Nigerian Journal of Cardiology最新文献

{"title":"Rare but not forgotten: Case series of pulmonary embolism with S1Q3T3 pattern","authors":"B. Chung, Z. Tan","doi":"10.4103/njc.njc_35_20","DOIUrl":"https://doi.org/10.4103/njc.njc_35_20","url":null,"abstract":"Pulmonary embolism (PE) is a common acute cardiovascular disorder. The most common electrocardiograph (ECG) finding in PE is sinus tachycardia. However, the S1Q3T3 pattern of acute cor pulmonale also called McGinn-White sign is classic. We report three cases of a 48-year-old man, 41-year-old woman, and a 66-year-old woman diagnosed with PE with the ECG findings of S1Q3T3 pattern. In conclusion, recognizing these ECG findings could prompt clinicians to consider PE and lead to earlier diagnosis.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131901734","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":"Anticoagulation in a pregnant patient with mechanical heart valves: Case reports and literature review","authors":"S. Isezuo, H. Umar, M. Usman, M. Ndakotsu","doi":"10.4103/njc.njc_18_19","DOIUrl":"https://doi.org/10.4103/njc.njc_18_19","url":null,"abstract":"Patients with prosthetic mechanical heart valves require a life-long anticoagulation. This is more so during pregnancy which increases the risk of thrombosis. We present two pregnant patients with prosthetic mechanical valves managed up to delivery. All the patients were on warfarin before conception which was changed to unfractionated heparin after confirmation of pregnancy. At 14 weeks gestation, they were changed back to warfarin until 36 weeks gestation. Unfractionated heparin was reintroduced until delivery. All the patients had minimal postpartum hemorrhage. Mrs. XX, one of them, had four successful deliveries since the placement of mechanical valve. Pregnancy for a woman mechanical valve poses a greater risk to both the mother and the fetus. This group of women should have preconception care in a specialized program.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123095596","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":"Assessment of right ventricular functions by echocardiography in patients with acute myocardial infarction in North India: An observational study","authors":"H. Showkat, Sadaf Anwar, L. Gupta, Rekha Mishra, S. Padmawati, A. Sarmast, B. Mujtaba, Vinoda Sharma, S. Saxena, Sudheer Saxena","doi":"10.4103/njc.njc_21_19","DOIUrl":"https://doi.org/10.4103/njc.njc_21_19","url":null,"abstract":"Background: Right Ventricle (RV) dysfunction may be primarily attributed to abnormality of RV myocardium or secondary to left ventricle (LV) dysfunction, as a consequence of “Ventricular Interdependence” between the two ventricles, as they are encircled by common muscle fibres, share a common septal wall and are enclosed within a common pericardium6,7 Early recognition of RV dysfunction is warranted but till today it remains a challenging task because of complex structure and asymmetric. Aims: To study Right Ventricular functions in Acute coronary syndrome. Method: All patients with first presentation of Acute STEMI/NSTEMI with a total of 100 patients who match our inclusion criteria were studied from June 2015 to May 2017 on Phillips Epiq 7 echocardiography Machine with follow up echocardiography at discharge. Results: A total of 100 patients of acute myocardial infarction were studied with 73% STEMI & 27% NSTEMI & among these 68% were anterior wall MI (AWMI) & 32% inferior wal MI (IWMI). Prevalence of different risk factors observed in study population was as follows: Dyslipidaemia in 68% patients, diabetes mellitus 64%, hypertension was present in 54%, Family history of coronary artery disease (CAD) was present in 43 % of patients & Smoking was prevalent in 27 % of cases. The present study demonstrated presence of RV dysfunction assessed by echocardiography, in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI. Conclusions: The present study demonstrates presence of RV dysfunction assessed by echocardiography (RVEDD (RV end diastolic diameter), TAPSE (transannular plane systolic excursion), FAC (Fractional area change), E/E', RV MPI (Myocardial performance index) by TDI (tissue Doppler imaging)), in acute MI (STEMI/NSTEMI) irrespective of infarction location and was more commonly seen in AWMI than IWMI. This study demonstrated presence of RV dysfunction in acute MI more so in STEMI than NSTEMI with high morbidity and mortality in patients with RV dysfunction irrespective of site of infarction.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128822640","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 atrial myxoma mimicking severe mitral stenosis and severe pulmonary hypertension","authors":"Balarabe Aminu, K. Karaye, N. Ishaq, S. Kana, M. Yakasai, M. Sani","doi":"10.4103/njc.njc_3_20","DOIUrl":"https://doi.org/10.4103/njc.njc_3_20","url":null,"abstract":"Cardiac myxomas are the most commonly encountered benign intracardiac tumors. Although the left atrium is the most commonly involved in majority of cases, myxoma can arise in any cardiac chamber. We present the case of a 53-year-old female with background hypertension, who presented with the features of heart failure and found to have large left atrial myxoma mimicking severe mitral stenosis and severe pulmonary hypertension. She had the excision of the myxoma mass. The case illustrates that atrial myxoma is the diagnosis to keep in view as an occasional cause of cardiac murmur even in a society with a high prevalence of rheumatic valvular heart disease and cardiomyopathies.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133375962","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":"Influenza myocarditis complicated with atrioventricular block in a pregnant woman","authors":"C. Chang, Joshua Khiong Chung, D. Perera","doi":"10.4103/njc.njc_2_20","DOIUrl":"https://doi.org/10.4103/njc.njc_2_20","url":null,"abstract":"Acute myocarditis is a well-recognized complication of influenza infection. The incidence of myocardial involvement in influenza infection is variable, and the clinical severity can range from asymptomatic to fulminant forms. Influenza infection can rarely be complicated by acute myocarditis leading to high-degree atrioventricular block and cardiogenic shock. We report a previously healthy pregnant woman, who initially presented with symptoms of influenza-like illness, later confirmed as influenza A infection. She developed hypotension shortly after admission that did not respond to fluid bolus and required inotropic support. On day 5, the electrocardiogram showed Mobitz I second-degree heart block, which later progressed to the third-degree heart block. Echocardiogram showed good cardiac contractility and minimal pericardial effusion while cardiac biomarkers were normal. A diagnosis of influenza myocarditis was made. She completed a course of oral oseltamivir and had temporary cardiac pacing performed, and subsequently recovered well.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122273025","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":"Rheumatic heart disease in Nigeria: A review","authors":"O. Ogah, F. Bode‐Thomas, C. Yilgwan, O. Ige, Fisayo Ogah, O. Ogunkunle, C. Okwuonu, M. Sani","doi":"10.4103/njc.njc_30_19","DOIUrl":"https://doi.org/10.4103/njc.njc_30_19","url":null,"abstract":"Rheumatic heart disease (RHD) is a major public health problem in resource-poor countries, especially in sub-Saharan Africa where about 1 million affected children between 5 and 14 years of age live with the disease. The aim of this paper is to review current knowledge on the clinical epidemiology of RHD in Nigeria, identify gaps, and suggest possible future directions. A systematic literature search was conducted using African Journal online (AJOL), Cinahl, Google Scholar, PubMed, and Web of Science. In PubMed, the following medical subject headings and free text terms were used: “Rheumatic heart disease” OR “Rheumatic “Valvular heart disease” OR “Rheumatic fever” AND “Nigeria”. The same text word search was used in Google scholar, AJOL, CINAHL, and Web of Science. A search date was limited to articles published from January 1950 to December, 2018. A total of 44 original studies were reviewed. Nineteen (45.2%) of the studies used clinical criteria for diagnosis of RHD, 19 (40.5%) used echocardiographic diagnosis, and 6 (14.3%) used autopsy or post mortem examination of the patients for the diagnosis of RHD. Five (11.9%) of the studies were conducted in children only, 9 (16.7%) were in both children and adults, and the remaining 31 (73.8%) were done in adults only. Only 6 (14.3%) of the studies reported complications seen in patients with RHD. Of the 6 studies that reported on complications, only 1 reported on recurrent of acute rheumatic fever. Mitral valvular disease was the most common lesion reported in all the studies. RHD still remains a major cardiovascular health problem in Nigeria. There is therefore a need for more recent clinical studies on the contemporary pattern of RHD in Nigeria. In addition, community based screening for RHD is needed to determine the true burden of the disease in Nigeria. Finally, primary and secondary preventive measures are needed to help reduce the burden of RHD in Nigeria.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124746265","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":"Electromechanical dyssynchrony and short-term outcomes of readmission and death, among heart failure patients in Aminu Kano teaching hospital, Kano State, Nigeria","authors":"Bashir Ahmad, M. Mijinyawa, M. Sani","doi":"10.4103/njc.njc_10_20","DOIUrl":"https://doi.org/10.4103/njc.njc_10_20","url":null,"abstract":"Background: Cardiac dyssynchrony refers to a difference in the timing of contractions in different chambers and/or segments of the heart. Left ventricular (LV) dyssynchrony is frequently seen in patients with heart failure (HF) and is a poor prognostic marker if left untreated. The impact of cardiac dyssynchrony among HF patients in Nigeria is unknown. We set out to assess the role of electromechanical dyssynchrony in short-term outcomes in terms of readmission and 6-month mortality among HF patients in our hospital. Methods: We conducted a prospective observational study among adult HF patients in our hospital. Electrical and mechanical dyssynchrony were measured using electrocardiography and echocardiography, respectively. Data on the outcome of readmission and death within 6 months were collected. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 16 software. Results: A total of 100 participants were recruited for this study. Electrical dyssynchrony (Duration of QRS complex on ECG > 120ms) was found in 11%, 8 (73%) of them had QRS width between 120 and 150 ms, while in three, the QRS width was >150 ms. The prevalence of interventricular dyssynchrony (LV preejection interval – right ventricular preejection interval ≥40 ms) was found to be 79%, while that of intraventricular (septal to posterior wall motion delay >130 ms) was 75%. Nineteen percent of the study participants were readmitted with worsening HF symptoms, while up to 37% died within the 6 months follow-up period. Electrical dyssynchrony was a significant predictor of short-term readmission and death. There was also a statistically significant difference (P < 0.005) between all forms of dyssynchrony and death. Conclusion: The presence of electromechanical dyssynchrony is associated with a poor short-term outcome of readmission and death. More studies are needed in our country to fully define the burden of dyssynchrony among HF patients in our environment.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123881115","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":"Ventricular tachycardia revealing a peripartum cardiomyopathy in a 33-year-old new mother","authors":"J. Makani, S. Kaky, M. Ikama, C. K. Kouala Landa","doi":"10.4103/njc.njc_29_19","DOIUrl":"https://doi.org/10.4103/njc.njc_29_19","url":null,"abstract":"We report a case of ventricular tachycardia due to peripartum cardiomyopathy in a 33-year-old woman. The clinical symptomatology was dominated by recurrent palpitations. Doppler echocardiography revealed dilated cardiac chambers and a left ventricular ejection fraction at 30%. Treatment with amiodarone led to cardioversion. Furosemide and captopril have been used to treat heart failure.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126601251","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":"Prevalence of arrhythmias on 24-h ambulatory Holter electrocardiogram monitoring in LASUTH: A report on 414 patients","authors":"P. Adebola, Folasade Daniel, A. Ajibare, Ajayi Reima","doi":"10.4103/njc.njc_26_19","DOIUrl":"https://doi.org/10.4103/njc.njc_26_19","url":null,"abstract":"Background: The 24-h ambulatory holter electrocardiogram (ECG) monitor is particularly able to document bradyarrhythmic or tachyarrhythmic episodes which might be missed on normal 12-lead resting ECG recordings. It is, therefore, particularly useful in evaluating patients with symptomatic or asymptomatic paroxysmal tachy/bradyarrhythmias and is also useful in monitoring patients on antiarrhythmic therapy. The present study was aimed at presenting our findings on the prevalence of arrhythmias on the 24-h Holter ECG of a relatively large cohort of patients referred to our cardiac facility, over the last few years. Methods: This was a retrospective audit of prevalence of cardiac arrhythmias among 414 patients consisting of 184 males and 230 females who were referred for 24-h Holter ambulatory ECG monitoring in LASUTH, Ikeja, Nigeria, between January 2014 and June 2019. Their age ranged from 13 to 95 years with a mean age of 50.42 ± 16.29. Results: The most common single indications for Holter monitoring in these patients were unexplained palpitation and presyncope/syncope. Ventricular extrasystole was the most common arrhythmias found on Holter ECG. Only 14 out of the 414 patients had Holter ECG evidence of nonsustained ventricular tachycardia (VT). There was no significant difference in the prevalence of cardiac arrhythmias in males compared to their female counterparts. However, elderly patients of 65 years and above had significantly higher prevalence of cardiac arrhythmias when compared to their younger counterparts (χ2 = 54.46, P < 0.01). Conclusion: The study suggests that palpitation is the most common reason for referral of patients for 24-h ambulatory Holter ECG test. It also showed that ventricular extrasystoles are the most common arrhythmias on the 24-h Holter ECG. In addition, it reinforces the fact that nonsustained VT is uncommon among the Nigerian patients and that elderly patients were more likely to have cardiac arrhythmias compared to their younger counterparts.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124048019","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":"Supraventricular tachycardia complicating pneumonia in a resource-poor setting","authors":"U. Susan, Uche-Ajunwa Ijeoma, Mankwe Chesa","doi":"10.4103/njc.njc_12_19","DOIUrl":"https://doi.org/10.4103/njc.njc_12_19","url":null,"abstract":"Pneumonia is a common condition in children, especially among the under-fives and a leading cause of morbidity and mortality. Cardiac complications, including congestive heart failure, arrhythmias, myocarditis, and myocardial infarction, are a significant burden among patients hospitalized for pneumonia. Supraventricular tachycardia (SVT) is the most common cardiac arrhythmia in children requiring therapy. We present a 6-week-old Nigerian female child admitted into our children emergency with clinical features suggestive of pneumonia who subsequently developed SVT confirmed by electrocardiogram without an underlying cardiac defect. The child improved on antibiotics, propranolol, and digoxin and was discharged home for follow-up. SVT is a life-threatening clinical condition. High index of suspicion is required as recognition could be made difficult by its nonspecific symptoms.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121497018","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}