Journal of Clinical Cardiology最新文献

{"title":"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","authors":"Abedin Zameer, Gough David, Abedin Moeen, S. Tariq, Mukherjee Debabrata, Ojha Chandra P, Mulla Zuber D, Abedin Zainul","doi":"10.23937/2378-2951/1410196","DOIUrl":"https://doi.org/10.23937/2378-2951/1410196","url":null,"abstract":"Introduction: A diagnosis of an old inferior wall myocardial infarction (IMI) by computerized interpretation of a routinely performed electrocardiogram (ECG) may lead to further consultations and imaging studies to confirm or refute that diagnosis. This study was designed to assess the value of abnormal Q waves combined with repolarization abnormalities in inferior leads for the diagnosis of an old IMI as confirmed by imaging studies. Methods: 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 techniques. Measures of accuracy were calculated and reported with 95% exact binomial confidence intervals (CI). Results: Computerized interpretation of the ECGs leading to the diagnosis of old IMI when compared with IMI confirmed by imaging studies, had a positive predictive value of 52.8% (95% exact CI: 35.5%-69.6%). Adding the manually measured Q waves wider than 40 msec and amplitude of -0.2 mV and repolarization abnormalities in leads II, III and aVF increased the positive predictive value of the test to 86.2% (95% exact CI: 68.3%-96.1%). Conclusions: These results suggest that the computerized interpretation of ECG results in a high rate of false positive readings of old IMI. Presence of diagnostic Q waves in inferior leads, if accompanied by repolarization abnormalities, improves the accuracy of the ECG for the diagnosis of old IMI.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"166 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77406693","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":"Analysis of Complications of Acute Coronary Syndrome and Their Outcomes in India","authors":"V. Balakumaran, H. Namrata, Anirudhya, Rathod Nitin","doi":"10.23937/2378-2951/1410194","DOIUrl":"https://doi.org/10.23937/2378-2951/1410194","url":null,"abstract":"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 with chest pain in early morning hours. Thrombolysis was given to 46 patients (92%); and out of these, 21 (42%) patients succumbed to death. This study emphasised mainly on health education on adoption of health lifestyles and symptoms; early access to health care algorithm control of hypertension and related morbidites. Thestudy hasalso tried to adress need of policy ramficication for strengthingfor Non-communicable diseases in developing countries. *Corresponding author: Dr. Namrata Hange, Resident Medical Officer, National University of Health System, Singapore coronary diseases has declined by 30% over past two decades [7-9], approximately 1 in every 25 patients survived the initial hospitalization dies in the first year after AMI [2,10]. In several patients, progressive nature of heart failure leading to ischemic cardiomyopathy reflects the progressive nature of underlying coronary artery disease [7,9]. Thus, identification of patients who are going to develop future heart failure after first myocardial infarct and detection of the extent of future heart failure is the corner stone of secondary prevention strategies and main prospective for treatment in reducing morbidity and mortality from heart failure following AMI [10,11]. Coronary heart disease is the greatest cause of death among women as well; mainly affecting women younger than 45 years [1,12,13]. Developing countries are trying to tackle the cardiac events especially government medical colleges which serves to cater needy population of the strata. This study presents brief snapshot of population presenting of complications of acute coronary syndromes. It also attempts to study clinical profile of patients presenting with complications of acute coronary syndrome in developing country like India.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81762873","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":"Extensive Coronary Thrombus in Patients Presenting with STEMI and COVID-19 Infection","authors":"L. Angela, N. Calvin, Boutis Loukas, M AzariBani","doi":"10.23937/2378-2951/1410195","DOIUrl":"https://doi.org/10.23937/2378-2951/1410195","url":null,"abstract":"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.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83001041","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 Case of New Onset Iohexol Contrast Induced Kounis Syndrome after Prior Contrast Exposure","authors":"Shah-Hinan Ahmed, Sangha Maheep","doi":"10.23937/2378-2951/1410193","DOIUrl":"https://doi.org/10.23937/2378-2951/1410193","url":null,"abstract":"• Page 1 of 3 • Shahab and Sangha. Int J Clin Cardiol 2020, 7:193 Citation: Shahab A, Sangha M (2020) A Case of New Onset Iohexol Contrast Induced Kounis Syndrome after Prior Contrast Exposure. Int J Clin Cardiol 7:193. doi.org/10.23937/2378-2951/1410193 Accepted: July 29, 2020; Published: July 31, 2020 Copyright: © 2020 Shahab A, 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. A Case of New Onset Iohexol Contrast Induced Kounis Syndrome after Prior Contrast Exposure","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84274482","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":"Percutaneous Reversal of Cyanosis on Catheterization Table in a 12-Year-Old Boy using Cera Vascular Plug - A Case Report","authors":"Sinha Santosh Kumar, Razi Mahmodullah, P. Umeshwar, K. Vinay","doi":"10.23937/2378-2951/1410192","DOIUrl":"https://doi.org/10.23937/2378-2951/1410192","url":null,"abstract":"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 (multiple) was diagnosed which was arising from right pulmonary artery. Complete occlusion was achieved using two 12 mm Cera vascular plug, thereby reversing the cyanosis on catheterization table. On follow up at 9 months, clubbing also disappeared.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88585978","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":"Syncope in a Patient with H/O Kearns Sayre Syndrome","authors":"Yasin Saddam, Mehmood Kanwal, A. Osama","doi":"10.23937/2378-2951/1410191","DOIUrl":"https://doi.org/10.23937/2378-2951/1410191","url":null,"abstract":"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 required in addition to pacing to prevent risk of sudden cardiac death. A subset of these patients might continue to experience life threatening arrhythmias including torsade de pointes and ventricular fibrillation despite a functional pacemaker.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74339445","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":"Impact of the SARS-Cov-2 Virus Pandemic on Children and Adults with Congenital Heart Disease: Its Burden and Risk Factors","authors":"A. Jairo","doi":"10.23937/2378-2951/1410190","DOIUrl":"https://doi.org/10.23937/2378-2951/1410190","url":null,"abstract":"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 paucity of published cases related to coronavirus infection, its ultimate behavior cannot yet be known. Based on the anatomical and hemodynamic abnormalities with systemic repercussions which accompany congenital heart disease, this review was carried out with the aim of describing and analyzing this population’s risk factors and potentially increased vulnerability to coronavirus infection. Systemic hematological abnormalities, along with the prothrombotic state, proinflammatory state, and altered immune response in cyanotic congenital heart disease are highlighted; along with the arrhythmias, pulmonary hypertension, underlying heart failure and target organ damage, among others, present in unrepaired congenital heart disease. This review searched for articles in PubMed, Science Direct, SciELO, MD Consult and Google Scholar using the MeSH terms “coronavirus disease 2019”, “COVID-19”, “SARS-CoV-2 pandemic”, “coronavirus and cardiovascular system”, “congenital heart diseases”, “hematologic disorders in congenital heart disease”, and “pro-inflammatory mediators”. Finally, a brief description of the collateral effects of the pandemic on the care of this population is provided.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73038432","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":"Rapid-Onset Thrombocytopenia Following Tirofiban Administration","authors":"M SmithAndrew, G PetrieTimothy, J PageBrian","doi":"10.23937/2378-2951/1410189","DOIUrl":"https://doi.org/10.23937/2378-2951/1410189","url":null,"abstract":"Thrombocytopenia, defined as a platelet count less than 150 × 10^9/L, has a broad differential of causes and can lead to life threatening complications. We present a case of rapid thrombocytopenia following an Aggrastat (tirofiban) bolus. The platelet count decreased from 195 × 10^9/L at the time of admission to 18 × 10^9/L. After discontinuing tirofiban, the platelet count increased to 95 × 10^9/L within several hours. PF-4 antibody and serotonin release assay testing for potential heparin induced thrombocytopenia were negative. This case highlights the importance of close monitoring of the platelet count with tirofiban administration. Medical professionals should remain aware of causes for acute thrombocytopenia in the coronary care unit and their management.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89729758","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":"Platelet Aggregation Capacity of Clopidogrel Bisulphate Inhibited by Rabeprazole and Simvastatin in Patients Undergoing Myocardial Infarction in a Tertiary Care System: Drug Interaction Study","authors":"Nagavi Jinesh Bahubali, G. Bannimath","doi":"10.23937/2378-2951/1410188","DOIUrl":"https://doi.org/10.23937/2378-2951/1410188","url":null,"abstract":"Background: 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 infarction (STEMI), cardiac stent and percutaneous coronary intervention (PCI). Objectives of the study: 1. To determine the potential drug-drug interactions among patients on dual antiplatelets, PPIs and statins. 2. To determine the demographic and clinical characteristics of the patients to understand the competitive metabolism of the drugs. 3. To estimate the platelet aggregation effect of dual antiplatelets in presence of PPI’s and statins. Methodology: In the present study, potential drug-drug interactions (pDDI) was analyzed in the patients on dual antiplatelet therapy (DAPT) along with proton pump inhibitors and patients on dual antiplatelet therapy with proton pump inhibitors and statins. Platelet aggregation was measured in 116 patients undergoing ST segment elevated Myocardial infarction (STEMI), cardiac stent and percutaneous coronary intervention (PCI) with clopidogrel bisulphate and aspirin along with PPI’s and statins. Results: In the current study, Rabeprazole and Simvastatin, but not Omeprazole and rosuvastatin, decreased the antiplatelet activity of clopidogrel. The percent platelet aggregation was 81 ± 5 (p = 0.001) and 33 ± 10 (p = 0.027) in the presence of clopidogrel with Rabeprazole and pantoprazole respectively. Aggregation was found to be 91 ± 4 (p = 0.001) and 22 ± 03 (p = 0.031) in presence of clopidogrel with Simvastatin and rosuvastatin respectively. Conclusion: A prominent drug-drug interaction was observed with patients on dual antiplatelet therapy along with Rabeprazole and Simvastatin.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72511010","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":"Increased Incidence and Prevalence of Cardiovascular Events and Mortality in Female Patients with NAFLD: A Meta-Analysis and Meta-Regression","authors":"Khalid Yaser, Dasu Neethi, S. Herman, Dasu Kirti, R. Debashis, Shah Ankit, McMahon Donald, L. Adam","doi":"10.23937/2378-2951/1410187","DOIUrl":"https://doi.org/10.23937/2378-2951/1410187","url":null,"abstract":"Background: 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 incidence and prevalence in patients with NAFLD. Objective: We assessed incidence and prevalence of CV events and mortality based on gender in patients with NAFLD, at any stage of fibrosis. A meta-regression was conducted to further analyze the impact of age on both genders. Methods: An aggregate analysis was performed on ten studies with NAFLD patients. A random-effects model was used to pool the overall incidence and prevalence rates of CV events and mortality as well as all-cause mortality to examine any gender disparity. We also performed a meta-regression analysis to evaluate the effect of age on mortality for men versus women with NAFLD and CV events and mortality. Summary odds ratios (OR) and 95% confidence intervals (CI) were estimated using a random-effects model. Results: In 259,598 patients with NAFLD, of which 44% were females and 56% were males, all-cause mortality was 1.5 × higher in women compared to men (OR 1.65, 95% CI 1.12-2.43, p < 0.012). CV events and mortality were also 2 × higher in women compared to men (OR 2.12 95% CI 1.652.73, p < 0.001). On meta-regression, females had higher mortality with advancing age starting at age 42 (coefficient = 0.0518, p = 0.00001). Conclusion: For patients with NAFLD, women had a markedly higher incidence and prevalence of CV events, CV mortality and all-cause mortality when compared to men. Meta-regression showed increased mortality among women with advancing age. As the incidence and prevalence of NAFLD and concomitant CV events increases worldwide, we urge the medical community to increase surveillance and perform rigorous cardiovascular risk assessments for women, especially beginning at age 42. Additionally, we recommend heterogenous surveys of gender disparities, increased focus on gender as a decisive factor for downstream CV events, the relationship between NAFLD severity and gender-based mortality differences, and larger studies representing equivalent male and female populations.","PeriodicalId":15510,"journal":{"name":"Journal of Clinical Cardiology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78983729","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}