiography revealed Takayasu's arteritis (TA) characterized by multiple stenosis involving innominate, left common carotid, and left subclavian arteries. With regard to cardiac imaging, coronary computed tomography angiography revealed calcified stenosis of the left anterior descending and diagonal branch arteries, with an abdominal aorta narrowed concomitantly. Restrictive diastolic dysfunction with concentric hypertrophic myocardium was observed on echocardiography, and cardiac MR imaging revealed diffuse, subendocardial late gadolinium enhancement compatible with cardiac amyloidosis (CA). Herein, we describe a case of RA with “full-blown” complications of TA, CA, and coronary artery disease.
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The pulse from ancient to modern medicine: Part 3
Rachel Hajar
July-September 2018, 19(3):117-120
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_16_19  PMID:31007864
  2 7,672 146
Study of nickel levels in patients with atrial septal defect undergoing amplatzer device closure
Ganesh Narayana, Ganavi Ramagopal, Bhanu Duggal, Narender Omprakash Bansal
July-September 2018, 19(3):85-87
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_76_17  PMID:31007856
Transcatheter closure of atrial septal defects (ASDs) using nickel titanium Naval Ordnance Laboratory (Nitinol)-containing devices (Amplatzer, AGA Medical, Golden Valley, Minnetosa) is being widely practiced. Controversies still exist regarding the release of nickel from these devices and the allergy and other ill effects of nickel and also the duration of antiplatelet therapy to aid endothelization of the device. Objective: To study the nickel levels in patients who underwent ASD closure with platinum-coated Nitinol-containing Amplatzer septal occluder. Methodology: A prospective study was conducted on 25 patients, between 6 years and 40 years of age who underwent ASD closure with Amplatzer septal occlude sizes ranging from 12 to 36 mm from January 2009 to January 2010. Blood nickel levels were estimated using atomic absorption photometry before and 24 h after the procedure and later at 1 month, 3 months, and 6 months postprocedure. A value of <2 mcg/dl was considered to be normal. Statistical analysis was performed by the use of the Wilcoxon test. Results: The blood nickel levels at mean baseline, 24 h, 1 month, 3 months, and 6 months postprocedure were 1.05, 1.39, 0.98, 0.79, and 0.74 (mcg/dl), respectively. Conclusions: Percutaneous ASD closure using Nitinol devices can be carried out safely without any significant ill effects related to nickel release.
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Design and rationale of gulf documentation of ambulatory sick patients with heart failure (Gulf DYSPNEA) registry
Mohammad Zubaid, Wafa Rashed, Mustafa Ridha, Mohammad Al-Jarallah, Adel Hamad, Rashed Al Banna, Kadhim Sulaiman, Nooshin Bazargani, Wael Almahmeed, Arif Al Mulla, Fahad Baslaib, Nidal Asaad, Sreeja Attur
July-September 2018, 19(3):81-84
Aim: The aim of this study is to describe the clinical characteristics of ambulatory patients with chronic heart failure (HF) in the Arabian Gulf and to examine several aspects including types of HF, causes, and adherence to management guidelines. Methods: Gulf documentation of ambulatory sick patients with HF (Gulf DYSPNEA) registry is a multicenter, cross-sectional study, recruiting adult ambulatory HF patients from 24 hospitals in five Arabian Gulf countries. Consecutive patients are recruited prospectively from participating clinics with no follow-up data collection. Recruitment started on November 07, 2016 and will stop when 3,500 patients are enrolled in this study. Collected data explore demographics, baseline patient characteristics, symptoms, previous medical history, comorbidities, physical signs, presenting electrocardiogram, echocardiographic findings, types of HF, and management. Conclusion: This registry is expected to provide useful data on several important aspects and features of ambulatory patients with chronic HF in Arabian Gulf countries. The trial registration number is “ number, NCT02793180”.
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Real-time imaging of aortic root rupture and cardiac tamponade in acute aortic dissection
Tomas Francisco Cianciulli, María Cristina Saccheri, Sergio Daniel Llanos Dethinne, Carlos Manuel Barrero, Víctor Miguel Mauro
July-September 2018, 19(3):114-115
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_33_17  PMID:31007862
  - 2,909 40
Should the humanities be incorporated in a doctor's education?
Rachel Hajar
July-September 2018, 19(3):116-116
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_17_19  PMID:31007863
  - 2,511 45
Glenn procedure in a baby with single pulmonary artery and single lung
Murat Ugurlucan, Didem Melis Oztas, Shiraslan Bahseliyev, Bahruz Aliyev, Yilmaz Yozgat, Emin Tireli, Ufuk Alpagut
July-September 2018, 19(3):106-108
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_19_18  PMID:31007860
Glenn followed by Fontan are still the main two procedures for the treatment of patients with single ventricle. Some patients may be challenging due to unfavorable cardiopulmonary anatomy. In this report, we present Glenn shunt procedure in a patient with single pulmonary artery and congenitally agenetic lung.
  - 3,034 57
Early recognition of acute pneumonitis in amiodarone treatment
Rishi Vinod Lohiya, Manoj P Pethe
July-September 2018, 19(3):109-113
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_22_18  PMID:31007861
Pulmonary complications of long-term amiodarone use are well known. However, acute pneumonitis causing respiratory distress with short-term administration of amiodarone although rare is associated with high mortality. Early diagnosis and treatment with glucocorticoids significantly decrease associated mortality and morbidity. We are reporting one such case of amiodarone-induced pulmonary pneumonitis and its complete resolution with short-course glucocorticoid therapy. Thus, every clinician prescribing amiodarone should be well acquainted with this entity.
  - 3,632 49
Dual communication of confluence of total anomalous pulmonary venous connection: An interesting but a rare entity
Gaurav Agrawal, Sitaraman Radhakrishnan
July-September 2018, 19(3):99-101
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_136_17  PMID:31007858
Here, we describe case of a 9-month-old male child who was diagnosed with a very unusual and rare variety of mixed total anomalous pulmonary venous connection.
  - 3,108 44