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Reuse of catheters and devices labelled for single use: evidence, recommendations and oversight. 标记为一次性使用的导管和器械的重复使用:证据、建议和监督。
Heart Asia Pub Date : 2018-11-09 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011033
Thomas C Crawford, Kim A Eagle
{"title":"Reuse of catheters and devices labelled for single use: evidence, recommendations and oversight.","authors":"Thomas C Crawford, Kim A Eagle","doi":"10.1136/heartasia-2018-011033","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011033","url":null,"abstract":"Cardiovascular disease has become the most common cause of death and morbidity throughout the world, not just the affluent societies. In 2015, there were 422 million prevalent cases of cardiovascular disease worldwide, and it accounted for an estimated 30% of deaths.1 2As most people live in low-income and middle-income countries, the burden of cardiovascular disease is the greatest in resource-poor countries. The cardiovascular epidemic has a direct impact on the health of the patients and also on the welfare of the economies in which those patients live and work. Poverty can be both a contributing cause and a consequence of cardiovascular disease. It is in the context of oppressive burden of healthcare spending that the discussion about reusing catheters and devices should be considered.\u0000\u0000### Historical context\u0000\u0000In the mid-20th century, most medical devices were made of metal, glass or rubber and were generally reusable. Technological developments in the 1960s and 1970s brought out a wave of new polymers, which could be harnessed and which would eventually transition a multiuse medical industry into a single-use paradigm. Many open surgical procedures were gradually replaced by laparoscopic or endovascular procedures. In the 1980s and 1990s, new concerns regarding transmission of bloodborne pathogens such as hepatitis B and C, and HIV coincided with the explosive development of new technologies. Advances in manufacturing techniques, and expectation of improved product performance and predictability deepened interest in single-use devices (SUDs). The confluence of all these factors led to the evolution and dramatic expansion of the SUD concept. Original equipment manufacturers (OEMs) began to submit applications to the United States Food and Drug Administration (FDA) asking for approval of their products as SUDs. In some instances, the manufacturers changed the labelling from multiuse to single use only without making significant structural changes to the devices.3 The designation …","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011033"},"PeriodicalIF":0.0,"publicationDate":"2018-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36788374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis. 癌症抗原125与急性心力衰竭的预后:一项系统回顾和荟萃分析。
Heart Asia Pub Date : 2018-10-26 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011044
Ka Hou Christien Li, Mengqi Gong, Guangping Li, Adrian Baranchuk, Tong Liu, Martin C S Wong, Aaron Jesuthasan, Rachel W C Lai, Jenny Chi Ling Lai, Alex Pui Wai Lee, Antoni Bayés-Genis, Rafael de la Espriella, Juan Sanchis, William K K Wu, Gary Tse, Julio Nuñez
{"title":"Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis.","authors":"Ka Hou Christien Li,&nbsp;Mengqi Gong,&nbsp;Guangping Li,&nbsp;Adrian Baranchuk,&nbsp;Tong Liu,&nbsp;Martin C S Wong,&nbsp;Aaron Jesuthasan,&nbsp;Rachel W C Lai,&nbsp;Jenny Chi Ling Lai,&nbsp;Alex Pui Wai Lee,&nbsp;Antoni Bayés-Genis,&nbsp;Rafael de la Espriella,&nbsp;Juan Sanchis,&nbsp;William K K Wu,&nbsp;Gary Tse,&nbsp;Julio Nuñez","doi":"10.1136/heartasia-2018-011044","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011044","url":null,"abstract":"<p><strong>Background: </strong>Carbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. A recent meta-analysis examined its prognostic value in heart failure generally. However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).</p><p><strong>Methods: </strong>PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.</p><p><strong>Results: </strong>A total of 129 and 179 entries were retrieved from PubMed and EMBASE. Sixteen studies (15 cohort studies, 1 randomised trial) including 8401 subjects with AHF (mean age 71 years old, 52% male, mean follow-up 13 months, range of patients 525.1±598.2) were included. High CA125 levels were associated with a 68% increase in all-cause mortality (8 studies, HRs: 1.68, 95% CI 1.36 to 2.07; p<0.0001; I<sup>2</sup>: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I<sup>2</sup>: 73%). CA125 levels were higher in patients with fluid overload symptoms and signs compared with those without them, with a mean difference of 54.8 U/mL (5 studies, SE: 13.2 U/mL; p<0.0001; I<sup>2</sup>: 78%).</p><p><strong>Conclusion: </strong>Our meta-analysis found that high CA125 levels are associated with AHF symptoms, heart failure-related hospital readmissions and all-cause mortality. Therefore, CA125 emerges as a useful risk stratification tool for identifying high-risk patients with more severe fluid overload, as well as for monitoring following an AHF episode.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011044"},"PeriodicalIF":0.0,"publicationDate":"2018-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36701507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 29
Preoperative cigarette smoking and short-term morbidity and mortality after cardiac surgery: a meta-analysis. 术前吸烟与心脏手术后短期发病率和死亡率的meta分析
Heart Asia Pub Date : 2018-10-24 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011069
Nicholas Gregory Ross Bayfield, Adrian Pannekoek, David Hao Tian
{"title":"Preoperative cigarette smoking and short-term morbidity and mortality after cardiac surgery: a meta-analysis.","authors":"Nicholas Gregory Ross Bayfield,&nbsp;Adrian Pannekoek,&nbsp;David Hao Tian","doi":"10.1136/heartasia-2018-011069","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011069","url":null,"abstract":"<p><p>Currently, the choice of whether or not to electively operate on current smokers is varied among cardiothoracic surgeons. This meta-analysis aims to determine whether preoperative current versus ex-smoking status is related to short-term postoperative morbidity and mortality in cardiac surgical patients. Systematic literature searches of the PubMed, MEDLINE and Cochrane databases were carried out to identify all studies in cardiac surgery that investigated the relationship between smoking status and postoperative outcomes. Extracted data were analysed by random effects models. Primary outcomes included 30-day or in-hospital all-cause mortality and pulmonary morbidity. Overall, 13 relevant studies were identified, with 34 230 patients in current or ex-smoking subgroups. There was no difference in mortality (p=0.93). Current smokers had significantly higher risk of overall pulmonary complications (OR 1.44; 95% CI 1.27 to 1.64; p<0.001) and postoperative pneumonia (OR 1.62; 95%  CI 1.27 to 2.06; p<0.001) as well as lower risk of postoperative renal complications (OR 0.82; 95%  CI 0.70 to 0.96; p=0.01) compared with ex-smokers. There was a trend towards an increased risk of postoperative MI (OR 1.29; 95%  CI 0.95 to 1.75; p=0.10). No difference in postoperative neurological complications (p=0.15), postoperative sternal surgical site infections (p=0.20) or postoperative length of intensive care unit stay (p=0.86) was seen. Cardiac surgical patients who are current smokers at the time of operation do not have an increased 30-day mortality risk compared with ex-smokers, although they are at significantly increased risk of postoperative pulmonary complications.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011069"},"PeriodicalIF":0.0,"publicationDate":"2018-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36650375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Association between apparent temperature and acute coronary syndrome admission in Rasht, Iran. 伊朗拉什特地区体表温度与急性冠状动脉综合征入院的关系
Heart Asia Pub Date : 2018-10-22 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011068
Mohammad Taghi Moghadamnia, Ali Ardalan, Alireza Mesdaghinia, Kazem Naddafi, Mir Saeed Yekaninejad
{"title":"Association between apparent temperature and acute coronary syndrome admission in Rasht, Iran.","authors":"Mohammad Taghi Moghadamnia,&nbsp;Ali Ardalan,&nbsp;Alireza Mesdaghinia,&nbsp;Kazem Naddafi,&nbsp;Mir Saeed Yekaninejad","doi":"10.1136/heartasia-2018-011068","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011068","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to assess the relations between apparent temperature and incidence of acute coronary syndrome (ACS) in Rasht, Iran.</p><p><strong>Methods: </strong>We used a time-series analysis to investigate the relationship between apparent temperature and hospital admission from 2005 to 2014. Distributed lag non-linear models were used to estimate the association between ACS hospitalisation and apparent temperature. To examine the high-temperature effect on ACS hospital admission, the relative risk of ACS hospital admission associated with high temperature, the 99th percentile of temperature (34.7°C) compared with the 75th percentile of temperature (26.9°C), was calculated. To assess the cold effect on ACS hospital admission, the relative risk of ACS hospital admission associated with cold temperature, the first percentile of temperature (-0.2°C) compared with the 25th percentile of temperature (8.2°C), was evaluated.</p><p><strong>Results: </strong>The cumulative effect of hot exposure on ACS admissions was statistically significant, with a relative risk of 2.04 (95% CI 1.06 to 4.16). The cumulative effect of cold temperature on ACS admissions was found to be non-significant. The highest risk of ACS admission in women was in 38°C (RR, 2.03, 95%  CI 1.04 to 4.18). The effect of hot temperature on ACS admission occurred immediately (lag 0) (RR, 1.09, 95%  CI 1.001 to 1.19).</p><p><strong>Conclusions: </strong>The high apparent temperature is correlated with a higher ACS admission especially on the same day. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related morbidity especially in the elderly.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011068"},"PeriodicalIF":0.0,"publicationDate":"2018-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36650374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 16
Economic burden of hospitalisation for congestive heart failure among adults in the Philippines. 菲律宾成年人因充血性心力衰竭住院的经济负担。
Heart Asia Pub Date : 2018-10-10 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011039
Bernadette A Tumanan-Mendoza, Victor L Mendoza, April Ann A Bermudez-Delos Santos, Felix Eduardo R Punzalan, Noemi S Pestano, Rudy Boy Natividad, Louie Alfred Shiu, Renelene Macabeo, Hilton Y Lam
{"title":"Economic burden of hospitalisation for congestive heart failure among adults in the Philippines.","authors":"Bernadette A Tumanan-Mendoza, Victor L Mendoza, April Ann A Bermudez-Delos Santos, Felix Eduardo R Punzalan, Noemi S Pestano, Rudy Boy Natividad, Louie Alfred Shiu, Renelene Macabeo, Hilton Y Lam","doi":"10.1136/heartasia-2018-011039","DOIUrl":"10.1136/heartasia-2018-011039","url":null,"abstract":"<p><strong>Objectives: </strong>Hospitalisation for congestive heart failure (CHF) was reported to be 1648 cases for every 100 000 patient claims in 2014 in the Philippines; however, there are no data regarding its economic impact. This study determined CHF hospitalisation cost and its total economic burden. It compared the healthcare-related hospitalisation cost from the societal perspective with the payer's perspective, the Philippine Health Insurance Corporation (PhilHealth).</p><p><strong>Methods: </strong>This is a cost analysis study. Data were obtained from representative government/private hospitals and a drugstore in all regions of the country. Healthcare costs included cost of diagnostics/treatment, professional fees and other CHF-related hospital charges, while non-healthcare costs included production losses, transportation and food expenses.</p><p><strong>Results: </strong>The overall mean healthcare-related cost for CHF hospitalisation (class III) in government hospitals in the Philippines in 2014 was PHP19 340-PHP28 220 (US$436-US$636). In private hospitals, it was PHP28 370-PHP41 800 (US$639-US$941). In comparison, PhilHealth's coverage/CHF case rate payment is PHP15 700 (US$354). The mean non-healthcare cost was PHP10 700-PHP14 600 (US$241-US$329). Using PhilHealth's case rate payment and the prevalence of CHF hospitalisation in 2014, the total economic burden was PHP691 522 200 (US$15 574 824). Using the study results on healthcare-related cost meant that the total economic burden for CHF hospitalisation would instead be PHP851 850 000-PHP1 841 563 000 (US$19 185 811-US$41 476 644).</p><p><strong>Conclusions: </strong>The calculated healthcare-related hospitalisation cost for CHF in the Philippines in 2014 demonstrates the disparity between the actual cost and PhilHealth's coverage. This implies a need for policymakers to review its coverage to make healthcare delivery affordable.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011039"},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203040/pdf/heartasia-2018-011039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36650373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013-2015. 2013-2015年阿拉伯联合酋长国阿布扎比院内心脏骤停流行病学
Heart Asia Pub Date : 2018-09-17 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011029
Faisal Aziz, Marilia Silva Paulo, Emad H Dababneh, Tom Loney
{"title":"Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013-2015.","authors":"Faisal Aziz,&nbsp;Marilia Silva Paulo,&nbsp;Emad H Dababneh,&nbsp;Tom Loney","doi":"10.1136/heartasia-2018-011029","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011029","url":null,"abstract":"<p><strong>Objective: </strong>Estimate the incidence and outcomes of in-hospital cardiac arrest (IHCA) in a tertiary-care hospital in Abu Dhabi emirate, United Arab Emirates (UAE).</p><p><strong>Methods: </strong>Retrospective data from 685 inpatients who experienced an IHCA at a hospital in Abu Dhabi (UAE) between 1 January 2013 and 31 December 2015 were analysed. Sociodemographic variables were age and gender, and IHCA event variables were shift, day, event location, initial cardiac rhythm and the total number of IHCA events. Outcome variables were the return of spontaneous circulation (ROSC) and survival to discharge (StD).</p><p><strong>Results: </strong>The incidence of IHCA was 11.7 (95% CI 10.8 to 12.6) per 1000 hospital admissions. Non-shockable rhythms were 91.1% of the cardiac rhythms at presentation. The majority of IHCA cases occurred in the intensive care unit (46.1%) and on weekdays (74.6%). More than a third (38.3%) of patients who experienced an IHCA achieved ROSC and 7.7% StD. Both ROSC and StD were significantly higher in patients who were younger and presenting with a shockable rhythm (all <i>p</i>'s≤0.05). Survival outcomes were not significantly different between dayshifts and nightshifts or weekdays and weekends.</p><p><strong>Conclusions: </strong>The incidence of IHCA was higher and its outcomes were lower compared with other high-income/developed countries. Survival outcomes were better for patients who were younger and had a shockable rhythm, and similar between time of day and days of the week. These findings may help to inform health managers about the magnitude and quality of IHCA care in the UAE.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011029"},"PeriodicalIF":0.0,"publicationDate":"2018-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36517522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Percutaneous closure of iatrogenic arteriovenous fistula after pacemaker implantation. 起搏器植入术后医源性动静脉瘘的经皮闭合。
Heart Asia Pub Date : 2018-08-31 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011072
Praveen Kumar Gupta, Santhosh Satheesh, Raja J Selvaraj
{"title":"Percutaneous closure of iatrogenic arteriovenous fistula after pacemaker implantation.","authors":"Praveen Kumar Gupta,&nbsp;Santhosh Satheesh,&nbsp;Raja J Selvaraj","doi":"10.1136/heartasia-2018-011072","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011072","url":null,"abstract":"A 76-year-old man presented with swelling of the left upper limb that started 1 year after pacemaker implantation. During the procedure, a single-pass VDD lead was introduced through an axillary vein puncture and was positioned in the right ventricular apex.\u0000\u0000Pitting oedema of the left upper limb was seen, with reddish-brown skin pigmentation, scaling and thickening (figure 1A). Subclavian …","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011072"},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36504992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Barriers and facilitators to treatment among patients with newly diagnosed hypertension in Nepal. 尼泊尔新诊断高血压患者治疗的障碍和促进因素
Heart Asia Pub Date : 2018-08-31 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011047
Sachita Shrestha, Archana Shrestha, Rajendra P Koju, James P LoGerfo, Biraj Man Karmacharya, Nona Sotoodehnia, Annette L Fitzpatrick
{"title":"Barriers and facilitators to treatment among patients with newly diagnosed hypertension in Nepal.","authors":"Sachita Shrestha,&nbsp;Archana Shrestha,&nbsp;Rajendra P Koju,&nbsp;James P LoGerfo,&nbsp;Biraj Man Karmacharya,&nbsp;Nona Sotoodehnia,&nbsp;Annette L Fitzpatrick","doi":"10.1136/heartasia-2018-011047","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011047","url":null,"abstract":"<p><strong>Objective: </strong>Hypertension is a significant and rising burden in Nepal. The disease remains undetected and inadequately managed. However, no studies have been conducted to understand the inhibiting and facilitating factors to hypertension treatment among newly diagnosed cases. This qualitative study aimed to explore barriers and facilitators to treatment among patients with newly diagnosed hypertension aged ≥18 years in Dhulikhel, Nepal.</p><p><strong>Methods: </strong>We conducted seven focus group discussions with 35 patients with newly diagnosed hypertension identified through community surveillance of the Dhulikhel Heart Study, an observational cohort of Dhulikhel Hospital, Kathmandu University. Audiotaped discussions were transcribed, inductively coded and analysed by the thematic framework method using Atlas.ti V.7.</p><p><strong>Results: </strong>Hypertension was viewed as a rising problem in the community. Participants had limited knowledge and many misbeliefs regarding hypertension and its treatment. The major barriers included absence of symptoms, reluctance to take medicine, low perceived seriousness of the disease, challenges in behaviour change (diet and exercise), lack of family support, and lack of communication and trust with the provider. The major reported facilitating factors were fear of consequences of the disease, and family support in controlling diet and adhering to treatment.</p><p><strong>Conclusions: </strong>A number of factors emerged as barriers and facilitators to hypertension treatment. This information can be useful in designing appropriate health interventions to improve hypertension management.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011047"},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36504991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
ST segment elevation myocardial infarction with normal coronary arteries. 冠状动脉正常的ST段抬高型心肌梗死。
Heart Asia Pub Date : 2018-08-17 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011084
Siddharthan Deepti, Raghav Bansal, Sandeep Singh
{"title":"ST segment elevation myocardial infarction with normal coronary arteries.","authors":"Siddharthan Deepti,&nbsp;Raghav Bansal,&nbsp;Sandeep Singh","doi":"10.1136/heartasia-2018-011084","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011084","url":null,"abstract":"<p><strong>Case presentation: </strong>A middle-aged patient presented to the emergency department with intermittent chest pain of 4-hour duration. The patient had been recently diagnosed with metastatic adenocarcinoma of the colon and was receiving 5-fluorouracil (5-FU)-based chemotherapy at the time of presentation. The ECG at presentation showed 1 mm ST segment elevation in leads II, III and aVF, with reciprocal changes in leads aVL, V1 and V2 (figure 1A). Serum cardiac troponin I level was elevated at 0.11 ng/mL (normal: 0.00-0.02 ng/mL). The patient was given sublingual nitrate and loading doses of aspirin, clopidogrel and atorvastatin, and was taken up for coronary angiography with an intent to perform primary percutaneous coronary intervention.Figure 1(A) 12-lead ECG done at presentation to the emergency department. (B) 12-lead ECG done 30 min after coronary angiography.The images of the coronary angiogram are shown in figure 2. The patient was angina-free by this time. A repeat ECG done 30 min after coronary angiography is shown in figure 1B. Two-dimensional transthoracic echocardiogram revealed normal left ventricle (LV) systolic function and no regional wall motion abnormality.Figure 2Images of the coronary angiogram of the patient. (A) Right anterior oblique view with a caudal angulation showing left anterior descending (LAD) artery and left circumflex (LCx) artery. (B) Left anterior oblique view with a cranial angulation showing right coronary artery (RCA).</p><p><strong>Question: </strong>What is the likely mechanism of myocardial infarction in this patient?In situ coronary artery thrombosis with spontaneous recanalisation.Epicardial coronary artery vasospasm.Coronary artery embolism.Coronary microvascular dysfunction.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 2","pages":"e011084"},"PeriodicalIF":0.0,"publicationDate":"2018-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36449429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Audit of defibrillators at an urban public sector hospital. 对一家城市公立医院除颤器的审计。
Heart Asia Pub Date : 2018-08-17 eCollection Date: 2018-01-01 DOI: 10.1136/heartasia-2018-011065
S'fisosikayise Madi, Feroza Motara, Callistus Enyuma, Abdullah Ebrahim Laher
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引用次数: 3
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