International Journal of Clinical Cardiology is an open access journal which publishes original clinical research in cardiology. This peer review journal publishes original articles, case reports and reviews targeted to cardiologists, cardiology researchers across the globe. The Journal welcomes submission of papers from experts, clinical academics and researchers. The journal publishes the latest findings in cardiovascular medicine, cardiovascular diseases and observational studies. The journal publishes original communications of scientific excellence concerned with clinical research on cardiology, clinical approach to the diagnosis and treatment of cardiovascular disease.
Through open access it expands shared knowledge across doctors; it provides the free, immediate, availability of the published work online. This journal also involved into publishing news with time by time developments and advances in research of various clinical advancements and their treatments. The journal also publishes all types of article like reviews, commentaries, case reports and many more. We mainly strengthen and request the authors to submit the results with the clear and detailed explanation to follow by the rigorous review process.
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Open Access DOI:10.23937/2378-2951/1410201
Hakan Duman, MD, Oğuzhan Bodur, MD and Yüksel Çiçek, MD
Article Type: Case Report | First Published: September 16, 2020
Use of intracardiac devices for heart diseases is increasing Worldwide. One of the important complications of pacemakers is infective endocarditis from the leads as the source. In this case, we report a 61-years-old male patient who is on dialysis and presented with implantable cardioverter defibrillator (ICD) lead endocarditis caused by Enterobacter Cloacae four months following implantation. Intracardiac devices are one of the predisposing conditions for infective endocarditis. It is known tha...
Open Access DOI:10.23937/2378-2951/1410200
Masakazu Hori, MD, Teruhiko Imamura, MD, PhD, Makiko Nakamura, MD, PhD, Masaki Nakagaito, MD, PhD and Koichiro Kinugawa, MD, PhD
Article Type: Case Report | First Published: September 03, 2020
Despite considerable improvement in the cardiac replacement therapy including durable left ventricular assist device and heart transplantation, some patients are not good candidates for such intensive therapies given their comorbidities. We had a 58-year-old patient with advanced heart failure who was assigned to INTERMACS profile 2 with progressive end-organ dysfunction refractory to inotropes. Following the detailed discussion, he decided not to receive cardiac replacement therapy dominantly g...
Open Access DOI:10.23937/2378-2951/1410199
Ruchika Meel, PhD, Liam Lorentz, FCRAD, Ricardo Goncalves, Bongane Ngutshane, MD and Shungu Mogaladi, MMED
Article Type: Case Report | First Published: September 03, 2020
Intra-Cardiac aneurysms are a rare entity. In the past case reports and series have described the entity of "annular sub-valvular left ventricular aneurysms" in patients of African descent. These authors proposed the aforementioned aneurysms to be of congenital aetiology. Majority of the time the aneurysms were located in the sub-mitral or sub-aortic positions and were diagnosed by echocardiography and ventriculography. Multiple discrete left ventricular aneurysms complicated by mitral valve per...
Open Access DOI:10.23937/2378-2951/1410198
Santosh Kumar Sinha, Puneet aggarwal and Umeshwar Pandey
Article Type: Case Report | First Published: August 31, 2020
Haematoma, dissection, local site granuloma, and persistent radial artery occlusion are few of the complications of conventional transradial access. The distal radial artery located in the fossa radialis or anatomical snuffbox on the dorsal side of the hand may be an attractive alternative to conventional radial stick. Here, we report a case of a 47-year-old diabetic male who presented with retrosternal chest pain and sweating of 2-hours duration, and diagnosed as acute inferior wall myocardial ...
Open Access DOI:10.23937/2378-2951/1410197
Anthony Weber, MD, Joseph Elliott, MD and Prabhakaran Gopalakrishnan, MD
Article Type: Case Report | First Published: August 20, 2020
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) with medical management and conservative therapies usually resulting in favorable outcomes. SCAD often is recurrent, especially in high risk individuals with underlying connective tissue disorders. Lethal ventricular arrhythmias have been reported in SCAD without clear indications for secondary prevention with implantable cardiovert-defibrillator (ICD). Depending on risk factor for recurrence as well a...
Open Access DOI:10.23937/2378-2951/1410194
Balakumaran V, Namrata H, Anirudhya and Nitin Rathod
Article Type: Research Study- Prospective Cohort | First Published: August 13, 2020
This study was conducted to reflect the clinical profile of patients presented to Emergency department (ED) with complications of acute coronary syndrome in developing country like India. This prospective cohort study was conducted in a cohort of 50 patients of acute coronary syndrome (ACS). They were followed up over duration of three months for the outcome. Male; smoker; age > 60 years; hypertension were representative risk factors for this cohort. More than 96% of patients presented w...
Open Access DOI:10.23937/2378-2951/1410196
Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF
Zameer Abedin, MS, MD, David Gough, MD, Moeen Abedin, MD, Tariq Siddiqui, MD, Debabrata Mukherjee, MD, Chandra P Ojha, MD, Zuber D Mulla, PhD and Zainul Abedin MD, FRCP(C), FHRS
Article Type: Original Research | First Published: August 14, 2020
Fifty-six patients, in whom computerized interpretation of the ECG resulted in the diagnosis of old IMI, and in whom imaging studies were also available, were included in this study. ECGs were interpreted using the MUSEGE system. These ECGs were also analyzed by manually measuring the depth and the width of the Q waves and morphology of ST and T-wave changes in inferior leads. Echocardiograms and nuclear medicine cardiac imaging were performed and interpreted using standard equipment and techniq...
Open Access DOI:10.23937/2378-2951/1410195
Angela Li, MD, Calvin Ngai, MD, Loukas Boutis, MD and Bani M Azari, MD, PhD
Article Type: Case Series | First Published: August 13, 2020
The pathophysiology of ST-elevation myocardial infarction (STEMI) is not well understood in Coronavirus disease 2019 (COVID-19). We present similar angiographic findings in two COVID-19 patients with STEMI. Despite percutaneous coronary intervention (PCI), distal coronary flow was not restored. The pro-thrombotic and inflammatory effects of COVID-19 may lead to myocardial infarction. The COVID-19 pandemic has caused a significant strain on global healthcare systems. STEMI management during this ...
Open Access DOI:10.23937/2378-2951/1410193
Ahmed Shahab and Maheep Sangha
Article Type: Case Report | First Published: July 31, 2020
A 76-year-old male with past medical history significant for prostate cancer (in remission), diabetes, hyperlipidemia and tobacco dependence but no identified coronary artery disease presented to emergency room complaining of Left abdominal and flank pain which started at rest. His initial work-up only revealed significant hematuria and his pain resolved IV Tylenol administration. The cause of hematuria was investigated with...
Open Access DOI:10.23937/2378-2951/1410192
Santosh Kumar Sinha, FACC, FAESC, FSCAI, Mahmodullah Razi, Umeshwar Pandey and Vinay Krishna
Article Type: Case Report | First Published: July 29, 2020
Pulmonary arteriovenous malformations are commonly treated by embolization with coils or balloons to prevent cerebral complications and to raise the oxygenation of the blood. The Cera vascular plug (Lifetech Scientific, Shenzhen, China) is a new vascular device made of a self-expanding cylindrical nitinol mesh. Here we report a case of a 13-year-old boy who had presented with 4 year history of progressive exertional dyspnoea, cyanosis, and clubbing. Pulmonary arterio-venous malformation (multipl...
Open Access DOI:10.23937/2378-2951/1410191
Saddam Yasin, MD, Kanwal Mehmood, MBBS and Osama Alsara, MD
Article Type: Case Report | First Published: July 29, 2020
Patients with history of mitochondrial disorders are at increased risk of having conduction disorders and cardiomyopathy and should have low threshold for pacemaker and implantable cardioverter defibrillator placement. Kearns Sayre syndrome is the result of deletions in mitochondrial DNA which causes bilateral pigmentary retinopathy and conduction abnormalities. Judicious use of implantable cardioverter defibrillator in this subset population with cardiomyopathy or prolonged QT interval is requi...
Open Access DOI:10.23937/2378-2951/1410190
John Jairo Araujo, MD
Article Type: Short Review | First Published: July 25, 2020
The novel coronavirus causes severe acute respiratory syndrome 2, and can infect any population. With the currently available information on the behavior of the pandemic, we conclude that the virus has come to stay. It is clear that the most aggressive behavior and worst outcome of the infection occurs in already established risk groups, such as those with cardiovascular disease. Those with congenital heart disease make up a special risk group. Due to this group’s high heterogeneity and the pa...
Open Access DOI:10.23937/2378-2951/1410189
Andrew M Smith, MD, Timothy G Petrie, MD and Brian J Page, MD
Article Type: Case Report | First Published: July 24, 2020
A 61-year-old male presented to the emergency department with a two day history of intermittent, burning chest pain which became constant and radiated to the left arm. His past medical history was significant for coronary artery disease with two prior myocardial infarctions, three prior cardiac stenting procedures (in 1999, 2001, and 2006), tobacco use with more than a forty pack year history, hypertension, hyperlipidemia, gastroesophageal reflux, cluster headaches, and an early family history o...
Open Access DOI:10.23937/2378-2951/1410188
Jinesh Bahubali Nagavi and Bannimath Gurupadayya
Article Type: Research Article | First Published: July 22, 2020
Proton pump inhibitors and statins reduce the effectiveness of clopidogrel in inhibiting the platelet aggregation. Clopidogrel, a prodrug adheres to CYP2C19, a hepatic enzyme to convert to its active metabolite in order to provide expected therapeutic action. Statins, mainly simvastatin metabolize through cytochrome P450 3A4, which also metabolizes clopidogrel partially. The combination of clopidogrel and PPI’s are co-administered in patients going through ST segment elevated Myocardial infarc...
Open Access DOI:10.23937/2378-2951/1410187
Yaser Khalid, DO , Neethi Dasu, DO, Herman Suga, DO, Kirti Dasu, BA, Debashis Reja, MD, Ankit Shah, DO, Donald McMahon, DO and Adam Levine, DO
Article Type: Meta-Analysis | First Published: July 10, 2020
Non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD) share similar risk factors. Recent studies have focused on obesity and insulin-resistance, but the link between NAFLD and CVD persists regardless of traditional risk factors. Despite the increased incidence and prevalence of NAFLD world-wide, there has been no thorough investigation of gender disparities nor a closer look taken into investigating the role gender may play in increased cardiovascular (CV) mortality inciden...
Open Access DOI:10.23937/2378-2951/1410186
Robert Abed, MD, MPH, Naveed Rajper, MD, Joseph Puma, MD and Justin Ratcliffe, MD
Article Type: Case Report | First Published: June 27, 2020
We present a 53-year-old male with a history of extensive peripheral vascular disease, including a repaired type B aortic dissection complicated by occlusion of the left subclavian artery requiring carotid to subclavian bypass. The patient then had a subsequent repair of a graft endoleak complicated by left iliac artery occlusion requiring fem-fem bypass. He presented to the ED with left foot pain concerning for acute limb ischemia needing for prompt revascularization. However, given the extensi...
Open Access DOI:10.23937/2378-2951/1410185
Ayman Hammoudeh, MD, FACC, Hadi Abu-Hantash, MD, FACC, Ramzi Tabbalat, MD, FACC, Eyas Al-Mousa, MD, FACC, Eyadeh Madanat, MD, Raad Al-Muhaisen, MD, Mahmoud Fakhri, MD and Imad A Alhaddad, MD, FACP, FACC
Article Type: Commentary | First Published: June 18, 2020
We examined the exposure to various triggering events among adults who presented with AMI (including ST-segment elevation MI [STEMI] and non-ST-segment elevation MI [NSTEMI]) to 6 tertiary care centers in Amman, Jordan during the Covid-19 imposed lockdown period from March 4 through June 1, 2020. Patients were enrolled if they reported exposure to at least one Covid-19 lockdown-related triggering event. Data obtained from patients or their immediate family members included baseline clinical char...
Open Access DOI:10.23937/2378-2951/1410184
atalia Lattanzio, MD, Qassem Abdelal, MD, Stephen Bell, MD, Talal Alkayali, MD, Christian Lorenzo, MD, Ricardo Villasmil, MD, Wilhelmine Wiese-Rometsch, MD and Manuel Gordillo, MD
Article Type: Case Report | First Published: June 18, 2020
Infective endocarditis (IE) is most commonly caused by species such as staphylococci, streptococcus and enterococci. When IE is caused by organisms such as Aerococcus urinae, misidentification of the organism in culture is common, resulting in misdiagnosis. We present a case of IE caused by Aerococcus urinae in a 67-year-old male with a bioprosthetic aortic valve whose culture initially grew micrococcus. Aerococcus urinae is a gram-positive catalase negative cocci that has been recognized as par...
Open Access DOI:10.23937/2378-2951/1410183
F Sawaya, A Zgheib, JS Karim and N Hachach-Haram
Article Type: Case Report | First Published: June 12, 2020
As COVID-19 spreads across the globe at an alarming pace, clinicians of all specialties are being forced to re-evaluate how they can continue to deliver the best quality of care to their patients during this turbulent time. Although elective procedures have been canceled indefinitely in many countries, urgent interventional cardiology procedures are still being performed. The interventional suite during COVID-19, however, is almost unrecognizable. Interventional suites used to be a welcome setti...
Open Access DOI:10.23937/2378-2951/1410182
Hayatu Umar, MBBS, MSc, FWACP, Simeon Alabi Isezuo, MBBS, MPH, FMCP, FESC, Muawiyya Zagga Usman, MBBS, FMCP, Adeshina A Yusuf, MBBS, Bello Tambuwal Umar, MBBS, MMED (Int. Med), Femi Akindotun Akintomide, MBBS, FMCP, Abdulaziz Aminu, MBBS, Aminu Sakajiki Muhammad, MBBS, MSc, FMCP, Abubakar Sadiq Maiyaki, MBBS, FWACP, Hamidu Muhammad Liman, MBBS, FMCP, Isah Omokhudu Oborien, MBBS, FMCP, Musa Baba Muhammad, MBBS, FWACP, Abdulmumini Yakubu, MBBS, FWACP, Samaila Bello, MBBS, Usman Muhammad Waziri, MB
Article Type: Original Research | First Published: June 12, 2020
Cardiovascular disease is a major cause of death among women of child bearing age in Northern Nigeria. As much as 60% of Peripartum Cardiomyopathy (PPCM) was reported among women with heart failures in a tertiary health institution in Sokoto, Northwestern Nigeria and was responsible for about 34% of deaths in peripartum women in South Africa. The Millennium and Sustainable Development Goals (MDG & SDG) 2000 to 2015 and 2015 to 2030, respectively have it as their cardinal quests, to reduce matern...
Open Access DOI:10.23937/2378-2951/1410181
Yaser Khalid, DO, Neethi Dasu, DO, Kirti Dasu, BA, Paul Jang, DO and Vivek Sailam
Article Type: Case Report | First Published: June 06, 2020
End-stage heart failure (HF) is defined as a lack of improvement of HF symptoms and frequent exacerbations despite maximal medical therapy. Current guidelines recommend against the use of Cardiac Resynchronization Therapy (CRT) as a rescue device in end-stage HF. CRT is a promising intervention for new-onset end-stage HF for patients who may be able to recover enough of their EF to restart goal-directed medical therapy (GDMT). This report highlights the promising clinical outcome of an unconvent...
Open Access DOI:10.23937/2378-2951/1410180
Olawale Adeyemi, BS, MD
Article Type: Commentary | First Published: June 03, 2020
There has been extensive research on developing a treatment regimen for COVID-19. Coadministering Chloroquine and Azithromycin have shown promising results in infected people. However, these medications have a peculiar side effect; QT prolongation. Physicians should be aware of the populations taking them and routine EKGs are recommended in these candidates. Since December 2019, there was an outbreak of a novel coronavirus disease (COVID-19), which was first reported in Wuhan, China. However, th...
Open Access DOI:10.23937/2378-2951/1410179
Yaser Khalid, DO, Neethi Dasu, DO and Kirti Dasu, BA
Article Type: Original Article | First Published: June 01, 2020
Tricuspid regurgitation is a poor prognostic marker of end-stage heart failure. Treatment options for severe tricuspid regurgitation are currently limited because these procedures have the highest mortality rates of all valve procedures. Isolated tricuspid valve surgery is reserved for rare cases during surgical viability evaluation with repair favored over tricuspid valve replacement, owing to the slightly more favorable mortality and downstream complication associated with the latter. Transcat...
Open Access DOI:10.23937/2378-2951/1410178
Allam Harfoush and Ousama Hayder
Article Type: Case Report | First Published: June 01, 2020
The patient was transferred from abroad hospital due to its medical costs, after performing a diagnostic CAG without PCI. However, the gentle-man did not have documents from his previous hospitalization but the videos of the CAG. Also, the patient has an undefined type of ACS due to the lack of information. The patient was asymptomatic when he consults the cardiovascular department in Tishreen University Hospital....
Open Access DOI:10.23937/2378-2951/1410177
Hema Balina, MD and Thomas Wool, MD
Article Type: Case Report | First Published: June 01, 2020
Acute Myocardial Infarction (AMI) during the early postpartum period is a rare event and carries a high mortality rate. We report an unusual case of Type A aortic dissection involving the left coronary ostium and presenting as anterolateral ST segment elevation myocardial infarction. Our patient was diagnosed to have aortic dissection at the time of left heart catheterization, and suffered a cardiac arrest prior to undergoing surgical intervention....
Open Access DOI:10.23937/2378-2951/1410176
Suleiman Suleiman, MB, BCH, BAO, JJ Coughlan, MB, BCH, BAO, MRCPI and Vincent Maher, MD, FRCPI, FESCFACC
Article Type: Review Article | First Published: May 16, 2020
High density lipoprotein cholesterol (HDL) has traditionally been considered athero-protective and has been associated with a reduced risk of atherosclerotic cardiovascular disease (ASCVD). This has led to an approach of increasing HDL levels in high risk patients. However, due the complexity of the HDL particle and its diverse role in inflammation and immunity, this simple approach may be detrimental to cardiovascular health. Recent analysis of large population cohorts has established a U-shape...
Open Access DOI:10.23937/2378-2951/1410175
Mary Gao, Justin Chin, DO, Gayathri Nagendiram, Derek Chen, Parth Rajyaguru, DO and Christine Lomiguen, MD
Article Type: Case Report | First Published: May 06, 2020
A 23-year-old Caucasian male presented to the emergency department after a 10-minute episode of dizziness, headache with visual aura, shortness of breath, palpitations, and chest pain after exercise, specifically running. Past medical history was significant for recent diagnosis of attention deficit hyperactivity disorder for which he was started on 54 mg Ritalin (extended release methylphenidate) three months prior. He denied any known congenital or structural heart disease, prior cardiac arrhy...
Open Access DOI:10.23937/2378-2951/1410174
Sharma Prachi, MD, DNB, Sethi Rishi , MD, DM, FACC, FESC, FRCP (Edin.), FCSAI, FAPSIC, MAMS, FCSI, FISC and V S Narain, MD, DM, FSCAI, FESC
Article Type: Commentary | First Published: April 29, 2020
While the world is badly hit by this SARS-CoV-2 pandemic, the cardiologists have a special role to play and risks too to bear. Patients with known cardiovascular diseases are at a risk of increased morbidity and mortality by this infection. Also, Covid-19 may present with varied cardiovascular manifestations. This puts the upfront managing cardiologist and his team at greater risk of catching infection. So, they need to find the best possible way to help such patients with minimum possible risk ...
Open Access DOI:10.23937/2378-2951/1410173
Abdulrahman S Museedi, MD, Mouhamed Nashawi, BS, Abdullah Ghali, BS, Aws Alameri, MD, Mustafa Al Qaysi, MD and Robert Nathanson, MD, FACP
Article Type: Observational study | First Published: April 20, 2020
The burden of cardiovascular disease within the United States is profound, with large volumes of economic and academic resources being utilized to treat patients with cardiovascular diseases. Myocardial infarctions (MI) represent one of the most acute forms of cardiovascular pathology, with a profound mortality rate if prompt treatment and medical attention is not sought out after. While elements of changes in clinical practice and the spurring of new guidelines are responsible for improved heal...
Open Access DOI:10.23937/2378-2951/1410172
Weiliang Huang, MBBS, MRCP
Article Type: Case Report | First Published: April 21, 2020
A 40-year-old Indian gentleman has a history of dilated cardiomyopathy secondary to viral myocarditis. He was treated with heart failure medications, received an automated implantable cardioverter-defibrillator in 2005, and left ventricular assist device (LVAD) in 2009. He subsequently underwent an orthotopic heart transplant in 2011 at the age of 34. The donor was a 38-year old male patient with a brain tumour, which was complicated by seizures that resulted in hypoxic-ischaemic encephalopathy....
Open Access DOI:10.23937/2378-2951/1410171
Danielle Louis E Villanueva, MD, Lauren Kay Evangelista, MD, Ma Cristina Espanillo-Villanueva, MD and John C Anonuevo, MD
Article Type: Research Article | First Published: April 10, 2020
Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demon...
Open Access DOI:10.23937/2378-2951/1410170
Jian Jing Tan, Sheldon Shao Guang Lee, Siang Chew Chai and Jason Jia Hao See
Article Type: Case Report | First Published: April 03, 2020
Fungal endocarditis is a notorious disease with a high mortality rate and commonly presents with embolic phenomenon. We report a case of prosthetic valve-related Aspergillus endocarditis with aortic root pseudoaneurysm that presented with acute limb ischemia. In addition, we highlight the significant morbidity that is associated with this fungal infection. With a high clinical index of suspicion and a multidisciplinary team approach, a favourable outcome can be achieved....
Open Access DOI:10.23937/2378-2951/1410169
Judit Ozse , Rainer Knur and Nicolas Von Beckerath
Article Type: Case report | First Published: March 24, 2020
Acute myocardial infarction is a major cause of death and disability worldwide. In general 4% to 7% of all patients diagnosed with AMI do not have coronary artery disease (CAD) at coronary angiography or autopsy. Embolisation as a mechanism of myocardial infarction is well known. Large diversity of aetiologies makes the precise diagnosis challenging. Its sources can be thrombi from left sided heart cavities, paradoxal embolism, tumors (myxoma, fibroelastoma), endocarditis (infective or nonbacter...
Open Access DOI:10.23937/2378-2951/1410167
Kareem M. M. Ibrahim, MBBCH
Article Type: Review Article | First Published: Feb 29, 2020
Hypertrophic cardiomyopathy is one of the major causes of cardiac death that affects 1 in every 500 persons worldwide. Surgical myectomy and alcohol septal ablation have been the gold standard well established procedures for the treatment of this condition. Starting 2004 a new procedure, radiofrequency septal ablation, has been applied and showed significant improvement in the NYHA classification as well as the left ventricular outflow tract (LVOT) gradients of these patients. With overall less ...
Open Access DOI:10.23937/2378-2951/1410166
Brinder S Kanda, MD, FACC, FSCAI, Nicholas E Hoyt , John Haas, MD, Houman Tavaf-Motamen, MD, Ronald Morford, MD, Tina Wesley, BSN, Kenneth Saum, MD and Michael MacCormac, MD
Article Type: Case Report | First Published: Feb 29, 2020
A middle-aged Caucasian woman presented with an ascending aortic pseudoaneurysm (AAP) located at the suture site of her previous surgical dissection repair. The pseudoaneurysm was located along the anterior aspect of the ascending thoracic aorta, above the right coronary cusp. We demonstrate successful percutaneous repair of the pseudoaneurysm using a ventricular septal occluder (VSO) and discuss the significance of this procedure for future cardiovascular care. A 56-year-old Caucasian woman wit...
Open Access DOI:10.23937/2378-2951/1410165
Numra Aleem, MD, Amna Qasim, MD and Ashraf M Aly, MD, PhD
Article Type: Case Report | First Published: February 26, 2020
Pericardial effusions (PE) in patients with Down syndrome (Trisomy 21) have been associated with hypothyroidism, viral infections and malignancies (particularly leukemia). The PE is usually not large enough to cause cardiac tamponade. We report two cases of idiopathic large PE with one of them progressing to develop a cardiac tamponade that required an urgent pericardiocentesis. A 3-year-old female with Trisomy 21 was seen at cardiology clinic for follow up of a small secundum ASD. Patient has b...
Open Access DOI:10.23937/2378-2951/1410164
Max E Valentinuzzi, EE, PhD and Luis Aguinaga Arriascu, MD
Article Type: Review Article | First Published: January 23, 2020
Atrial fibrillation (AF), not to be confused with atrial flutter, is the term used to describe an irregular or abnormal heart rate. While AF and atrial flutter are similar, AF has more serious health implications such as an increased risk of having a stroke or a blood clot (thrombosis). The resting heart rate of someone without AF is usually between 60 and 100 beats per minute but this number is usually over 100 in AF. It is usually the result of an underlying condition such as hypertension (hig...
Open Access DOI:10.23937/2378-2951/1410163
Robert W Murdock, DO, Todd Thomas, DO and David K Murdock, MD
Article Type: Case Report | First Published: December 13, 2019
Takotsubo syndrome (TTS) typically presents like an acute coronary syndrome and is commonly associated with acute physical and/or emotional stress. TTS is characterized by transient moderate to severe left ventricular (LV) dysfunction in the absence of obstructive coronary artery disease (CAD). Excessive beta adrenergic stimulation remains the most widely accepted theory to account for development of TTS. Importantly a variety of commonly used pharmacologic agents which enhance catecholaminergic...
Open Access DOI:10.23937/2378-2951/1410162
Han B Xiao, Waleed Arshad, Arvinder Kurbaan and Timothy J Bowker
Article Type: Research Article | First Published: November 27, 2019
First-degree AV block, though considered benign, has been reported to be associated with an increased risk for atrial fibrillation, permanent pacing, heart failure and allcause mortality. It is possible that the extent of PR prolongation indicates the severity of adverse outcome. This study investigated whether the length of PR and its change with heart rate can predict the need for permanent pacing. We retrospectively studied 21 patients with a PR over 270 ms. Nine patients underwent permanent ...
Open Access DOI:10.23937/2378-2951/1410161
Asif Surani, MD, Beatriz Martinez Quintero, MD, David Brual, MD, Hadi Elias, MD, Fahad Uddin Ahmed, MD and Matthew Peters, MD
Article Type: Case Report | First Published: November 25, 2019
Rivaroxaban is a direct oral anticoagulant with a favorable safety profile when compared to warfarin in respect to bleeding. During post-marketing surveillance, intracranial and retroperitoneal bleedings have been reported; however, hemopericardium has not been frequently described. In this case series, we present three cases of spontaneous hemopericardium where rivaroxaban was thought to be the causative agent. Predisposing factors for rivaroxaban induced hemopericardium might include impaired ...
Open Access DOI:10.23937/2378-2951/1410160
Valerio Massimo Magro, MD, Carla Coppola, MD, Eugenio Boccalone, MD, Michele Caturano, MD, Giovanni Scala, MD and Walter Verrusio, MD, PhD
Article Type: Commentaries | First Published: October 14, 2019
Thiazide diuretic drugs are the most commonly used molecules for the treatment of systemic hypertension. Despite their established role in the treatment of this disease, well recognized by the guidelines of national (such as the Italian Society of Cardiology - SIC - for example, which incorporates the directives of the European Society of Cardiology - ESC -) scientific societies. Several evidences have shown that hydrochlorothiazide therapy in chronic renal disease with advanced grade of kidney ...
Open Access DOI:10.23937/2378-2951/1410159
Ramazan Asoglu, Abdulmecit Afsin, Emin Asoglu3 and Arif Suner
Article Type: Research Article | First Published: September 26, 2019
Inflammation and platelet activation play a central role in the initiation and progression of the atherosclerosis process. The Platelet-to-lymphocyte ratio (PLR) is a new prognostic marker in coronary artery disease. The PLR is a significant independent predictor of longterm mortality after none-ST elevated myocardial infarction (NSTEMI). We aimed to evaluate the relationship between PLR and no-reflow (NR) in patients with NSTEMI. The present study included 173 patients with NSTEMI. The patients...
Open Access DOI:10.23937/2378-2951/1410158
Walid Hassan, MD, MACP, FACC, FSCAI, Amr Aljareh, MD, Mariam Hassan, Khaldoun Al Saadi, MD and Sahar Sharaf Eldin, MD
Article Type: Case Report | First Published: September 23, 2019
Atherosclerotic disease in one arterial site, raise the probability of having other sites affected by about 50% within the vascular axis. Hence once vascular pathology found in one site i.e. coronary artery disease (CAD), other sites i.e. Cerebral and peripheral circulation must be assessed thoroughly, especially in patients with multiple risk factors. Percutaneous intervention (PCI) is a conservative reasonable solution for high risk and inoperable cases; sometimes it supersedes the choice surg...
Open Access DOI:10.23937/2378-2951/1410157
Abdulhalim Jamal Kinsara
Article Type: PATIENT CARE | First Published: September 21, 2019
Advanced cardiac life support (ACLS) has been made with many algorithms. We are suggesting a simple combined one as a time frame expected to attend is minutes and maintaining coherent neurological status is crucial. In institutions with multiple nationalities, the way in which ACLS is taught might vary and the time frame expected to attend the important minutes in saving a life and maintaining coherent neurological status might been delayed....
Open Access DOI:10.23937/2378-2951/1410156
Robert Tonks, MD, Rajiv Sharma, MD and Raj Baljepally, MD, FACC
Article Type: Case Report | First Published: August 26, 2019
Congenital anomalies of the coronary vasculature are usually asymptomatic and rare with an incidence of less than 1% and there are few cases reported of congenital absence of the left circumflex artery. It is important to recognize this anomaly and define the anatomy by left heart catheterization or coronary angiography by computerized tomography when considering percutaneous intervention or coronary artery bypass surgery on patients without a left circumflex artery. 71 yo male that recently mov...
Open Access DOI:10.23937/2378-2951/1410155
Taeko Sato, RN, Issei Yoshimoto, MD, Naoya Oketani, MD, Hideki Okui, MD, Yasuhisa Iriki, MD, Hitoshi Ichiki, MD, Ryuichi Maenosono, PhD, Fuminori Namino, MT, Masaaki Miyata, MD and Mitsuru Ohishi, MD
Article Type: Original Article | First Published: August 14, 2019
Catheter ablation is an effective approach for managing patients with atrial fibrillation (AF). Currently, irrigation catheters are widely used in AF ablation. This causes volume overload during the procedure and occasionally causes heart failure after the procedure. Volume overload during catheter ablation caused heart failure not only in the patient with reduced ejection fraction but also who with preserved left ventricular ejection fraction. Heart failure with preserved left ventricular eject...
Open Access DOI:10.23937/2378-2951/1410154
Syed Haseeb Raza Naqvi, MBBS, FCPS, Han Naung Tun, MBBS, MD, Abdul Razzaq, MBBS, FCPS, Zubair Zaffar, MBBS, FCPS, Syed Nauman Ali, MBBS, FCPS, Haroon Babar, MBBS, FCPS and Tariq Abbas, MBBS, FCPS, FRCP
Article Type: Research Article | First Published: August 09, 2019
A total of 115 patients were included in the study. The mean age of patients was 62.40 years with standard deviation of 2.78 years. Majority of the patients in the study were male (68.7%). Mean ABI was of study participants was 1.2 with standard deviation of 0.58 while mean duration of disease was 3.2 years with standard deviation of 0.7 years. 97 of the study participants were hypertensive and 18 were smokers. A total of 28 patients (24.3%) did not have CAD as per angiography while the rest had...
Open Access DOI:10.23937/2378-2951/1410153
Abdulmecit Afsin, MD, Veysi Kavalcı, MD, Zeynep Ulutas, MD, Hakan Kaya, MD, Erdal Akturk, Arif Suner and Necip Ermis
Article Type: Original Article | First Published: August 03, 2019
Transcatheter aortic valve implantation (TAVI) has become a novel therapeutic option for patients with severe aortic stenosis who have been considered inoperable or high risk for conventional surgical aortic valve replacement. The aim of this study was to determine the effect of TAVI on neutrophil to lymphocyte ratio (NLR). A total of 97 patients with severe aortic valve stenosis undergoing TAVI in our clinic were included in the study. The patients were divided into two groups based on valve t...
Open Access DOI:10.23937/2378-2951/1410152
Nicolo Sisti, MD, Giulia Elena Mandoli, MD, Antonio Pagliaro, MD, Giuseppe Guerrieri, MD, Carlotta Sciaccaluga, MD, Matteo Cameli, MD, PhD, Sergio Mondillo, MD and Serafina Valente, MD
Article Type: Case Report | First Published: July 18, 2019
Spontaneous coronary artery dissection (SCAD) should always be suspected in presence of chest pain during post-partum, since it is one of the possible causes. Strategies for the management of such disease and its complication are not still clearly encoded. A 40-years-old woman was referred with chest pain, started while breastfeeding, associated with an EKG pattern suggesting ischemia. After hospital admission, coronary angiography was performed showing a Type 1 left main coronary dissection. Gi...
Open Access DOI:10.23937/2378-2951/1410151
Christian Grebmer, Carsten Lennerz, Amir Brkic, Patrick Blazek, Severin Weigand, Verena Semmler, Marc Kottmaier, Felix Bourier, Lena Friedrich, Elena Risse, Stephanie Brooks, Marie Kornmayer, Marta Telishevska, Tilko Reents, Christof Kolb, Gabriele Hessling and Isabel Deisenhofer
Article Type: Research Article | First Published: June 19, 2019
Spontaneous echo contrast (SEC) in the left atrial appendage (LAA) is associated with an increased risk of cerebral embolism in patients with atrial fibrillation (AF). Novel oral anticoagulants (NOACs) are increasingly prescribed as first-line therapy and have shown a comparable benefit-risk ratio compared to vitamin K antagonists (VKAs). The aim of this study was to investigate whether NOACs decrease the incidence of SEC compared to VKA. ...
Open Access DOI:10.23937/2378-2951/1410150
Maria E Franco-Fuenmayor, MD, Numra A Aleem, MD, Jorge D Salazar, MD, and Ashraf M Aly, MD
Article Type: Case Report | First Published: June 13, 2019
Isolated partial or complete absence of the coronary sinus roof hemodynamically behaves like an atrial septal defect and rarely causes pulmonary hypertension. We report a case of unroofed coronary sinus (URCS) presenting with post-operative cyanosis due to pulmonary hypertensive crisis following surgical repair of a ventricular septal defect at 6 months of age. He had progressively decreased stamina with gradual increase in pulmonary pressure requiring surgical closure of the URCS by 6 years of ...
Open Access DOI:10.23937/2378-2951/1410149
Ismail Mohamed Ibrahim, Ahmed S Eldamanhory, Mahmoud Abdelaziz and Abdelrashid Abdelaziz
Article Type: Research Article | First Published: June 05, 2019
In ST elevation myocardial infarction (STEMI), intracoronary thrombolysis after primary percutaneous coronary intervention (PPCI) was found to improve microvascular perfusion, yet without improvement in left ventricular (LV) remodeling. Our study aimed to find out possible effect on LV longitudinal function. 102 anterior STEMI patients eligible for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated ...
Open Access DOI:10.23937/2378-2951/1410148
Sara Khodor, Shreya Mishra, Dany Sayad and Anant Kharod
Article Type: Case Report | First Published: June 01, 2019
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alt...
Open Access DOI:10.23937/2378-2951/1410147
Maria Carolina Neves, Luis Sette, Monica Becker, Lucila Valente and Brivaldo Markman Filho
Article Type: Research Article | First Published: June 01, 2019
The presence of structural and functional changes in the left ventricle (LV) are good predictors of cardiovascular events in patients with chronic kidney disease (CKD) and are associated with decreasing renal function. Studies in CKD patients on hemodialysis evidenced associations of serum 25-OH vitamin D (vit D) with myocardial function and structural changes. However, it is not known whether serum vit D is associated with Doppler echocardiogram (ECHO)-based cardiac changes in patients with CKD...
Open Access DOI:10.23937/2378-2951/1410146
Abdulhalim Jamal Kinsara
Article Type: Original Article | First Published: June 01, 2019
Significant improvement in control of cardiovascular risk factors has been driven by performance measurement that focused on attainment of specific risk factor thresholds for blood glucose, lipids and blood pressure. Diet, statin and ezetimibe have reasonably controlled hyperlipidemia. However the discovery of proprotein convertase subtilisin-kexin type 9 inhibitors has given new hope of reaching the target lipid profile especially in the high-risk group and familial hypercholesterolemia. Here w...
Open Access DOI:10.23937/2378-2951/1410145
Ambrin Farizah Babu
Article Type: Review Article | First Published: May 31, 2019
Pulmonary hypertension is a life threatening incurable disorder. The advances in physiology, genetics, and molecular biology have greatly improved our understanding of the cellular and molecular mechanisms underlying the disorder. In this review, the recent progresses in the understanding of molecular mechanism are presented. Many studies show that pulmonary hypertension is caused due to mitochondrial dysfunction, endothelin-1, prostacyclin and serotonin. These findings and their exploitation wi...
Open Access DOI:10.23937/2378-2951/1410144
Article Type: Review Article | First Published: May 30, 2019
Infective endocarditis (IE) defined as an infection caused by bacteria that enter the bloodstream and settle in the endocardium, a heart valve or a blood vessel, has maintained a high prevalence, morbidity and mortality over the past few decades. The most obvious changes over time have been in terms of factors that lead to IE. For e.g. A larger elderly population, decrease in Rheumatic heart disease (RHD) cases, Increased use of prosthetic heart valves, increased intravenous drug abuse, and incr...
Open Access DOI:10.23937/2378-2951/1410143
Liew Boon Wah Matthew, Lee Shao Guang Sheldon and Lim Yaozong Benji
Article Type: Case Report | First Published: May 04, 2019
Giant coronary artery aneurysm is an uncommon finding during coronary angiogram. There is limited data or consensus on the management of patients with giant coronary artery aneurysm in the setting of acute coronary syndrome. We present a unique case of a recurrent thrombotic occlusion of the right coronary artery presenting as recurrent inferior wall ST segment elevation myocardial infarction (STEMI) requiring percutaneous coronary intervention. He had failed trial of novel anticoagulant with an...
Open Access DOI:10.23937/2378-2951/1410142
Arianna Cirasa, MD, Antonio Popolo Rubbio, MD, Paolo Zappulla, MD, Angelo Di Grazia, MD, Daniela Dugo, MD, Salvatore Scandura, MD, Sarah Mangiafico, MD, Carmelo Grasso, MD, Corrado Tamburino, MD, PhD, Davide Capodanno, MD, PhD and Valeria Calvi, MD, PhD
Article Type: Research Article | First Published: April 03, 2019
This study sought to evaluate the clinical outcome in cardiac resynchronization therapy (CRT) patients with residual moderate-to-severe functional mitral regurgitation (FMR) who underwent percutaneous treatment with the Mitraclip System or were managed with medical therapy alone. Significant FMR can persist in 20-25% of patients after CRT and its management can be a challenge, due to the advanced heart failure (HF) and a variety of concomitant comorbidities. From a single center, two different g...
Open Access DOI:10.23937/2378-2951/1410141
Article Type: Case Report | First Published: March 25, 2019
The case of a 52-year-old female patient is reported who suffered aborted sudden cardiac arrest, got layman’s resuscitation, and then defibrillation into normal sinus rhythm with temporary right precordial ST segment elevation. The patient was admitted to hospital, the diagnosis of early-stage arrhythmogenic cardiomyopathy by ECG, echocardiography and left ventricular, right ventricular and coronary angiography was made. Echocardiography findings revealed dilatation of the right ventricular ou...
Open Access DOI:10.23937/2378-2951/1410140
Haitham Galal Mohammed, MD, Mohammed Ahmed Abdelrahman, MD and Tarek Rashid Mohammed, MD
Article Type: ORIGINAL ARTICLE | First Published: March 06, 2019
Worldwide, the prevalence of vitamin D deficiency is as high as almost 50% among the elderly and the association between vitamin D and heart failure is widely debated. To study the relation between serum 25-hydroxy vitamin D levels and echocardiographic parameters of cardiac function in heart failure patients with cardio-renal syndrome. The study included 90 patients of all age groups and both sexes. They were divided into 3 groups of patients: 1: Systolic dysfunction and renal insufficiency (30...
Open Access DOI:10.23937/2378-2951/1410139
Putri Yubbu, Ong Yun Jin, Mohd Amin Itam, Hamdan Leman and Koh Ghee Tiong
Article Type: CASE REPORT | First Published: March 04, 2019
Superior vena cava (SVC) obstruction is a recognized complication following cardiac surgery that may result in significant clinical sequelae if not treated early. Transcatheter stenting is rapidly becoming the treatment of choice, considering its reduced post-procedure morbidity and faster recovery time. In early postoperative vascular lesion, primary stenting is preferred over balloon angioplasty to prevent fresh suture line disruption. In paediatric, small patient sizes as well as the need for...
Open Access DOI:10.23937/2378-2951/1410138
Jae-Jin Kwak, Joon Hyung Doh and Sung Yun Lee
Article Type: CASE REPORT | First Published: February 27, 2019
Wolff-Parkinson-White (WPW) syndrome can develop paroxysmal supraventricular tachycardia (PSVT) or/and paroxysmal atrial fibrillation (AF). AF in WPW syndrome is a potentially life-threatening arrhythmia. Radiofrequency catheter ablation is recommended in patients with AF in WPW syndrome. Atrioventricular nodal blockers can precipitate ventricular fibrillation and should not be used. We present patients with PSVT and AF in WPW syndrome who was treated with bisoprolol and flecainide. ...
Open Access DOI:10.23937/2378-2951/1410137
Article Type: ORIGINAL ARTICLE | First Published: February 14, 2019
Brugada syndrome is characterized by coved-type ST-segment elevation in one or two right precordial leads. Two types of coved-type ST elevation has been described: A form of complete right bundle branch block (about 60%), in which right precordial leads demonstrate complete block and left precordial leads reveal nearly normal QRS configuration. In about 40% complete right bundle branch block with nearly identically increased QRS intervals....
Open Access DOI:10.23937/2378-2951/1410136
Ibrahim AlQassas, MD, Walid Hassan, MD, MACP, Nadia Sunni, MD, Mohammed Lhmdi, MD, Alaa Nazzal, MD, Mohammed J Mohamed, Farhan Dar, MD, Sahar Sharafeldin, MD, Amr Aljareh, MD, Hasan Balubaid, MD, Basema Alshengiti, MD, Ehab Hasan, MD, Heba Waez, MD, Sarah Bahnshal, MD, Momen Nassani, MD, Mohammed Al-Kulak, MD, Maha AlKudsi, MD, Hala Zein Elabidinm, MD and Ibrahim Mansour, MD
Article Type: RESEARCH ARTICLE | First Published: February 14, 2019
Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no correlation was found between age and troponin levels (the statistical number r value needs to be put here). Although expectedly patients with diagnosis of acute coronary syndrome displayed TnT-HS values significantly higher than those of other groups, positivity to TnT-HS (> 40 ng/l) was also observed in patients with other clinical conditions....
Open Access DOI:10.23937/2378-2951/1410135
Veronica Hernandez Jimenez, Aranzazu Garcia Romero and Jesus Saavedra Falero
Article Type: Case Report | First Published: January 16, 2019
Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) are two causes of acute non-arteriosclerotic myocardial infarction. These two entities share some characteristics such as greater involvement in women, preceded by an emotional stressor and an etiopathogeny not clearly known. Recently it has been seen that these two entities may be related. We describe a case of a young woman with a myocardial infarction due to a SCAD who developed a TTS. A 44-year-old woman, without know...
Open Access DOI:10.23937/2378-2951/1410134
Gil Ramirez Andreina, Burgos Lucrecia Maria, Chillik Ivan Ezequiel, Pelletier Maria, Larocca Calvino Mariana, Spaletra Pablo and Elizari Maria Amalia
Article Type: Case Report | First Published: January 14, 2019
The incidence of CF is 0.002% of general population, observed in 0.2% of adult patients undergoing coronary angiography. More frequently of congenital origin, they have also been described related to invasive procedures, chest trauma or post myocardial infarction. In 55% of cases they are originated from the right coronary artery, in 35% from left coronary artery and 5% in both simultaneously. Seventy percent of CF drain into right cavities (low pressure circuits), 15% into pulmonary artery and ...
Open Access DOI:10.23937/2378-2951/1410133
Sung Yun Lee, Sang-Wook Kim, Jin Bae Lee, Eun-Seok Shin, Joon Hyung Doh, Young Joon Hong, Jae-Jin Kwak and Hyung Yoon Kim
Article Type: Research Article | First Published: December 24, 2018
The objective of this study is to investigate pre-intervention IVUS characteristics of in-stent restenosis (ISR) lesion correlated with PEB failure. We performed pre-intervention IVUS for 58 patients with ISR and treated with PEB angioplasty. The PEB failure was defined as death, myocardial infarction and symptom driven revascularization. IVUS images were analyzed at 6 locations: Proximal and distal vessel segment within 3 mm from stent edge, proximal and distal stent edge, lesion site at minima...
Open Access DOI:10.23937/2378-2951/1410132
Guglielmo Stefanelli, Fabrizio Pirro, Andrea Macchione, Gianpiero Patrizi, Luca Weltert and Andrea Barbieri
Article Type: Original Article | First Published: December 22, 2018
Aim of this study was to evaluate by transthoracic echo the hemodynamic behaviour and the changes in dimensional data of a stentless aortic bioprosthesis between rest and exercise conditions. se of exercise echocardiography to assess changes in hemodynamics and function of aortic bioprostheses can be helpful in the choice of appropriate aortic valve substitutes. SPF pericardial stentless valve presents favourable and durable hemodynamic characteristics at rest and on exercise, similar to native ...
Open Access DOI:10.23937/2378-2951/1410131
John Jairo Araujo
Article Type: Short Review | First Published: December 01, 2018
Congenital heart disease is the most frequent malformation. In the most recent data has a prevalence of thirteen cases per 1,000 children and six cases per 1,000 adults. Great strides in pediatric cardiovascular surgery have increased the number of survivors, especially in adulthood. Nowadays more adults are living with congenital heart disease than children, particularly in developed countries, and more than two thirds fall into the categories of moderate and high complexity defects. This growi...
Open Access DOI:10.23937/2378-2951/1410130
Ksenija Stevanovic, Ranko Trailovic, Biljana Kukic, Marko Dragas, Slobodan Cvetkovic and Lazar Davidovic
Article Type: Case Report | First Published: November 12, 2018
Carotid sinus syndrome (CSS) is defined as syncope with reproduction of symptoms during 10s of carotid sinus massage. The etiology of this condition is unknown, patients are usually symptomatic and present with episodes of syncope. Due to the associated marked sinus bradycardia, sinus arrest or severe hypotension, carotid sinus syndrome may be life-threatening. In patients without previous symptoms, CSS must be promptly recognized and treated, otherwise may lead to catastrophic consequences. If ...
Open Access DOI:10.23937/2378-2951/1410128
Sahin Iscan and Bortecin Eygi
Article Type: Research Article | First Published: November 07, 2018
Cerebral protection is a big technical difficulty for aortic surgery. Increased use of antegrade cerebral perfusion (ACP) and deep hypotermic circulatory arrest in experienced hands made open surgery of the ascending aorta and aortic arch aneurysms more successful today. The increase in the variety of surgical equipment to provide unilateral and bilateral cerebral perfusion or monitorization, the effectiveness of the cerebral protection instantly decreased the risk of perioperative stroke or pos...
Open Access DOI:10.23937/2378-2951/1410127
Simon W Rabkin
Article Type: Review Article | First Published: November 07, 2018
The optimal method to correct the QT interval, an important indication of arrhythmia risk, for the impact of heart rate has been controversial. The fundamental biologic relationship of the QT interval-heart rate relationship has rarely been studied across different species. The literature on the QT and heart rate of 32 different species was examined specifically in the whales, dolphins, Asian elephants, rhinoceros, camels, brown bears, grizzly bear, lions, tigers, sea lions, seals, donkeys, poni...
Open Access DOI:10.23937/2378-2951/1410126
Article Type: Case Report | First Published: October 24, 2018
A few case reports found an association between left ventricular apical ballooning and transient thromboembolic occlusion in myocardial bridging of the mid-portion left anterior descending coronary artery. In two additional, so far unpublished case reports distal or mid-portion thromboembolic occlusion of the left anterior descending coronary artery and the first diagonal branch were described. Both cases had a tragic outcome-either due to myocardial perforation or disseminated intravascular coa...
Open Access DOI:10.23937/2378-2951/1410125
Manabu Nitta, Teruyasu Sugano, Yusuke Matsumoto and Munetaka Masuda
Article Type: Case Report | First Published: October 11, 2018
A 38-year-old male with previous surgeries for an incomplete atrioventricular septal defect successfully underwent percutaneous transcatheter tricuspid balloon valvuloplasty for a deteriorated bioprosthetic valve. Our case highlights the imperative of considering catheter-based minimally invasive therapy for the increasing number of adults with congenital heart disease who may present multiple risks factors for surgery....
Open Access DOI:10.23937/2378-2951/1410124
Amit C Shah, Srijan Shrestha and Mark Rosenthal
Article Type: Case Report | First Published: September 29, 2018
This is a rare case of a 53-year-old woman with history of oophorectomy and hysterectomy 3 years prior to presentation admitted for gait abnormality and found to have a basal ganglia stroke. Transthoracic echocardiogram for stroke work up revealed a cardiac mass in the right atrium emanating from Inferior Vena Cava (IVC). Computed Tomography imaging of abdomen and pelvis ruled out malignancy. The mass was surgically removed due to high risk of embolization. Intraoperative, transesophageal echoca...
Open Access DOI:10.23937/2378-2951/1410123
Gurkirat Singha, Hemant Khemani, Zahidullah Khan and Narender Omprakash Bansal
Article Type: Case Report | First Published: September 27, 2018
Twiddler's syndrome is a rare complication after pacemaker implantation. It is caused by conscious or unconscious manipulation at the implantation site by the patient with the result of device malfunction. It results in lead dislodgment, diaphragmatic stimulation, and loss of capture. In a pacemaker dependent patient, it can be a lethal complication. It usually occurs in the first year following pacemaker implantation. The treatment involves readmission, repositioning of the dislodged leads and ...
Open Access DOI:10.23937/2378-2951/1410122
Ines Monte, Francesco Calvo, Giovanni Millan, Vincenzo Lavanco, Corrado Tamburino
Article Type: Original Article | First Published: September 24, 2018
Chronic total coronary occlusions (CTO) are found in approximately 15-30% of patients who undergo coronary angiography for suspected or known coronary artery disease. Speckle Tracking Echocardiography (STE) is a novel technology to assessing modifications of myocardial deformation with higher accuracy than the simple visual of regional wall motion. The study was to evaluate, using STE applied to dobutamine stress echocardiography (DSE), changes in echo parameters before and after successful reca...
Open Access DOI:10.23937/2378-2951/1410121
Ali Buturak, Ulaankhuu Batgerel and Duhan Fatih Bayrak
Article Type: Case Report | First Published: September 24, 2018
Femoral artery aneurysm is a rarely seen peripheral aneurysm which may lead to thrombosis, embolism and fatal rupture in untreated cases. Although femoral artery aneurysm is usually caused by atherosclerosis or chronic inflammation, aneurysm formation in sites of anastomosis, grafts or endarterectomy territory may occur at late term. A 57-years-old man presenting with stable angina pectoris was admitted for coronary angiography with documented ischemia in exercise stress test. The patient had a ...
Open Access DOI:10.23937/2378-2951/1410120
Blanca Alcon Duran
Article Type: Case Report | First Published: June 25, 2018
Bioprosthetic valve thrombosis (BPVT) is considered to be a rather unusual complication among this type of prosthesis. However, several recent data show the importance of a careful diagnosis and the adequate discrimination with respect to other possible complications, which may be the cause of an underestimation of its incidence. We present the case of a woman with biological prosthesis thrombosis after a mechanical prosthesis thrombosis....
Open Access DOI:10.23937/2378-2951/1410119
Zain Sharif, Cian O' Carroll-Lolait, David Moore and Bryan Loo
Article Type: Case Report | First Published: June 04, 2018
A 65-year-old caucasian man with a history of aortic valve replacement with a St. Jude bi-leaflet mechanical prosthesis in 1984, mitral valve replacement in 2004 with Edwards Starr Ball and Cage prosthesis, atrial fibrillation and ulcerative colitis presented to our emergency department with central chest pain radiating to his jaw with associated diaphoresis and nausea. Symptom onset was an hour pre-admission....
Open Access DOI:10.23937/2378-2951/1410118
Evan D Levine, Arber Kodra, Rachel M Bond, Fadi Khoury, Dan Inder S Sraow and Georges Y Nseir
Article Type: Case Report | First Published: June 04, 2018
Iatrogenic aortic dissection is a rare complication of both diagnostic and interventional coronary angiography. In the few case studies that have been reported in current medical literature, surgical management was generally opted for; however, with poor overall outcomes. Given these unfavorable outcomes, a different treatment strategy should be considered. We report a case of iatrogenic aortic dissection successfully treated with intensive medical therapy and utilization of a multi-modality ser...
Open Access DOI:10.23937/2378-2951/1410117
Miguel Montero-Baker, Bernadino Castelo Branco Rocha, David G Armstrong, Kay R Goshima, John Miller and Joseph L Mills Sr
Article Type: Original Article | First Published: June 04, 2018
Diabetic foot ulcers are common, costly, frequently recurrent and chronic. Once infected they all too often are the precursors of major limb amputation. Increased pressure decreased angiogenic response, neuropathy, trauma and deformity all contribute in varying degrees to the pathogenesis of these ulcers. Patients with limited mobility are at higher risk of developing an even more morbid subtype of diabetic foot complication: The heel ulcer....
Open Access DOI:10.23937/2378-2951/1410116
Angelica Abbate, Giulia Teresi, Davide Piraino, Giuseppe Andolina and Pasquale Assennato
Article Type: Letter To Editor | First Published: June 04, 2018
An 82-year-old man with chronic atrial fibrillation was admitted to our department for progressive dyspnea, III NYHA class. Almost 10 years ago, he underwent replacing of mitral valve with a mechanical prosthesis CarboMedics size 31 (Sorin Group - Milan, Italy) due to severe mitral valve insufficiency and plastic of tricuspid valve due to moderate - severe insufficiency....
Open Access DOI:10.23937/2378-2951/1410115
Cicera Jacqueline da Conceicao Silva, Rafaely Pereira de Alencar, Leticia Miranda Tenorio, Nathanielly Lima da Silva, Amanda Feitosa de Barros, Chiara Rachel Maciel Marinho and Raphael de Souza Pinto
Article Type: Research Article | First Published: June 04, 2018
Cardiovascular diseases are the leading causes of death in patients undergoing hemodialysis. Despite new treatments and advances in dialysis processes, patients with chronic kidney disease (CKD) have 10 to 20 times higher mortality rate from cardiovascular disease compared to geral population....
Open Access DOI:10.23937/2378-2951/1410114
Jose Ramon Lopez-Minguez, Juan Manuel Nogales-Asensio, Victoria Millan-Nunez, Patricia Marquez-Marquez, Bruno Blenga-Limpo, Carmen Garcia Corrales, Diego Felix Arroyo-Monino, Concepcion Lopez-Fernandez, Eugenia Fuentes-Canamero, Reyes Gonzalez-Fernandez and Antonio Merchan-Herrera
Article Type: Research Article | First Published: June 01, 2018
Non-valvular atrial fibrillation (NVAF) is a significant health problem, particularly in the older population. Since the introduction of novel oral anticoagulants (novel OAC), greater numbers of patients at risk of stroke who previously were not candidates for oral anticoagulation (OAC) with warfarin or acenocumarol due to the risk of bleeding are now being treated. Until then, up to 30%-40% of patients who needed OAC treatment were not treated due to fear of bleeding on the part of the patient ...
Open Access DOI:10.23937/2378-2951/1410113
Sandra Kutkiene, Zaneta Petrulioniene, Aleksandras Laucevicius, Pranas Serpytis, Justina Staigyte, Akvile Saulyte, Emilija Petrulionyte, Urte Gargalskaite, Egle Skiauteryte, Gabija Matuzeviciene, Milda Kovaite, Egidija Rinkuniene and Vilma Dzenkeviciute
Article Type: Research Article | First Published: May 23, 2018
Cardiovascular mortality in Lithuania is extremely high and abnormal lipid levels are very common among Lithuanian adults. Dyslipidemia is one of the main independent risk factors for cardiovascular diseases (CVD) leading to high absolute CVD risk. The aim of this study was to assess CVD risk in dyslipidemic middle-aged subjects....
Open Access DOI:10.23937/2378-2951/1410112
Robin Jacob, Ritesh S. Patel and Francisco Fuentes
Article Type: Case Report | First Published: May 12, 2018
It is well known that electrolyte derangements such as hypokalemia, hypomagnesaemia, and hypocalcaemia can potentially cause dangerous arrhythmias in hospitalized patients. This can be a common concern for acute care physicians, as the occurrence of arrhythmias predisposes patients to higher morbidity, mortality, and longer length of stay. Phosphorus, however, has been less studied....
Open Access DOI:10.23937/2378-2951/1410111
Sahin Iscan, Bortecin Eygi and Koksal Donmez
Article Type: Case Report | First Published: May 10, 2018
Today, ablation techniques for atrial fibrillation (AF) are successfully increasing but catheter ablation may have important complication risks. We report the case of a 56-year-old woman with chronic AF who had left atrial rupture during catheter ablation. Echocardiography showed pericardial effusion during procedure and she was operated immediately. Left atrial rupture repaired with sternotomy. After stabilizing the hemodynamic and metabolic parameters, intraoperative bipolar ablation was perfo...
Open Access DOI:10.23937/2378-2951/1410110
Giordano Tasca, FrancescoTrinca, Beatrice Riva, Douglas Skouse, Elisabetta Lobiati, Caterina Chiara DeCarlini and Amando Gamba
Article Type: Research Article | First Published: April 11, 2018
Left ventricular (LV) hypertrophy is a form of adaptation to a chronic cardiac overload. In the setting of aortic stenosis (AS), LV hypertrophy develops to limit the increase of LV systolic wall stress. Aortic valve replacement (AVR), is expected to eliminate the LV burden, inducing regression of LV hypertrophy....
Open Access DOI:10.23937/2378-2951/1410109
Gabriel A Hernandez, Abhijt Ghatak, Jorge M Diego and Eduardo De Marchena
Article Type: Case Report | First Published: February 16, 2018
We present a patient who developed post kidney transplant renovascular hypertension due to Fibromuscular dysplasia, which was unseen on donor's renal artery angiography. The temporal relationship to the clinically manifested hypertension and the patient's profound weight loss makes us postulate her intra-abdominal fat redistribution led to nephroptosis of the transplanted kidney, causing stretching of the renal artery, exaggerating the Fibromuscular dysplasia and hemodynamically significant sten...
Open Access DOI:10.23937/2378-2951/1410108
Emre Ozdemir Farris, Mustafa Karaca and Mehmet Serdar Bayata
Article Type: Case Report | First Published: February 14, 2018
Certain drugs can induce ventricular tachycardia (VT) in a different mechanism. Most knowed mechanisms are creating new reentry, enhancing ventricular after potentials or exaggerating the slope of phase 4. These kind of arrhythmias can or can not be symptomatic, sustained or non-sustained and have variable ECG changes: Monomorphic or polymorphic ventriculer extras, bidirectional or torsades de pointes ventricular tachyarrhythmias. Zuclopenthixol decanoate blocks postsynaptic Dopamine receptor in...
Open Access DOI:10.23937/2378-2951/1410107
Serio Farris and Serio M Kerala
Article Type: Case Report | First Published: January 11, 2018
Platypnea-Orthodeoxia Syndrome (POS) is a rare clinical syndrome characterized by dyspnea and hypoxemia while upright that are relieved when the patient is supine. A right to left shunt in combination with several hypothesized hemodynamic or structural factors are needed to develop the syndrome. It is an important source of dyspnea in a small percentage of often-elderly patients. The exact mechanism for the positional increase in the shunt has remained elusive....
Open Access DOI:10.23937/2378-2951/1410106
Zehra Pinar Koc, Necati Dagli, Tansel Ansal Balci, Ilgin Karaca, Ferat Kepenek and Tolga Cakmak
Article Type: Research Article | First Published: December 30, 2017
Stress Echo was performed by an experienced cardiologist and MPS results were interpreted by an experienced nuclear medicine physician who didn't know stress Echo results according to 17 segment models. Sixteen patients underwent coronary angiography. Ischemia territory size in both the adenosine stress Echo and MPS were recorded and compared in segment and in patient basis....
Open Access DOI:10.23937/2378-2951/1410105
Janaki Rami Reddy Manne
Article Type: Case Report | First Published: October 11, 2017
Even though the new onset of T wave inversions on the electrocardiogram is always an alarming finding, but they are not always pathognomonic of myocardial ischemia. Many cardiac and non-cardiac conditions have been described in association with T wave inversions on the electrocardiogram....
Open Access DOI:10.23937/2378-2951/1410104
Hacer Kamalı, Abdullah Erdem, Cengiz Erol and Atıf Akçevin
Article Type: Case Report | First Published: October 09, 2017
Many acquired and congenital pathologies could cause enlargement of Right Atrium (RA). In rare pathologies we couldn't find an obvious reason for enlargement of RA. Sometimes it leads to misdiagnosis if we try to explain an unknown pathology with well known pathology....
Open Access DOI:10.23937/2378-2951/1410103
Article Type: Review Article | First Published: September 27, 2017
Endothelium is a layer of the endothelial cells lining to the lumen of blood vessels, lymphatic vessels, the heart and other organs. Vascular endothelium is considered to be the largest endocrine organ in human body. Its total weight is about 1.5 kg, and it is responsible for maintaining homeostasis of the living body by exerting various functions....
Open Access DOI:10.23937/2378-2951/1410102
Yaariv Khaykin, Pouria Alipour, Meysam Pirbaglou, Paul Ritvo, Zahra Azizi, Zaev Wulffhart, Bonnie Whaley, David Giewercer, Kellie Winger and Atul Verma
Article Type: Research Article | First Published: September 25, 2017
Pulmonary Vein Antrum Isolation (PVAI) targeting PV triggers is an established treatment for paroxysmal Atrial Fibrillation (AF). Ablation lesions are typically delivered around the entire circumference of each individual PV. This study tested a strategy where electrical inputs to the PVs were mapped using the NavX system and selectively targeted before ablation....
Open Access DOI:10.23937/2378-2951/1410101
Simon W Rabkin
Article Type: Research Article | First Published: August 03, 2017
QT interval correction for heart rate (QTc) is essential for clinical usage. A new QTc formula has been developed based on a data agnostic mathematical approach in a large population ECG data base. The formula requires testing on a within individual basis under conditions of intervention to increase heart rate....
Open Access DOI:10.23937/2378-2951/1410100
Max E Valentinuzzi
Article Type: Critical Review | First Published: July 26, 2017
The objective of this paper tries to answer the questions posed in the title, that is, why Cardiac Resynchronization Therapy (CRT) is usually prescribed along with Automatic Implantable Defibrillation (AID)? Is it a sensible decision? For that matter....
Open Access DOI:10.23937/2378-2951/1410099
Naoki Nishida and Yukiko Hata
Article Type: Case Report | First Published: June 26, 2017
We present an autopsy case of a 66-year-old man who died during walking. Besides a history of hypertension for 5 years, mild chest oppression appeared to occur shortly before death. A full autopsy and the police examination concluded that the cause of death was sudden cardiac death....
Open Access DOI:10.23937/2378-2951/1410098
Anna F Thomsen J Tobias Kuhl, Klaus F Kofoed, Andreas Fuchs, Patricia M Udholm, Jakob B Norsk, Xu Chen, Steen Pehrson, Borge G Nordestgaard, Lars Kober and Peter K Jacobsen
Article Type: Research Article | First Published: June 26, 2017
Atrial Fibrillation (AF) is the most common cardiac arrhythmia and a cause of increased morbidity and mortality. Left Atrial (LA) tissue characteristics play an important role in the pathogenesis of AF. Catheter ablation of AF has emerged as a popular treatment option, however predictors of treatment success are not clearly defined....
Open Access DOI:10.23937/2378-2951/1410097
Caroline Sanchez, Vincent Achard, Michel Grino and Stephane Tanguy
Article Type: Research Article | First Published: June 24, 2017
Visceral obesity, a feature of the metabolic syndrome, is associated with metabolic and cardiovascular diseases. Our aim was to study the influence of increased fat intake, a major determinant of central obesity, on Smooth Muscle Cells (SMC) reactivity and its interaction with Perivascular Adipose Tissue (PVAT), which plays an important role in the local regulation of vascular function, with a special emphasis on oxidative stress....
Open Access DOI:10.23937/2378-2951/1410096
Walter Serra Francesco Tafuni, Nicola Sverzellati, Maria Alberta Cattabiani and Angelo Placci
Article Type: Case Report | First Published: June 08, 2017
A 21-year-old woman presented for a history of exertional dyspnoea and atypical chest pain. No history of allergies or tuberculosis. A chest X-ray showed asymmetry of the chest walls from a reduced expansion of the right lung caused by parenchymal loss and right deviation of the mediastinum and ipsilateral elevation of the diaphragm....
Open Access DOI:10.23937/2378-2951/1410095
Harmony R Reynolds and Leon H Charney
Article Type: Case Report | First Published: April 13, 2017
Coronary artery spasm is a cause of myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary spasm may occur spontaneously or in response to prescribed or illicit drugs. Myocardial injury and cardiomyopathies have been reported in association with the use of stimulants in children and adults with attention deficit hyperactivity disorder (ADHD)....
Open Access DOI:10.23937/2378-2951/1410094
Maysa Saleh and Samir Sajwany
Article Type: Case Report | First Published: April 01, 2017
One-year-old boy was admitted to a hospital suffering from acute myocarditis, dilated cardiomyopathy and congestive heart failure. He was experiencing vomiting for 2 days, breathing difficulty and poor oral intake. In view of deterioration of his condition that has required ventilator support, inotropes, anti-failure medications and antibiotics, hence, he was transferred to our hospital....
Open Access DOI:10.23937/2378-2951/1410093
Francisco J Hidalgo, Francisco Carrasco, Juan C Castillo, Sara Rodriguez, Laura Pardo, Enrique Duran, Carlos Ferreiro, Jose Sanchez, Monica Delgado, Dolores Mesa, Martin Ruiz and Manuel Anguita
Article Type: Original Article | First Published: March 06, 2017
Heart rate (Hr) has prognostic value in patients with heart failure, depressed ejection fraction (HFrEF) and sinus rhythm. Objective: Is to analyze the effect of the early co-administration of ivabradine added to beta-blockers (intervention group) versus only beta blockers (control group) in patients hospitalized with HFrEF on Hr and clinical and functional outcomes at long term. ...
Open Access DOI:10.23937/2378-2951/1410092
Jadan Alsaddah, Mohammad Almutairi, Wael Aboshokka, Saad Alkandari, PRS Remya and Hany Younan
Article Type: Original Article | First Published: February 25, 2017
Acute coronary syndrome (ACS) is a major cause of morbidity and mortality globally. The world has started laying emphasis on risk stratification based on gender differences. Hence, there seemed to be a void to be filled regarding ACS which aimed to identify patient characteristics (especially gender) and clinical management, as well as angiographic, PCI, and hospital outcomes in Kuwait....
Open Access DOI:10.23937/2378-2951/1410091
Marco A Trujillo, Haydee M Carmona and Jorge T Mendoza
Article Type: Perspective | First Published: February 23, 2017
In the city Manaus, Amazonas, with the Dutch Lipid Register Network. Were analyzed 1294 lipid profiles, of the North and West zone of city, neither with DMII, between June 2014 and March 2015, from people aged range 18 to 77 years old. Whose clinical history of familial cardiovascular disease (CVD) was wondered....
Open Access DOI:10.23937/2378-2951/1410090
Dawod Sharif, Saeed Khaleeliah, Amal Sharif-Rasslan and Uri Rosenschein
Article Type: Original Article | First Published: February 21, 2017
Coronary disease is the most frequent disease and cause of mortality in women. The aim of this study was to examine gender effects in acute anterior ST-elevation myocardial infarction (STEMI) and primary percutaneous intervention (PPCI) on coronary artery and myocardial perfusion and left ventricular systolic function....
Open Access DOI:10.23937/2378-2951/1410089
Mario Gioia, Reehan Shahzad and Jordan Safirstein
Article Type: Case Report | First Published: January 21, 2017
Acute aortic dissection during pregnancy is a rare and potentially fatal disease. Connective tissues disorders, including Marfan syndrome, in combination with the physiological stress of pregnancy and delivery substantially increase the risk of aortic dissection. It is vital to recognize symptoms early, if present, in order to undergo medical and surgical management to increase the chance of survival....
Open Access DOI:10.23937/2378-2951/1410088
Nasser Hayat, Jadan Al Saddah, Mohammad Al Mutairi, Mariam Abdulla Almelahi and PRS Remya
Article Type: Original Article | First Published: January 20, 2017
Post coronary artery bypass graft (CABG) patients were arbitrarily divided into 2 groups at the time of cardiac catheterization. Catheterization was performed because of ischemic manifestations. Group A had their surgery less than 5 years. Group B had their surgery more than 5 years....
Open Access DOI:10.23937/2378-2951/1410087
Mehmet İleri, Koray Gursel, Funda Basyigit, Pınar Turker Bayır, Deniz Sahin, Umit Guray, Ozgul Ucar, Burak Acer and Yahya Buyukasık
Article Type: Research Article | First Published: September 20, 2016
Determinants of coronary collateral circulation (CCC) in human heart are still incompletely identified. In acute non-ST elevation myocardial infarction (NSTEMI), abrupt vessel occlusion results in myocardial necrosis in the jeopardized area. Angiographic collaterals to myocardial tissue distal to an acutely occluded coronary vessel can reduce infarct size and risk for post-infarct complications as well as infarct related mortality. These prognostic implications of collateral function, makes it n...
Open Access DOI:10.23937/2378-2951/1410086
Dhruti Mankodi, Ashish Sharma, Fulvia Banu, Sameer Shaharyar, Pedro Martinez-Clark and Ali Bazzi
Article Type: Case Report | First Published: August 12, 2016
Coronary-cameral fistula (CCF) is a rare condition most commonly caused by an embryologic developmental anomaly. Fifty-five percent of CCFs originate from the right coronary artery, 35% from the left coronary artery, and 5% from both. More than 90% of them drain into the venous system and low pressure sites such as the right ventricle (41%), right atrium (26%), pulmonary artery (17%) and only 3% drain into the left ventricle or atrium....
Open Access DOI:10.23937/2378-2951/1410085
Article Type: Case Report | First Published: August 11, 2016
A nine-year history of a young to middle-aged male who was diagnosed with coronary artery ectasia after presenting with impaired vision in one of his eyes is presented. Throughout this period, four exercise stress tests were carried out and improvements were noted: from a positive stress test indicative of myocardial ischemia, the outcome gradually progressed to negative. A distinct feature of this case is that the patient was only on moderate statin and dual antiplatelet therapy and his cholest...
Open Access DOI:10.23937/2378-2951/1410084
Nalan Karabayir, Kelesoglu E, Helen Bornau, Kazim Oztarhan, Aktas D and Erdem A
Article Type: Case Series | First Published: August 06, 2016
Dilated cardiomyopathy, which mostly has an idiopathic etiology or is caused by genetic inheritance or infection, may cause irreversible congestive heart failure. Hypocalcemia is a rare etiology of reversible dilated cardiomyopathy. Cardiogenic shock related to hypocalcemic cardiomyopathy is a rare event. Here we report two cases with congestive heart failure who was diagnosed as having dilated cardiomyopathy secondary to hypocalcemia....
Open Access DOI:10.23937/2378-2951/1410083
Nobuhiko Hiraiwa, Kohei Abe, Kunihiko Yoshino, Manabu Yamasaki and Hiroyasu Misumi
Article Type: Case Report | First Published: July 30, 2016
A 28-year-old pregnant woman was admitted to our hospital with tonic seizure and dyspnea, and was diagnosed with acute massive pulmonary embolism. An emergency surgical embolectomy was performed under cardiopulmonary bypass (CPB). Several fragments of the thrombi were carefully removed from the right and the main pulmonary arteries, and sufficient back-flow from the pulmonary artery was established. The postoperative course was uneventful. After the embolectomy, the ratio of pulmonary to systemi...
Open Access DOI:10.23937/2378-2951/1410082
Rania Gaber, Wessam Salah Ibrahim and Manal Hamesa
Article Type: Research Article | First Published: July 30, 2016
Atrial Fibrillation (AF) is the commonest arrhythmia encountered in clinical practice and is increasingly considered as an emerging health epidemic. Despite rapidly evolving treatment strategies, AF presents a complex management challenge to the physician and is now attracting substantial clinical and academic interest because of a strong association with substantial mortality and morbidity....
Open Access DOI:10.23937/2378-2951/1410081
Hisao Matsuda, Tomoo Harada, Yui Nakayama, Marika Yamada, Yasushi Takagi, Makoto Takano, Ikutarou Nakajima, Emi Nakano, Yukako Takimura, Satoru Nishio, Toshiyuki Furukawa, Hidekazu Miyazaki and Yoshihiro J Akashi
Article Type: Original Article | First Published: July 18, 2016
Background:The effect of pulmonary vein isolation (PVI) on left ventricular (LV) function after restoration of sinus rhythm remains unclear in patients with chronic atrial fibrillation (CAF). This study aimed to evaluate LV systolic function in the early phase after PVI using speckle tracking echocardiography. Methods:Twelve patients with CAF could be restored to sinus rhythm by PVI and maintained sinus rhythm after PVI. Echocardiography was performed before, immediately after and 3 months afte...
Open Access DOI:10.23937/2378-2951/1410080
Akika Ando, Adnan Bhopalwala and Christian Spies
Article Type: Case Report | First Published: June 23, 2016
A coronary arteriovenous (AV) fistula is defined as a connection between one or more coronary arteries and a cardiac chamber or great vessel, bypassing the myocardial capillary bed. For symptomatic patients, surgical intervention is the standard treatment plan. Recently, the use of transcatheter vascular plugs for the percutaneous closure of coronary AV fistulae has been reported in a few selected cases. We report the case of a 66-year-old woman with diffusely ectatic right and left coronary AV ...
Open Access DOI:10.23937/2378-2951/1410079
Nadim Shah, Christopher Wang, Vanessa Lee, Nicholas Cox, Chiew Wong, Anne-Maree Kelly and Kean Soon
Article Type: Original Article | First Published: May 28, 2016
Background: Coronary heart disease (CHD) remains a major cause of death worldwide. This study looked at the proportions, demographics, risk profile, angiographic data and in-hospital outcomes of young versus older myocardial infarction (MI) patients presenting to a community teaching hospital in Melbourne, Australia. Methods: This was a retrospective study of patients presenting prospectively, with acute MI between August 2013 and July 2014, who demonstrated coronary stenosis ≥ 50% on inva...
Open Access DOI:10.23937/2378-2951/1410078
Robert W Murdock and David K Murdock
Article Type: Original Article | First Published: May 27, 2016
Takotsubo Syndrome (TS) is characterized by sudden localized left ventricular (LV) dysfunction and clinical features suggesting an acute coronary syndrome. It occurs more in women and is frequently associated with emotional or physical stress. Pharmacologically induced TS (PITS) has been reported but a comprehensive characterization has not been performed. Such a characterization could provide insight into mechanisms and treatment of spontaneous TS....
Open Access DOI:10.23937/2378-2951/1410077
Muna aseel, Amal Al-Ali, Zelaikha Alwahedi and Mohamed Salem
Article Type: Research Article | First Published: May 18, 2016
Proper documentation of Atherosclerotic Cardiovascular Disease (ASCVD) risk score and its consequent management in the newly applied electronic medical records (EMR) for diabetic's patients attending non-communicable diseases clinic in West Bay Health Center is less than ideal during Jan 2015 and Feb 2015. Poor documentation of ASCVD risk score and its consequent management will result in improper management for type 2 diabetic patients, and it will lead to undesirable consequences....
Open Access DOI:10.23937/2378-2951/1410076
Benigno Linares-Segovia, Estela Nunez Lemus, Manuel Lara Marquez, Rogelio Torres Guzman, Juan Manuel Guizar-Mendoza and Norma Amador-Licona
Article Type: Research Article | First Published: April 28, 2016
Introduction: The aim of this study was to evaluate the short term effect of a moderate-intensity physical activity program on heart sympathetic activity and lung function in Mexican obese adolescents. Materials and methods: We performed a longitudinal study in 38 healthy obese adolescents (24 female and 14 male). Subjects were submitted to aerobic exercise training during 90 minutes for 16 weeks, 5 days per week. Before and after the intervention program, blood pressure, anthropometric measurem...
Open Access DOI:10.23937/2378-2951/1410075
Harsh V Thakkar and John V Amerena
Article Type: Original Article | First Published: April 20, 2016
Implantable Cardioverter Defibrillator (ICD) therapy is now standard therapy for prevention of Sudden Cardiac Death (SCD) in high-risk patients. In 2006, the Medical Services Advisory Committee (MSAC) reviewed the role of ICDs and approved them to be used for both primary and secondary prevention. This study reviews the temporal trends in indications for insertion of ICD at Geelong Cardiology Practice (GCP)....
Open Access DOI:10.23937/2378-2951/1410073
Xue Zhao, Yinxiang Zhu, Xiang Mei, Jiayou Zhang, Jianqiang Hu, Wenliang Lu, Xingui Guo, Li Dai, Kailei Shi and Zhenguo Liu
Article Type: Research Article | First Published: March 16, 2016
A total of 22 dogs of both sexes (5-7 years old) were divided into two groups: 10 in control and 12 in ablation group. Multiple radial-linear lesions were created from PV orifice to peri-PV area in the dogs with CARTO guidance. The control animals went through the same procedure except ablation. AF inducibility was evaluated before and immediately after the procedure. All animals had inducible AF (100%) by atrial pacing combined with or without isoproterenol at baseline....
Open Access DOI:10.23937/2378-2951/1410072
Fritha A Munday, Sirisha Asuri, Sarah McIntosh, Heather Jackson, Anthony Tang and Laura Arbour
Article Type: Original Article | First Published: January 30, 2016
Long QT Syndrome (LQTS), a genetic predisposition to sudden cardiac death is defined by a prolonged corrected QT interval (QTc) measured on electrocardiogram (ECG). A participatory research project has been underway with the Gitxsan of Northern BC for more than ten years where the condition (LQTS1) is common, due to a founder mutation (V205M) in KCNQ1. It is effectively treated with beta blockers and avoidance of QT prolonging drugs. Some chronic conditions are also known to increase the QTc, wh...
Open Access DOI:10.23937/2378-2951/1410071
Armando Faa, Gavino Faa, Eliana Di Felice, Pietro Pampaloni, Daniela Fanni, Daniele Scano, Clara Gerosa, Maria Elena Pais, Panagiotis Vasileiou, Dimitrios Barouxis, Pavlos Lelovas, Theodoros Xanthos, Charalampos Pantazopoulos, Apostolos Papalois and Nicoletta Iacovidou
Article Type: Research Article | First Published: January 28, 2016
Ventricular fibrillation was induced via a pacing wire forwarded into the right ventricle in 20 female Landrace/Large-White pigs, allocated into 2 groups; the experimental group treated with a bolus dose of 5,000 U/Kg recombinant human erythropoietin and the control group which was administered saline. Cardiopulmonary resuscitation (CPR) was performed immediately after drug administration....
Open Access DOI:10.23937/2378-2951/1410070
Adolfo Ferrero Guadagnoli, Miguel A Ballarino, Carlos R Leonardi, Alejandro E Contreras, Eduardo J Brenna and Jonathan Miara
Article Type: Research Article | First Published: January 27, 2016
We present our recent casuistry on such an interesting issue as coronary dissections. Provide data to assist the diagnosis and treatment of this disease. Spontaneous coronary artery dissection is a non-traumatic and non-iatrogenic separation of the coronary artery walls. It is a rare cause of acute coronary syndrome, mainly affecting women with no significant cardiovascular risk factors and has varying presentations from mild chest pains to sudden cardiac death....
Open Access DOI:10.23937/2378-2951/1410069
Lyndsay M. Mueller, Samuel H. Cho, Timothy Fritz and Asghar Khaghani
Article Type: Case Report | First Published: January 18, 2016
Standard surgical approach to the implantation of a Left Ventricular Assist Device (LVAD) is through a median sternotomy. The inflow cannula is attached to the apex of the left ventricle, while the outflow graft is usually attached to the ascending aorta. We present 2 patients with prohibitive chest wall abnormalities who underwent left thoracotomy for LVAD placement, and the outflow graft alternatively attached to the descending aorta....
Open Access DOI:10.23937/2378-2951/1410068
Alexander Alzate, Marcela Munoz Urbano and Kenny Buitrago-Toro
Article Type: Case Report | First Published: December 15, 2015
Electrolytic variability modifies normal structures of segments and intervals on the electrocardiogram (ECG). We present a case that was referred to the Internal Medicine department by the Neurosurgery division for several pathological fractures.The electrocardiogram led us to a diagnostic approach and finally we show how electrocardiographic tracing changed after a treatment implementation. Finally, in this study we highlight the importance of an electrocardiogram on a patient's approach....
Open Access DOI:10.23937/2378-2951/1410067
Mustafa Yilmaztepe, Fatih Mehmet Ucar, Gokay Taylan, Hanefi Yekta Gurlertop, Volkan Yuksel, Suat Canbaz and Serhat Huseyin
Article Type: Case Report | First Published: December 12, 2015
A 48 years old male patient was referred to our clinic for intraventricular mass, detected incidentally during non-cardiac preoperative evaluation. The medical history of the patient was unremarkable except suspicious history of heart attack four years ago. Physical examination was normal. ECG showed normal sinus rhythm 76 beats per minute. Echocardiographic examination (Figure 1) revealed isodense mobile mass attached to left ventricle apex, moving in every systole towards the left ventricle o...
Open Access DOI:10.23937/2378-2951/1410066
I.Y. Nizami and Saeed Akram
Article Type: Research Article | First Published: December 11, 2015
The accuracy of Doppler echocardiography in estimating pulmonary arterial hypertension has been a center of debate with recent reports suggesting poor correlation between the Doppler echocardiographic estimation of pulmonary pressure with the one measured by right heart catheterization. Our aim is to study the correlation between the Doppler echocardiographic estimates of pulmonary artery pressures with the right heart catheterization measured pulmonary artery pressures at our center....
Open Access DOI:10.23937/2378-2951/1410065
Lopez-Aguilera J, Suarez de Lezo J, Mazuelos-Bellido F, Suarez-de-Lezo Jr, Casado-Adam P, Heredia-Torres MA, Mayordomo-Riera FJ and Cano-Lliteras MP
Article Type: Research Article | First Published: December 10, 2015
Prospective observational before-after study in the Cardiac Rehabilitation Unit of Cordoba (Spain) between March 2013 and June 2014 during phase 2 of cardiac rehabilitation program (CRP). Demographic variables, LVEF, functional capacity and biochemical parameters were analyzed. Outcome variables at the beginning and end of the treatment were compared using the paired student t-test. In addition, a multiple linear regression analysis was completed to identify the variables related to the increase...
Open Access DOI:10.23937/2378-2951/1410064
Marie-Philippe Verge, Geraldine Allain, Luc-Philippe Christiaens and Guillaume Lucas
Article Type: Case Report | First Published: December 09, 2015
Subaortic membranes are uncommon causes of left ventricular outflow tract obstruction. Combined subaortic membrane and aortic valve stenosis is even more rare and can be challenging for echocardiographic diagnosis. A 58 year old woman, known for symptomatic aortic stenosis was referred to our hospital department for dyspnoea. Her most important medical history was aortic coarctation surgery at the age of 13 without any significant event since that time. The trans-thoracic echocardiography showed...
Open Access DOI:10.23937/2378-2951/1410063
Teo Tee Yin Tracy, McNeely Parren, Demetroulis Elaine, Staffey Kimberly and Graham Michael
Article Type: Case Report | First Published: November 30, 2015
We present a case of stress-induced cardiomyopathy in a 66 year old male precipitated by electroconvulsive (ECT) for catatonia related to severe recurrent depression. Patient suffered from decades of bipolar syndrome with severe depression that is refractory from medication therapies. As the frequency of the recent admissions increases, the patient's guardian consented to ECT to treat his depression. During the ECT procedure, he developed non-sustained ventricular tachycardia (NSVT). The onset o...
Open Access DOI:10.23937/2378-2951/1410062
Silvio Nocco, Laura Concas, Daniele Congiu and Rinaldo Aste
Article Type: Case Report | First Published: November 30, 2015
A young female, cardiovascular risk factors free, was admitted to the coronary care unit for a sub-acute myocardial infarction caused by a critical ostial stenosis of the left anterior descending artery, treated with coronary angioplasty and insertion of two drug-eluting stents. Despite the administration of aggressive treatment, just 5 days after discharge, the patient was readmitted for early recurrence of myocardial infarction caused by left main coronary artery thrombosis treated with emerge...
Open Access DOI:10.23937/2378-2951/1410061
Eman M Alissa, Maisa'a M Al-Salmi, Nabeela Alama and Gordon A Ferns
Article Type: Original Research Article | First Published: November 21, 2015
Background: Whilst chronic subclinical inflammation is now considered to be a predisposing risk factor of cardiovascular diseases. The extent by which adipokines induce metabolic abnormalities in humans is not fully resolved. The purpose of this study was to examine the relationship between insulin resistance and serum inflammatory markers in obese subjects. Methods: One hundred and five subjects without any clinically evident CVD were classified into 3 coronary risk levels according to Framingh...
Open Access DOI:10.23937/2378-2951/1410060
Abdulmelik Yildiz, Mustafa Budancamanak and Cennet Yildiz
Article Type: Case Report | First Published: November 20, 2015
38 year old male patient with preauricular abcess developed presyncope during high-grade fever and diagnosed as having Brugada syndrome with type 1 ECG pattern. The diagnosis of Brugada syndrome was made in educational and research hospital. His Electroencephalography (EEG) was normal. Coronary angiography showed myocardial bridging of the left anteriyor descending coronary artery after second diagonal branch and no hemodynamically significant coronary artery disease. Technesium (TC99 MIBI) Myoc...
Open Access DOI:10.23937/2378-2951/1410059
Miruna Mihaela Micheu, Oana-Maria Udrea, Nicoleta Oprescu, Alina Ioana Scarlatescu, Daniela Pitic, Lucian Calmac and Maria Dorobantu
Article Type: Research Article | First Published: November 13, 2015
In the assessment of stem cell therapy post myocardial infarction, the rapport between the medical intervention and the patient's compliance and psychological factors represent a research and treatment management challenge. Purpose: Identifying the implication of psychological and behavioral factors associated with compliance on therapeutic success in relation to cell therapy in acute myocardial infarction patients....
Open Access DOI:10.23937/2378-2951/1410058
Hossein Asgar Pour, Reza Norouzzadeh and Mohammad Reza Heidari
Article Type: Original Article | First Published: November 05, 2015
Acute coronary syndromes (ACS) are the leading cause of death in older adults. Early recognition of symptoms suggestive of ACS by the emergency triage nurse can improve patient outcomes. The aim of this study was to determine risk factors associated with typical and atypical symptoms in older and younger patients with ACS....
Open Access DOI:10.23937/2378-2951/1410057
Antonio Pellegrino, Paolo Nardi, Luigi Chiariello, Marco Russo, Guglielmo Saitto, Juxhin Ganellari, Alberto Siracusano, Francesco Bianchi and Piero Caporali
Article Type: Research Article | First Published: October 13, 2015
Although relationships between ischemic heart disease and psychiatric disorders (PD) have been highlighted, a link between PD and acute aortic dissection (AAD) has not been shown. Aim of this study was to define the psychological profile of patients treated for AAD and analyze the impact of PD postoperatively and at 5-year follow-up period....
Open Access DOI:10.23937/2378-2951/1410056
Jorge A Restrepo, Jorge Salamanca, Guillermo Diego, Fernando Rivero, Fernando Alfonso and Rio Aguilar
Article Type: Case Report | First Published: October 10, 2015
A 51-year-old man, smoker (20 packs-year) with no known allergies and no medical history of previous symptoms or cardiovascular disease. Two hours after eating a raw fish dish of hake and prawn, the patient presented intense oppressive chest pain, dyspnea, diaphoresis, abdominal pain, diarrhea, nausea and vomit....
Open Access DOI:10.23937/2378-2951/1410055
Lindy Moore, Anita L Sengupta and Bibhuti Das
Article Type: Case Report | First Published: October 10, 2015
Mycophenolate Mofetil (MMF) is a frequently used immunosuppressive medication in pediatric heart transplant (HT) patients. Although therapeutic monitoring of MMF has been an integral part of routine practice for many years, there is growing evidence that genetic variation in host can lead to adverse outcomes such as drug toxicities. Maintaining a reasonable balance between efficacy and toxicity in an individual patient remains one of the major challenges in pediatric HT recipients....
Open Access DOI:10.23937/2378-2951/1410054
David Boutarin Raphaelle - Ashley Guerbaai and Patricia Armand
Article Type: Perspective | First Published: September 24, 2015
Venovenous ultrafiltration is an alternative therapy used in patients with chronic heart failure (CHF), persistent congestion and failing diuretics. This therapy enables removal of excess water in order to reduce fluid overload. Ultrafiltration has been used for over ten years in the United-States, however was only introduced in France three years ago, in very few hospitals....
Open Access DOI:10.23937/2378-2951/1410053
Ramirez-Moreno A and JR. Siles-Rubio
Article Type: Case Report | First Published: September 21, 2015
We report a case of 65-year-old woman who presented sporadic exercise chest pain episodes. The rest ECG, cardiac ultrasound were normal, exercise test shows nonspecific repolarization ECG changes, myocardial Stress/Rest Tc-99m MIBI SPET disclosed a reversible defect in the medial and distal portions of the anterior wall and the apex....
Open Access DOI:10.23937/2378-2951/1410052
Md. Zahidus Sayeed, Md. Abdus Salam, Muhammad Afsar Siddiqui, Pampa Chandra, Joydeep Bhaduri and Zahurul A. Bhuiyan
Article Type: Case Report | First Published: September 17, 2015
LEOPARD syndrome is a complex dysmorphogenetic disorder of variable penetrance and expressivity. Mutations in the PTPN11 gene are frequently reported in patients with Noonan syndrome (NS) and LEOPARD syndrome (LS). Q510E mutation in PTPN11 has always been associated with lethal or rapidly progressive hypertrophic cardiomyopathy both in NS and LS patients. Besides, deafness is also frequently present in these patients, but reproductive fitness is questioned. ...
Open Access DOI:10.23937/2378-2951/1410051
Arthur J. Siegel
Article Type: Review Article | First Published: September 15, 2015
Reducing sudden cardiac death during sport is the highest clinical priority in preventive sports cardiology. While the overall cardiovascular risk of long distance running is low, the frequency of cardiac arrest and sudden death in middle-aged males during marathons has increased since the year 2000. An evidence-based strategy for reducing race-related acute cardiac events in this vulnerable subgroup is considered based on identification of the underlying cause....
Open Access DOI:10.23937/2378-2951/1410050
Muhittin Celik, Heybet Tuzun, Bedri Aldudak and Osman Akdeniz
Article Type: Case Report | First Published: September 15, 2015
Transient isolated right ventricular hypertrophy is rarely encountered in neonates. We describe a term neonate in whom right ventricular hypertrophy was detected in the first postnatal day by echocardiography. There are several reasons that cause transient isolated right ventricular hypertrophy such as gestational diabetes, mother's dietary patterns, and certain drugs....
Open Access DOI:10.23937/2378-2951/1410049
Nguyen Huu Uoc and Pham Tien Quan
Article Type: Research Article | First Published: September 14, 2015
27 year-old female patient had complex CHD that involved dextrocardia situs inversus, double outlet right ventricle type TGA, pulmonary artery stenosis, total atrio-ventricular canal, and total anomalous pulmonary venous connection type supra-cardia. She was experiencing end-stage heart failure and severely cachexia with risk of death within few months. The transplanted heart was from a multi-organ donor; male, 26 years old, normal heart structure. Although the difference in biological parameter...
Open Access DOI:10.23937/2378-2951/1410048
Abellas-Sequeiros RA, Ocaranza-Sanchez R, Garcia-Acuna JM and Gonzalez-Juanatey JR
Article Type: Case Report | First Published: September 03, 2015
We report the case of a 37-year-old Caucasian man, with prior history of smoking and DM. He had complained about multiple episodes of syncope during last year. However, the day of his hospitalization, he described a sudden and acute episode of chest pain which stopped him from sleeping. He arrived to the emergency department after 45 minutes of successful resuscitation, with VF as first cardiac rhythm detected....
Open Access DOI:10.23937/2378-2951/1410047
ErsanTatli, MustafaYilmaztepe, Ali Buturak and Yusuf Can
Article Type: Case Report | First Published: August 30, 2015
Increased interest focusing on coronary chronic total occlusions has emerged since several studies have proven improved cardiovascular outcomes and quality of life after successful chronic total occlusion (CTO) revascularization. CTO of an epicardial coronary artery is one of the leading challenging complex lesion type when percutaneous coronary intervention (PCI) is indicated. Advanced antegrade and retrograde techniques performed with dedicated equipment have provided significant improvements ...
Open Access DOI:10.23937/2378-2951/1410046
Jun Gu, Wei Hu, Xu Liu and Chang-Qian Wang
Article Type: Research Article | First Published: August 30, 2015
Atrial Fibrillation (AF) is the most common type of sustained heart rhythm disorder confronted in clinical practice, which confers a high risk of mortality and morbidity from abnormal hemodynamics and thromboembolism. The beat-to-beat alteration of flow dynamics in AF has disadvantageous effects on cardiac haemodynamics and is associated with endothelial dysfunction. Endothelial dysfunction may contribute to a prothrombotic state in patients with AF and cardiovascular events. Besides, the presen...
Open Access DOI:10.23937/2378-2951/1410045
Osama A. Khamis, Tarek Abd El-Hamid Elzyat and Abd El-Rahman Ibrahim Mohammed Ali
Article Type: Research Article | First Published: August 29, 2015
Background:Pulmonary hypertension is increasingly being recognized as a factor that can affect outcome in end stage renal disease. This study was carried out to evaluate the prevalence of pulmonary hypertension among CKD patients and it's relation to vascular access blood flow and location. Patient and Methods:30 patients on regular hemodialysis, 30 patients in predialysis and 30 healthy individuals participated in this study. Each patient underwent full clinical evaluation, chest radiography...
Open Access DOI:10.23937/2378-2951/1410044
Ruth M. Kleinpell, Boaz Avitall, Cathy Catrambone, Tricia Johnson, Louis Fogg, Shirley Moore and Nicole T. Thompson
Article Type: Research Article | First Published: August 28, 2015
Despite diagnostic and treatment advances, coronary heart disease (CHD) remains the leading cause of death in Americans over the age of 65. Coronary artery bypass surgery (CABG) is the most frequently performed major surgery for CHD in the United States (U.S.). While the rates of CABG surgeries have declined in recent years due to the increased use of percutaneous coronary procedures, current treatment guidelines from the American Heart Association and the American College of Cardiology identify...
Open Access DOI:10.23937/2378-2951/1410043
Debora Corsi, Michele Celiento, Stefano Pratali, Alberto Balbarini and Uberto Bortolotti
Article Type: Case Report | First Published: August 27, 2015
A 58-year-old man had undergone mitral valve replacement with a 27 mm Carpentier-Edwards porcine bioprosthesis (Edwards Lifesciences, Irvine, USA) in 1993. Nineteen years later he presented with dark urine, fatigue and moderate dyspnea denying any history of infection. He was in atrial fibrillation with a systolic mitral regurgitant murmur. Hematologic evaluation was consistent with haemolytic anemia; particularly, reduced hemoglobin, hematocrit and haptoglobin (6.6 mg/dl), and increased total b...
Open Access DOI:10.23937/2378-2951/1410042
Pierre-Philippe Nicol, Jean-Philippe Talarmin and Thierry Joseph
Article Type: Case Report | First Published: July 25, 2015
Herpes simplex encephalitis is responsible for progressive alteration of behaviour, epilepsy, focal neurological signs, and cognitive problems, but is rarely involved in sinus node dysfunction. We describe this association in a 66-year-old woman with a complete cardiac and neurologic recovery after acyclovir treatment. Consequently, this aetiology of sinoatrial arrest should be recognized in order to systematically assess cardiac monitoring and avoid unnecessary pacemaker implantation. Moreover ...
Open Access DOI:10.23937/2378-2951/1410041
Abdulrahman M Abdulbaki and Shivang Shah
Article Type: Case Report | First Published: June 24, 2015
The incidence of coronary anomalies in patients undergoing coronary angiography varies from 0.27% to 1.66%. Many of these anomalies are clinically benign; while, others are associated with serious morbidity. We describe the case of a patient undergoing coronary angiogram to evaluate her cardiomyopathy revealing an anomalous right coronary artery arising from the ascending aorta above the left sintubular junction plane. We discuss the rarity of this anomaly along with its clinical importance....
Open Access DOI:10.23937/2378-2951/1410040
Minoru Ichikawa and Yoshiyuki Kijima
Article Type: Case Report | First Published: July 23, 2015
We here report a case with in-stent chronic total occlusion (CTO) of sirolimus-eluting stent (SES). The SES-CTO lesion was successfully treated with additional implantation of Endeavorzotarolimus-eluting stent (E-ZES) into the lesion. During the follow up period of 50 months, coronary angioscopy and optical coherence tomography revealed the favorable plaque sealing process after E-ZES implantation into SES-CTO....
Open Access DOI:10.23937/2378-2951/1410039
Nicola Vitulano, Pio Cialdella, Massimo Gustapane, Lorenzo Vitulano, Daniela Pedicino and Gemma Pelargonio
Article Type: Review Article | First Published: July 18, 2015
The aims in the treatment of angina are relief of pain and prevention of disease progression through risk reduction. A number of patients may have contraindications or remain unrelieved from anginal discomfort with conventional drugs. Among newer alternatives, ranolazine indirectly prevents the intracellular calcium overload involved in cardiac ischemia and it is a considered as a valid addition to traditional treatments. Recent findings showed potential positive side effect of ranolazine in the...
Open Access DOI:10.23937/2378-2951/1410038
Shivadeep S, Anandaraja S and Devi Jansirani D
Article Type: Case Report | First Published: June 30, 2015
Chiari network is a fenestrated membranous structure most commonly observed near the valve of inferior vena cava. It is considered as an embryological remnant of right valve of sinus venosus. Inspite of its benignity, its complications have been reported in the literature. This article contributes a detailed review compiling the association of Chiari network with various pathological conditions and its complications. We report a case of Chiari network diagnosed in a 36-year old female by trans-e...
Open Access DOI:10.23937/2378-2951/1410037
Paul S. Greenman, Jonathan Jette, Isabelle Green-Demers and Jean Grenier
Article Type: Research Article | First Published: June 25, 2015
People who suffer from depression, post-traumatic stress, or anxiety following cardiac events and treatment are more likely to have further cardiac complications resulting in death than are people who do not. Although there have been advances in psychological techniques to elicit behavior and lifestyle changes in heart patients, there is currently a dearth of information on how to address the psychological sequelae of heart disease effectively....
Open Access DOI:10.23937/2378-2951/1410036
Oluwadare Ogunlade, Abiodun O Ayoka, Anthony Akintomide, Rufus Ojo Akomolafe, Olumide S Akinsomisoye and David Oyewusi Oyebola
Article Type: Research Article | First Published: June 10, 2015
Background: This study assessed the responses of Blood Pressure (BP) and Heart Rate (HR) to change of posture, Sustained Handgrip (SH),deep breathing(DB) and Valsalva manoeuvre (VM) in order to determining the normal limits and pattern of Autonomic Cardiovascular Indices (ACI) among healthy young adults. Methods: Two hundred and four volunteer (98 men and 106 women) aged 18-40 years (mean, 22.45 +/- 4.86 years) participated in the study. After excluding systemic diseases by clinical evaluation, ...
Open Access DOI:10.23937/2378-2951/1410035
Early Administration of Tirofibanin Mid- to High-risk Patients with Non-ST Elevation Acute Coronary Syndrome Referred for Elective Percutaneous Coronary Intervention (ETN-STEP): A Multi-center Randomized Controlled Clinical Trial in China
Jianping Li, Bo Zheng, Xingang Wang, Tieci Yi, Wei Dong, Zhan Gao, Shaoping Nie, Yawei Luo, Xiaobo Mao, Xi Su, Hui Chen, Ning Tan, Xufen Cao, Jun Zhang and Yong Huo
Article Type: Review Article | First Published: June 08, 2015
The objective of this randomized controlled clinical trial was to evaluate the efficacy and safety of upstream administration of Tirofiban in mid- to high-risk patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing early percutaneous coronary intervention (PCI)....
Open Access DOI:10.23937/2378-2951/1410034
Kavita Sharma and Stuart D Russell
Article Type: Review Article | First Published: June 02, 2015
Peripartum cardiomyopathy (PPCM) is a pregnancy-associated idiopathic cardiomyopathy secondary to marked left ventricular systolic dysfunction. The disease presents towards the end of pregnancy through the first 5 months post-delivery, with ethnic and geographic variation in incidence and outcomes. While it is relatively rare, PPCM is associated with significant morbidity and can be fatal....
Open Access DOI:10.23937/2378-2951/1410033
P. Lanzer and P. Wang
Article Type: Logical Study | First Published: May 30, 2015
Performance of percutaneous coronary interventions (PCI) is largely based on empirical experience of individual operators. Due to the perceived mostly intuitive character to date little data concerning formal and reasoning structure of PCI is available. Non-axiomatic logic (NAL) provides consistent format allowing systematic analysis of reasoning applicable to PCI. In this report we introduce the basic principles of NAL and provide relevant introductory examples representing clinical reasoning i...
Open Access DOI:10.23937/2378-2951/1410032
Gurpreet Sodhi, Jennifer Shea, Farzad Najam and Allen J Solomon
Article Type: Research Article | First Published: May 26, 2015
Atrial fibrillation (AF) is the most common postoperative complication of cardiovascular surgery. In large cohorts, genetic variants in the 4q25 chromosome region have been associated with postoperative AF. However, the role of genetic testing in an individual patient to predict the development of AF has been understudied....
Open Access DOI:10.23937/2378-2951/1410031
Anomalous Right Coronary Artery Arising from the Ascending Aorta Above the Left Sinus of Valsalva in the Setting of Acute Inferior ST-Elevation Myocardial Infarction: Unique Challenges and Literature Review
Nisharahmed Kherada, Sandeep Singla, Saqib Ali Gowani, Francesca Gallarello and Nirat Beohar
Article Type: Case Report | First Published: May 02, 2015
Anomalous origin of the right coronary artery arising from ascending aorta above the left sinus of Valsalva is an extremely rare coronary anomaly. In the setting of an acute myocardial infarction rapid identification, localization and selective cannulation of this 'culprit' anomalous right coronary artery presents a challenging scenario. Here we describe a case with this anomaly presenting as an acute inferior wall myocardial infarction along with description of its distinctive interventional ch...
Open Access DOI:10.23937/2378-2951/1410030
Kenichi Yokoyama, Toshiya Kariyasu, Shigehide Kuhara, Masamichi Imai, Rieko Ishimura and Toshiaki Nitatori
Article Type: Research Article | First Published: April 24, 2015
Purpose: The influence of MRI-conditional cardiac pacemakers on the quality and interpretability of images acquired in cardiac MRI (CMR) examinations was retrospectively investigated. Materials and methods: The subjects in this study were 12 patients (7 men and 5 women, mean age: 68.4 +/- 8.7 years) with MRI-conditional cardiac pacemakers who underwent CMR examinations at our institution between July 2013 and December 2014....
Open Access DOI:10.23937/2378-2951/1410029
Sunny-Skye Keppel and Philip Varriale
Article Type: Case Report | First Published: April 19, 2015
We present a case of an unusual cause of atrial fibrillation-induced cardiomyopathy, which is a diet pill, known as phentermine. This medication used for weight loss and can function as a stimulant is intended for short-term use but when taken for an extensive period of time can become a significant risk factor for developing arrhythmias such as atrial fibrillation....
Open Access DOI:10.23937/2378-2951/1410028
Dhavalkumar Patel and Rajendrakumar Patel
Article Type: Case Report | First Published: April 13, 2015
Takotsubo Cardiomyopathy (TCMP), also known as apical ballooning syndrome or stress induced cardiomyopathy, is characterized by left ventricular mid and/or apical wall motion abnormality in the absence of obstructive coronary artery disease. TCMP is a disorder of left ventricular myocardial contractility, and rarely associated with serious cardiac conduction abnormalities....
Open Access DOI:10.23937/2378-2951/1410027
Norliza Othman, Alwi Mohamed Yunus, Raad H. Mohiaddin and Masliza Mahmod
Article Type: Case Report | First Published: April 11, 2015
We report a patient with asymptomatic left atrial appendage aneurysm. Cardiac magnetic resonance was performed to further delineate the aneurysm, and the patient underwent successful surgical resection....
Open Access DOI:10.23937/2378-2951/1410026
Lins TCB, Valente LM, Oliveira KTMN and Brandao SCS
Article Type: Case Report | First Published: April 10, 2015
Myocardial bridge is a cause of sudden death in athletes, but syncope is somewhat related to this disease symptom. This paper reports a case of a young athlete, swimming practitioner with syncopal episodes related to physical exertion....
Open Access DOI:10.23937/2378-2951/1410025
Ovidio A. Garcia-Villarreal
Article Type: Letter to the Editor | First Published: March 22, 2015
I have read with great interest the article by Kammoun et al., and I congratulate them for this paper. Functional mitral regurgitation (MR) is a very hard-to-treat illness, because it is not a disease itself but just the final result of an impaired and/or geometrically distorted left ventricle. Agricola et al. have described in a fie way the high impact played by the tethering mechanism of the posterior mitral complex in this kind of patients....
Open Access DOI:10.23937/2378-2951/1410024
Article Type: Case Report | First Published: March 21, 2015
Thombosis of a mechanical aortic valve is a rare but life threatening complication and in most cases is caused by inadequate or interrupted anticoagulant treatment. Prosthetic valve thrombosis may cause systemic embolization with clinical manifestation dependent on the organ involved. Multiple systemic embolization resulting from non-infective thrombotic aortic prosthetic valve is a rare occurrence....
Open Access DOI:10.23937/2378-2951/1410023
Ayumi Goda, Haruki Itoh, Yoshiko Ebi, Kumiko Kondo, Tomoko Maeda and Toshitsune Shimada
Article Type: Research Article | First Published: March 20, 2015
The aim of this study was to evaluate the improvement in hemodynamic, metabolic, and ventilatory response during exercise along with the improvement of anemia with EPO treatment in anemic hemodialysis patients. Methods: Thirty-seven hemodialysis patients with anemia (48.8 +/- 13.6 years) received EPO (1500 or 3000 unit, 3 times a week). Parameters measured prospectively before and after EPO treatment included hemoglobin, cardiac output by dye dilution method, echocardiography, and cardiopulmonar...
Open Access DOI:10.23937/2378-2951/1410022
William Ng and Robert Lundstrom
Article Type: Research Article | First Published: February 28, 2015
This study aimed to assess the safety & medium/long-term outcome of using double-stenting strategy on left main (LM) stem for the treatment of significant suboptimal angiographic result after initial left main coronary artery (LMCA) stent implantation. Between August 2005 & June 2010, patients undergoing PCI with double stenting of LMCA lesions comprised the study cohort....
Open Access DOI:10.23937/2378-2951/1410021
Urrutia A, Cepeda JM, Formiga F, Manzano L, Conde-Martel A, Aramburu-Bodas O, Suarez I, Gonzalez-Franco A, Quiros-Lopez R and Montero Perez-Barquero M
Article Type: Research Article | First Published: February 12, 2015
Background: Atrial Fibrillation (AF) is a common condition in the elderly and often occurs together with Heart Failure (HF). The differences between elderly patients with HF according to the presence or absence of AF were analysed. Material and methods: Patient data were collected from consecutively admitted patients 75 years of age and older with acute decompensated HF from the Spanish National Heart Failure Registry (RICA) with data retrieved from internal medicine settings....
Open Access DOI:10.23937/2378-2951/1410020
Naohiko Nemoto, Rintarou Nakajima, Kennji Ymazaki, Makoto Utsunomiya, Masaki Hori, Shingo Ito, Itaru Yokouchi, Masamichi Wada, Masanori Shiba, Hisao Hara, Hidehiko Hara, Takuro Takagi, Kaoru Sugi and Masato Nakamura
Article Type: Review Article | First Published: February 06, 2015
Background: While some therapies implemented for newly diagnosed Diabetes Mellitus (DM) or impaired Glucose Tolerance (IGT) are effective in preventing cardiovascular events, investigations of coronary plaque in patients with newly diagnosed DM or IGT are lacking. Methods: We evaluated 96 patients with acute coronary syndrome. The External Elastic Membrane (EEM), Lumen Cross-Sectional Area (CSA), plaque CSA, and plaque burden in the Left Anterior Descending (LAD) artery proximal to the lesion, d...
Open Access DOI:10.23937/2378-2951/1410019
John P. Higgins
Article Type: Review Article | First Published: January 27, 2015
The physical examination, while frequently not performed well, is critical to the diagnosis and management of cardiovascular disorders. This paper describes a basic cardiovascular physical examination and explains findings, with the goal of improving skills in this area....
Open Access DOI:10.23937/2378-2951/1410018
Gregoriana Zanini, Elio Gorga, Francesca Del Magro, Bola Okunuga, Federica Pasini and Gian Franco Pasini
Article Type: Research Article | First Published: January 06, 2015
The prevalence of cardiovascular disease has shown a marked increase over the last decade, representing the leading cause of death in the United States of America but also in Italy. Cardiovascular diseases recognize a multifactorial etiology: age, obesity, distribution of body fat, cigarette smoking, sedentary lifestyle, high blood pressure, dyslipidemia. In recent years has been paid particular attention to the cardiovascular risk factors prevention particularly in adulthood (> 30 years old). T...
Open Access DOI:10.23937/2378-2951/1410017
David L. Johnson, John D. Day, Brian G. Crandall, J. Peter Weiss, Heidi T. May, Tami L. Bair, Jeffrey S. Osborn, Jeffrey L. Anderson, Joseph B. Muhlestein, Donald L. Lappe and T. Jared Bunch
Article Type: Research Article | First Published: December 29, 2014
Background: Atrial fibrillation (AF) has been reported to worsen renal function over time. Renal dysfunction in the setting of AF decreases response to rhythm control approaches and increases risk of cardiovascular morbidity and mortality. Aggressive rhythm control approaches, such as catheter ablation, may interrupt this cycle and impact renal function favorably over time. Methods: Patients were enrolled from the large ongoing prospective Intermountain Cardiovascular Health Study....
Open Access DOI:10.23937/2378-2951/1410016
Svetla Gadzhanova, Elizabeth Roughead and Jenni Ilomaki
Article Type: Research Article | First Published: December 28, 2014
Background: Statins are the fist drug choice for lowering high cholesterol and are one of the most widely used classes of medicines in Australia. Although well tolerated, some adverse effects are dose and potency dependent to which older people are particularly susceptible. Objective: The aim of this study was to examine the use of statins in elderly Australians, and how usage had changed over time with respect to dose and potency of statin prescribed....
Open Access DOI:10.23937/2378-2951/1410015
William F McIntyre, Andres Enriquez, Kevin Michael and Adrian Baranchuk
Article Type: Case Report | First Published: December 15, 2014
We describe the case of a 39-year old man with acute necrotizing pancreatitis. A twelve-lead electrocardiogram (A) showed signs of pericarditis and a computed tomography of the abdomen showed focal pericardial effusion, confirming the diagnosis....
Open Access DOI:10.23937/2378-2951/1410014
Sharan Rufus Ponniah, Pradeepto Ghosh, Nagapradeep Nagajothi, Srinivasa Satti, Kavitha Nidamanuri and Baskar Rajala
Article Type: Case Report | First Published: December 16, 2014
We report a case of immediate extubation following primary percutaneous intervention (PCI) for ST elevation myocardial infarction (STEMI). The optimal timing of extubation following revascularization in STEMI is unclear. Early extubation in this scenario, if feasible has a mortality benefit. Duration of mechanical ventilation following STEMI is a strong predictor of mortality. In this case, we report a scenario of immediate extubation following revascularization, which we believe contributed to ...
Open Access DOI:10.23937/2378-2951/1410013
Y. E. Razvodovsky
Article Type: Research Article | First Published: November 26, 2014
Objective: It was repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate and the dramatic fluctuation in Russian Ischemic Heart Disease (IHD) mortality rate during the last decades, while other traditional risk factors identified in epidemiologic studies had little predictive value. The link between IHD mortality and beverage-specific alcohol drinking has been analyzed in a number of aggregate-level studies with conflicting results. The aim of this stud...
Open Access DOI:10.23937/2378-2951/1410012
Nikhil Mehta, Medhat Abdelmessih, Lachlan Smith, Daniel Jacoby and Mark Marieb
Article Type: Research Article | First Published: November 25, 2014
Head and neck cancers rarely manifest as Carotid Sinus Syndrome (CSS). CSS is a rare complex of symptoms found in 1% of all patients who experience syncope, the pathophysiology of which is yet to be fully understood. Common trigger mechanisms for CSS include neck movement, shaving, constricting neck wear, coughing, sneezing and straining to lift heavy objects. The left carotid sinus mainly causes AV block while the right carotid sinus mainly causes sinus bradycardia. The incidence of AV block in...
Open Access DOI:10.23937/2378-2951/1410011
Jason C. Rubenstein, Jason Jacobson, Jeffrey J. Goldberger, Rod Passman, Alan Kadish and Michael H. Kim
Article Type: Research Article | First Published: November 25, 2014
Background: The range of elevation of troponin I (tI) that is within expected limits from left atrial radiofrequency ablation for atrial fibrillation (AF) is not well described, though such information may be of clinical value. Objectives: Identify the expected range of tI values post-atrial fibrillation (AF) ablation. Methods: 31 patients undergoing AF ablation had a single tI level drawn the day following the procedure. Clinical variables were also collected, such as ablation type and radiof...
Open Access DOI:10.23937/2378-2951/1410010
Donatella B, Angela V, Emilia I, Kristian E, Claudia C, Rita SA, Francesco F and Riccardo F
Article Type: Research Article | First Published: November 25, 2014
Aims: Cardiac Autonomic Modulation (CAM) may be pivotal for Atrial Fibrillation (AF) occurrence and affect early recurrence (ER) after Electrical Cardioversion (EC). Previous studies investigating linear (L) Heart Rate Variability (HRV) after EC have given conflicting results about which CAM pattern favours ER. This study aimed at evaluating if non-linear (NL) HRV analysis (HRVa) could provide better accuracy in predicting ER. Methods: 36 patients, 16 under Antiarrhythmic Drugs (AAD), were enrol...
Open Access DOI:10.23937/2378-2951/1410009
Wenjian Jiang, Haiyang Li, Dong Guo, Yongqiang Lai and Hongjia Zhang
Article Type: Case Report | First Published: November 24, 2014
A 64-year-old woman, received implantation of a Permanent Pace Maker (PPM) 7 years ago, was referred for severe tricuspid valve regurgitation with a lead impingement of the tricuspid valve leaflets. We fied the lead to the posterior septal commissure, used 28 # Edwards MC3 ring to annulus form the tricuspid valve ring and then sutured the posterior septal commissure by edge to edge. This patient recovered uneventfully, with only mild tricuspid valve regurgitation by echocardiography after one ye...
Open Access DOI:10.23937/2378-2951/1410008
Kammoun I, Marrakchi S, Zouari F, Fersi I, Ibn Elhaj Z, Mokrani S, Added F and Kachboura S
Article Type: Research Article | First Published: November 21, 2014
Background: Functional mitral regurgitation (FMR) is one of the common and severe complications in patients with dilated cardiomyopathy. Then determinants of degree of FMR must be more defined. Purpose: We sought to determine a cut off value of the tenting area and the coaptation depth which correlate with the severity of the FMR. Methods and results: We enrolled prospectively 96 patients (71 males; age 57 ± 13 years) with left ventricular (LV) dilation and systolic dysfunction (LV ejecti...
Open Access DOI:10.23937/2378-2951/1410007
Anupam Dey, Ramesh Aggarwal and Shridhar Dwivedi
Article Type: Letter to Editor | First Published: November 21, 2014
Rheumatic heart disease (RHD) has practically vanished from developed countries; however one often sees complicated rheumatic valvular disease in elderly individuals, in developing countries. It is not very common to see operated cases of mitral stenosis (MS) coexisting with coronary artery disease (CAD). Studies have reported prevalence of CAD coexisting with rheumatic MS ranging from 1.7% to 28%. We recently had a case of rheumatic MS, who was operated twice, had again developed restenosis, an...
Open Access DOI:10.23937/2378-2951/1410006
John P. Higgins and Brandon L. Ortiz
Article Type: Review Article | First Published: October 31, 2014
It is an age-old idea to try to boost one's performance in order to achieve an elusive goal or conquer an obstacle. Many energy products, especially energy drinks (ED) are now marketed to this need, and examples include Red Bulls' 'Gives You Wings', as well as Monster Energy's 'Unleash the Beast' advertising campaigns. In the light of ED consumption recently being associated with high risk behaviors, unhealthy habits, and some deaths in adolescents and young adults, especially when consumed wh...
Open Access DOI:10.23937/2378-2951/1410005
Valliappan Muthu, Sahajal Dhooria and Inderpaul Singh Sehgal
Article Type: Case Report | First Published: October 30, 2014
Organophosphorus pesticides related self-harm is afairly common clinical entity responsible for over two thirds of pesticide related deaths in the rural areas of developing countries. Organophosphates by their action at muscarinic and nicotinic receptors can have a myriad of presenting symptoms. Here we describe a fatal case of phorate (organophosphorus) toxicity manifesting with hypothermia and cardiotoxicity....
Open Access DOI:10.23937/2378-2951/1410004
D. Olga McDaniel, Lance Majors, Taolin Fang, Feng Zhang and Larry S. McDaniel
Article Type: Research Article | First Published: October 29, 2014
The emerging role of the innate immune response in organ transplantation heightens the significance of molecular markers released from the donor organ due to ischemia/reperfusion injury (IRI) during organ procurement. These molecules are prime activators of innate immunity. Allograft inflmmatory factor-1 (AIF- 1) has been implicated in the regulation of inflmmation and organ rejection. To verify expression level of AIF-1 in cardiac tissues, we developed a rat model of IRI, in which the left ante...
Open Access DOI:10.23937/2378-2951/1410003
Nimmathota Arlappa, Avula Laxmmaiah, Nagalla Balakrishna, Rachakula Harikumar, Kodavanti Mallikharjuna Rao and GNV Brahmam
Article Type: Research Article | First Published: October 02, 2014
Background: The world has witnessed the demographic transition in which there is increased proportion of elderly (≥ 60 years) population. This increased longevity is associated with the burden of chronic noncommunicable diseases. Objective: To assess the prevalence of hypertension and its relationship with adiposity among the elderly in rural India. Subjects and methods: A community based cross-sectional study was carried out among 3133 elderly (Men: 1677; Women: 1456). Height, weight,...
Open Access DOI:10.23937/2378-2951/1410002
Article Type: Editorial | First Published: September 29, 2014
Greetings to all readers as we move in to the era of science and technology. Let us hope to witness several exciting developments in the field of cardiology that would pave way to the cure of many cardiological disorders in this new era. This year the International Journal of Clinical Cardiology is debuting in field of open access. We hope to bring to you some of scientific excitements. There had been much progress in the field of Heart Transplantation Surgery. Doctors and Researcher from all ac...
Open Access DOI:10.23937/2378-2951/1410001
Wilbert S. Aronow
Article Type: Editorial | First Published: September 01, 2014
Dyslipidemia in diabetics should be treated with lifestyle measures. Statins are the only lipid-lowering drugs that have been demonstrated to lower the incidence of cardiovascular events and mortality in patients with diabetes mellitus. This review article will discuss the treatment of dyslipidemia in diabetics and the current guidelines supporting the use of statins in the treatment of diabetics....
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