Journal of Clinical Cardiology最新文献

{"title":"Giant Coronary Artery Aneurysm due to Polyarteritis Nodosa in an Eight-Year-Old Child","authors":"Maza Olga Cecilia, Gallon Carlos Alberto, Echeverria Rafael Vicente, Mora Isabel, A. Jairo","doi":"10.23937/2378-2951/1410221","DOIUrl":"https://doi.org/10.23937/2378-2951/1410221","url":null,"abstract":"Systemic polyarteritis nodosa is a vasculitis characterized by inflammation and fibrinoid necrosis of medium and small arteries, with a global incidence of 0.7/100,000 and a prevalence of 6.3/100,000. Its cause is as yet unknown, and it affects both children and adults. The clinical presentation tends to be insidious and vague in its initial stages. Cardiac involvement is one of the signs of severity, with coronary artery impairment and aneurysmal lesions of varying degrees. The consequent heart failure and acute myocardial infarction are complications which increase mortality. Without treatment, five-year survival is 13%. Medical treatment is aimed at halting the inflammatory process and treating the consequences of the dysfunction of various organs and systems. We present a case of an eight-year-old boy with polyarteritis nodosa who developed giant aneurysms of the coronary arteries with severe cardiac dysfunction and multisystem impairment. The proper diagnosis and prompt treatment achieved clinical recovery and early survival.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75434990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Pediatric Cardiology over the Last 50 Years (Trends in Transcatheter Interventions for Pediatric Heart Disease - Part I)","authors":"Rao P Syamasundar","doi":"10.23937/2378-2951/1410220","DOIUrl":"https://doi.org/10.23937/2378-2951/1410220","url":null,"abstract":"Citation: Rao PS (2021) Evolution of Pediatric Cardiology over the Last 50 Years (Trends in Transcatheter Interventions for Pediatric Heart Disease Part I). Int J Clin Cardiol 8:220. doi.org/10.23937/23782951/1410220 Accepted: March 06, 2021: Published: March 08, 2021 Copyright: © 2021 Rao PS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72468802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Spontaneous Coronary Artery Dissection Presenting as Acute STEMI - Is Intervention the Only Answer?","authors":"Sinha Santosh Kumar, Sharma Awadesh Kumar, Razi Mahmodullah, P. Umeshwar","doi":"10.23937/2378-2951/1410219","DOIUrl":"https://doi.org/10.23937/2378-2951/1410219","url":null,"abstract":"Spontaneous coronary artery dissection (SCAD) is a rare but an important cause of ST elevation myocardial infarction (STEMI) in young patients. Here, we report case of a 32-year-old male presenting as acute anterior wall STEMI for which was thrombolysed. Coronary angiogram revealed spiral luminal filling defects with extensive contrast staining of proximal left anterior descending artery involving diagonal branch representing Type D dissection. As patient refused any intervention, he was managed conservatively. He presented with unstable angina 6-weeks later. Repeat angiogram revealed complete healing of dissection along with borderline lesion. As his treadmill test was negative for exercise induced myocardial ischaemia, he was managed conservatively. This case highlights that beside intervention, patients with high grade dissection may respond to conservative management.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78413712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Spatial Dispersion of P-Wave, QRS Complex, and QT-Interval on 12-Lead Electrocardiogram in Apparently Healthy Adults","authors":"I OguanobiNelson, U OdenigboCharles, C OguejioforOgonna, C OkonkwoUchenna, M OdenigboUkamaka, Agogbua Tobenna","doi":"10.23937/2378-2951/1410218","DOIUrl":"https://doi.org/10.23937/2378-2951/1410218","url":null,"abstract":"Background: The spatial dispersion of P-wave, QRS complex, and QT interval on 12-lead electrocardiogram are related to the electrical instability in cardiac conducting tissues and elevated parameters are associated with increased risk of cardiovascular morbidity and mortality. Objectives: We sought to evaluate the dispersion of P-wave, QRS complex, and QT interval in healthy adult Nigerians and assess their relationship to age, gender, anthropometric and some physiologic parameters. Methods: A total of 128 subjects were recruited for the study. The participants consist of two groups; a young age group of 62 apparently healthy individuals (aged 18-35 years) and an elderly age group of 66 participants (aged 60-89 years) drawn from attendees to the quarterly medical lectures of the Ebreime Foundation for the Elderly, a non-Governmental organization. The exclusion criteria for the study were presence of acute or chronic illnesses and medications capable of affecting electrocardiogram. All subjects had background medical history assessment, clinical examination and resting 12-lead electrocardiography. The dispersion of P-wave, QRS and QT intervals were measured manually under magnifying glass by one observer and were taken as the difference between the maximum and minimum values of each parameter on standard 12lead electrocardiogram. Results: The elderly subjects had significantly higher body mass index compared to the young subjects. Blood pressure indices were comparable in the two groups. The dispersions of P-wave, QRS and QT on 12-lead electrocardiography were all significantly increased in the elderly. Significant gender variations were noted in QRS dispersion, QTc interval and QT dispersion which were all significantly increased in women. A significant correlation was noted between QT dispersion and body mass index (r = 0.280; p = 0.023). Conclusion: Age, gender and body mass index are significant determinants of P-wave, QRS, and QT dispersion in the adult population. Identification of high risk individuals for cardiovascular disease for prompt preventive intervention is of prime importance.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75294723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Global Longitudinal Strain to Predict Post-Operative Outcomes in Non-Cardiac Surgeries","authors":"Park Chang Joon, Tan Si, Huang Pei, Tan Puay Joo, See Jason Jia Hao","doi":"10.23937/2378-2951/1410217","DOIUrl":"https://doi.org/10.23937/2378-2951/1410217","url":null,"abstract":"Background: Pre-operative echocardiography is performed in select groups of patients for cardiac risk stratification. Many parameters, including Left Ventricular Ejection Fraction (LVEF), are assessed during echocardiography. While many studies have cited association between low LVEF and poor operative outcomes, patients with preserved LVEF might have subtle LV dysfunction that may result in adverse outcome. Studies have described the routine use of global longitudinal strain (GLS) as an alternative measure of ventricular function that can detect subtle LV dysfunction. The aim of this study is to determine the value of GLS in predicting post-operative outcomes in non-cardiac surgeries. Methods: This was a retrospective study of patients who had normal LVEF, had undergone subsequent non-cardiac surgery, and had post-operative troponins measured. Outcomes for post-operative myocardial injury, as well as hospital re-admissions and mortality up to 1-year post-surgery were collected. Post-op myocardial injury was defined as a peak Troponin T value of > 0.030 ng/dL or a > 20% increment from baseline. Results: A total of 42 patients were included. 61.9% (n = 26) were males and mean age was 72.3 years. Mortality at 1 year was 14.3% (n = 6) and 28.6% (n = 12) were deemed to have post-operative myocardial injury. 1-year mortality was associated with lower GLS (-18.95% vs. -23.75%, p = 0.001). However, GLS was not associated with post-operative myocardial injury and hospital readmissions. Conclusion: Although GLS values were decreased in non-survivors, our study did not demonstrate the utility of GLS in predicting post-operative events. BRief RePoRT","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78497386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Risk Factors and its Reduction by Plant-Based Diet with Emphasis on Diabetes: A Preliminary Report","authors":"Panigrahi Gunadhar","doi":"10.23937/2378-2951/1410216","DOIUrl":"https://doi.org/10.23937/2378-2951/1410216","url":null,"abstract":"Background: The common coronary risk factors are hypertension, hyperlipidemia, obesity and diabetes. These can be improved with Plant-Based diet. Objective: To reduce coronary risk factors by Plant-Based diet with emphasis on diabetes. Methods: In the first part (Part A), the subjects are 805 patients treated for hypertension, hyperlipidemia, obesity, diabetes, and coronary artery disease (CAD) from January 2012 through October 2015. Primary prevention group (without CAD) consisting of 423 patients are compared to the Secondary prevention group (with CAD) consisting of 382 patients (Table 1). The second part (Part B) is to determine the effect of plant-based diet in reducing coronary risk factors in 20 patients with diabetes, divided in to two groups, dietary compliant vs. dietary non-compliant group. Results: Part A: Analysis of risk factors for CAD shows that risk ratio for hypertension is 1.4803 (p = 0.0002), hyperlipidemia 1.9118 (p = 0.0023), diabetes 1.5357 (p < 0.0001), obesity 0.8637 (p = 0.0565), age ≥ 65 years 1.4665 (p < 0.0001), male sex 1.6509 (p < 0.0001) (Table 2). Gender related analysis of CAD risk factors indicated higher incidence of diabetes in females compared to males (Table 3). Part B: In the diabetic cohort analysis of risk factors between dietary compliant and non-compliant group (Table 4) showed an average drop in HbA1c of 3.03% vs. decrease of 0.03%, p = 0.0049, total cholesterol decreased by 68.8 mg/dl vs. increase of 13.2 mg/dl, p = 0.0018, weight decreased by 9.02 kg vs. increase of 1.78 kg, p = 0.0071, BMI decreased by 3.28 kg/m2 vs. increase by 1.22 kg/m2, p = 0.0071. There was no significant difference for systolic and diastolic blood pressures between the two groups (Table 5). The reduction in HbA1c was associated with reduction in the number of antidiabetic medications only in the compliant group and this is unchanged in the non-compliant groups, a decrease from 2.1 to 1.2 vs. no change from 2.6 to 2.6, p = 0.0753 (Table 6). Conclusion: Plant-based diet improved coronary risk factors, including decrease in HbA1c in the patients with diabetes. This is associated with the need for reduced number of antidiabetic medications.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87348595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Assist Devices and Their Role in Cardiogenic Shock: Literature Review and Contemporary Data","authors":"S. Tzikas, Evan Ap, A. Boulmpou, G. Loufopoulos, C. Papadopoulos, Vassilikos","doi":"10.23937/2378-2951/1410215","DOIUrl":"https://doi.org/10.23937/2378-2951/1410215","url":null,"abstract":"Despite tremendous progress in the therapeutic algorithms of hemodynamically unstable patients, cardiogenic shock remains a clinical challenge with high mortality rate. Conservative management with inotropic agents remains the first-choice treatment, though it has been associated with serious adverse events and is not always adequate. Circulatory support with mechanical devices has been widely implemented in patients with cardiogenic shock during high-risk percutaneous coronary interventions or post-cardiac surgery complications and has been associated with favorable outcomes. In patients with acute decompensated heart failure, ventricular assist devices have been used to prolong the recovery period and reverse the cause of hemodynamic instability. In the present review, we discuss the current evidence on the use of percutaneous assist devices for the treatment of cardiogenic shock, plus we highlight the need for future evolution in this particular field that may permit the optimal choice of each device for different patients or clinical situations.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86774781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Vagococcus fluvialis Prosthetic Valve Endocarditis and Aortic Root Abscess","authors":"M BackLiam, M. Joseph, Guiney Liam, L. Roger, H. Akram, W. David","doi":"10.23937/2378-2951/1410213","DOIUrl":"https://doi.org/10.23937/2378-2951/1410213","url":null,"abstract":"We describe a case of Vagococcus fluvialis infective endocarditis with associated aortic root abscess in a 50-year-old male on his second bioprosthetic aortic valve replacement. Only two cases of Vagococcus endocarditis have been recorded to our knowledge, and this case reinforces the fulminant nature of a rare organism. Case RepoRt","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77587955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximising the Diagnostic Utility of the Exercise Treadmill Test","authors":"Asamoah Kofi Tekyi","doi":"10.23937/2378-2951/1410214","DOIUrl":"https://doi.org/10.23937/2378-2951/1410214","url":null,"abstract":"Ischaemic heart disease was the leading cause of mortality according to the World Health Organisation in the year 2018 and disease burden keeps increasing steadily across the globe. Early diagnosis and intervention are therefore key in mitigating its effect on society. The exercise treadmill test is an important, cost-effective investigation employed in the evaluation of coronary artery disease, allowing for early diagnosis and a decision on revascularization to be made. Reliable interpretation depends on multiple factors, combined in the Duke Treadmill Score. An early positive test result suggests a severe coronary artery obstruction which requires urgent revascularisation to reduce morbidity and mortality risk. This is a report on a patient who had an early positive test, with subsequent angiographic findings validating the exercise treadmill test results. It also highlights relevant considerations in performing and interpreting the exercise treadmill test.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73026889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Coronary Artery Dissection with Predisposing Fibromuscular Dysplasia: Diagnosed during a Single Catheterisation Procedure","authors":"Lepper Agw de, W Aarnoudse, A. Algin, M. Winkens, M. Magro","doi":"10.23937/2378-2951/1410212","DOIUrl":"https://doi.org/10.23937/2378-2951/1410212","url":null,"abstract":"A middle-aged woman presented with a non-ST-segment elevation myocardial infarction which was due to a spontaneous coronary artery dissection of the distal right coronary artery. Angiography of the femoral artery prior to placement of a closure device revealed tortuosity consistent with multifocal fibromuscular dysplasia. CAse RePoRt","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85125578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}