Heart Views最新文献

{"title":"Characteristics of Significant Pericardial Effusion and Outcomes of Pericardiocentesis: A 4-year Retrospective Data Review.","authors":"Mohamed Salah Abdelghani, Mohammad Altermanini, Alaa Rahhal, Osama Alkhalailah, Khalid Shunnar, Mohanad Shehadeh, Adalah Alqalalwah, Baraa AlQudah, Ahmed Shebani, Ibrahim Obeidat, Haneen AlAni, Mohamed Izham Mohamed Ibrahim, Mawahib Elhassan, Rasha Kaddoura, Jassim Al Suwaidi, Abdulrahman Arabi","doi":"10.4103/heartviews.heartviews_120_24","DOIUrl":"10.4103/heartviews.heartviews_120_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pericardial effusion can lead to severe complications such as cardiac tamponade, necessitating immediate intervention. Various causes and prevalence vary according to the region. To the best of our knowledge, there is limited data from the Middle East region about pericardial effusion and outcomes of pericardiocentesis.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at Heart Hospital, the only tertiary cardiology center in Qatar, to assess the clinical and echocardiographic characteristics of pericardial effusion and the impact of pericardiocentesis. Patients admitted to the cardiac intensive care unit between January 2017 and February 2021 with significant pericardial effusion confirmed either by large amount using transthoracic echocardiography (TTE), clinical signs, or echocardiographic signs suggestive of tamponade were included. The study evaluated clinical outcomes, including complications of pericardiocentesis and laboratory parameters before and after the procedure.</p><p><strong>Results: </strong>A total of 114 patients were included in our retrospective analysis. The most common etiology of pericardial effusion in the study was idiopathic (31.6%), followed by malignancy (25.4%), viral infection (13.2%), and tuberculosis (12.3%). Most patients (95%) had moderate to large effusions by TTE. Pericardiocentesis was successfully performed in 82.5% of patients. After pericardiocentesis, heart rate significantly decreased from 105 to 95 bpm (<i>P</i> < 0.001), and laboratory results showed significant improvement in renal and liver function, including serum creatinine, alanine transaminase, aspartate aminotransferase, and bilirubin levels. There were no pericardiocentesis-related deaths, but 6.38% of patients died within 28 days due to advanced primary diseases.</p><p><strong>Conclusion: </strong>Idiopathic causes were the most common, followed by malignancy. Pericardiocentesis, performed in an ICU setting with TTE guidance, was safe, with a 100% survival rate and low complication risk. Patients with impaired kidney and liver functions experienced significant improvement postprocedure. These findings offer valuable insights into pericardial effusion in Qatar and allow for comparisons with neighboring Middle Eastern countries.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"212-218"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249951","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}

{"title":"Cardiac Involvement in Chronic Kidney Disease: Epidemiology, Pathophysiology, and Complications.","authors":"Eleni Tzatzaki, Matthaios Didagelos, Eleni Karlafti, Christina Melexopoulou, Dimitrios Tsavdaris, Antonios Ziakas, Smaragdi Marinaki, Haralambos Karvounis","doi":"10.4103/heartviews.heartviews_118_24","DOIUrl":"10.4103/heartviews.heartviews_118_24","url":null,"abstract":"<p><p>There is a complex interaction between the heart and kidneys. Cardiac and renal function are both affected physically, chemically, and biologically. In end-stage renal disease (ESRD) patients, cardiovascular disease is the leading cause of mortality. The pathophysiological mechanisms leading to cardiac manifestations in end-stage chronic kidney disease are the decreased oxygen supply to the myocardium, the increased preload, and the left ventricular (LV) afterload alterations. The cardiac complications observed in these patients are LV hypertrophy, myocardial fibrosis, diastolic dysfunction of the left ventricle, coronary artery disease, calcification of the mitral annulus and the aortic valve, and pulmonary hypertension. Several biomarkers that may lead to prevention and early identification of heart complications in these patients are being investigated. In conclusion, the complex relationship between cardiac and renal functions significantly affects patient outcomes in ESRD, highlighting the urgent need for early recognition and intervention strategies to limit cardiovascular complications and improve overall patient care.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 4","pages":"249-254"},"PeriodicalIF":0.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249950","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}

{"title":"Incidental Cardiac Lipoma in a Pediatric Patient.","authors":"Sebahattin Memis, Mehmet Semih Demirtas","doi":"10.4103/heartviews.heartviews_38_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_38_24","url":null,"abstract":"<p><p>Cardiac lipomas are primary benign tumors of the heart, consisting mainly of fat cells and the capsule surrounding them. They are rare, usually detected incidentally, and are mostly asymptomatic or may cause symptoms depending on their location. In this case, we planned to present a 13-year-old male patient who was diagnosed with cardiac lipoma, had echocardiography follow-up at regular intervals, and was treated symptomatically. Although cardiac magnetic resonance imaging and histopathological diagnosis are required to confirm the diagnosis of cardiac lipoma, resection may not be necessary due to the location of the mass and the fact that it does not cause any life-threatening symptoms, as in our patient.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"162-165"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543552","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}

{"title":"Transient Left Ventricular Outflow Tract Obstruction in an Elderly Patient Admitted with Takotsubo.","authors":"Waleed Khalid Abdullatef, Khaled Al Khodari, Smitha AnilKumar","doi":"10.4103/heartviews.heartviews_16_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_16_24","url":null,"abstract":"<p><p>A 68-year-old elderly individual presented with takotsubo cardiomyopathy, and echocardiography revealed left ventricular outflow tract obstruction with a substantial gradient, particularly exacerbated by the Valsalva maneuver. Resolution occurred within a few days through meticulous fluid management and beta-blocker administration, concurrent with an improvement in ejection fraction.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"152-156"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543564","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}

{"title":"The Promising Role of Speckle-tracking Echocardiography in Detecting the Patchy Nature of Myocarditis, Insights from Case Series in the Largest Pediatrics Tertiary Center of UAE.","authors":"Antoine Fakhry AbdelMassih, Arshad Khan, Zahra Majichian, Afnan Musleh, Ashutosh Goyal, Sara M AlDarmaki","doi":"10.4103/heartviews.heartviews_54_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_54_24","url":null,"abstract":"<p><p>There is increasing evidence that myocarditis starts as a patchy process, accordingly, the detection of segmental affection is important for early recognition of the disease and proper initiation of anti-inflammatory treatment. We present our first experience here with using speckle-tracking echocardiography (STE) to detect subtle segmental involvement of the left ventricle in two cases with suspected myocarditis. STE consolidated the diagnosis and helped with the early initiation of intravenous immunoglobulins and subsequent control of the disease. STE was also able to show the specific topography of distribution of each pathogen linked to inflammation.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"157-161"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543562","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}

{"title":"Anterolateral Minithoracotomy Mitral Valve Surgery with Central Cannulation: A Three-year Single-Center Experience.","authors":"Anil Sharma, Sunil Dixit, Mohit Sharma, Jai Kishan Suthar, Sourabh Mittal","doi":"10.4103/heartviews.heartviews_10_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_10_24","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, minimally invasive mitral valve surgery has become a standard procedure all over the world. A simplified and reproducible technique for performing mitral valve surgery through a right minithoracotomy with central aortocaval cannulation from the same incision, utilizing conventional instruments, has been developed. This innovative approach eliminates the requirement for endoscopic assistance, femoral arterial cannulation, and associated complications. This study aims to analyze the outcomes of patients who underwent minimally invasive mitral valve replacements (MVRs) with central cannulation between January 2016 and June 2018.</p><p><strong>Methods: </strong>To conduct this analysis, preoperative variables, intraoperative data, and postoperative outcomes of patients undergoing minimally invasive MVRs were prospectively collected in our database from January 2016 to June 2018.</p><p><strong>Results: </strong>A total of 350 patients underwent minimally invasive MVR surgery, with a mean age of 33.40 ± 10.89 years. Among them, 9.4% underwent concomitant procedures, such as tricuspid valve surgery and atrial septal defect closure. The mean cardiopulmonary bypass and cross-clamp times were 54.45 ± 4.95 min and 36.85 ± 4.39 min, respectively. Conversion to sternotomy was required in none of the patients. Major morbidities included stroke (<i>n</i> = 1; 0.29%) and new-onset dialysis requirement (<i>n</i> = 3; 0.85%). The mean blood transfusion requirement was 0.15 ± 0.27 units. The mean intensive care unit stay was 2.13 ± 0.32 days, and the hospital stay was 5.36 ± 1.12 days.</p><p><strong>Conclusions: </strong>This study represents a valuable option in MVR surgery. Thoracotomy MVR is a safe and reproducible technique with excellent cosmesis.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"127-132"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543069","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}

{"title":"Extremely Unusual Coronary Involvement in Cardiac Sarcoidosis.","authors":"Amanpreet Singh Wasir, Manish Bansal, Anand Jaiswal, Surbhi Pande, Abha Thakur, Haimanti Sarin, Kartikeya Bhargava","doi":"10.4103/heartviews.heartviews_67_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_67_24","url":null,"abstract":"<p><p>Left ventricular (LV) regional wall motion abnormalities are common in cardiac sarcoidosis but coronary occlusion is very rare. Here, we report a case of cardiac sarcoidosis with very unusual coronary involvement. A 43-year-old man presented with a persistent cough and a history of uveitis 6 months back with no other comorbidities. He was initially treated with empirical antitubercular treatment but continued to have an intractable cough and hence, underwent further evaluation. Echocardiography revealed global LV systolic dysfunction with inferior wall akinesia and LV ejection fraction 25%-30%. Cardiac magnetic resonance imaging confirmed these findings. It also showed subendocardial late gadolinium enhancement localized to the inferior wall segments with 50%-75% transmural extent. 18-fluorodeoxyglucose (FDG) positron emission tomography showed multiple FDG-avid lymph nodes all over the body along with intense myocardial FDG uptake confined to the inferior wall. Coronary angiography was performed which showed double-vessel disease with critical stenosis of the right coronary artery (RCA). Ultrasonography-guided fine-needle aspiration cytology from inguinal lymph nodes showed nonnecrotizing granulomas without any evidence of tuberculosis. He was started on steroids and appropriate heart failure medications and underwent percutaneous transluminal coronary angioplasty with stent to RCA. Later, he presented with hemodynamically stable ventricular tachycardia and received an implantable cardioverter defibrillator.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"187-192"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543551","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}

{"title":"The Heart's Secret Bridge: Ruptured Sinus of Valsalva Aneurysm Masquerading as a Gerbode Defect.","authors":"Khalid Sawalha, Angel Lopez-Candales","doi":"10.4103/heartviews.heartviews_48_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_48_24","url":null,"abstract":"<p><p>Our case presents a 53-year-old male with type 2 diabetes and dyslipidemia presenting to the emergency department with symptoms of chest pressure, palpitations, dyspnea, and exercise intolerance. On initial imaging, an abnormal color flow signal was seen that was initially thought to be secondary to a Gerbode defect. However, using more detailed imaging, cardiac computed tomography angiography suggested the possibility of a noncoronary sinus of Valsalva aneurysm (SOVA) rupture into the right atrium, making the diagnosis challenging. Finally, transesophageal echocardiography confirmed rupture of a SOVA. This case report highlights the importance of maintaining a high index of suspicion when considering rare cardiac anomalies and emphasizes the significance of using different imaging modalities to reach an accurate diagnosis.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"174-178"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543560","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}

{"title":"Characteristics and Outcomes of Heart Failure Outpatients with Improvement in Ejection Fraction in Qatar.","authors":"Rasha Kaddoura, Jassim Zaheen Shah, Mohamed Izham Mohamed Ibrahim, Rajvir Singh, Ammar Chapra, Haisam Alsadi, Maha Al Amri, Tahseen Hamamyh, Manar Fallouh, Farras Elasad, Mohamed Salah Abdelghani, Sumaya Alsaadi Alyafei, Amr Badr, Ashfaq Patel","doi":"10.4103/heartviews.heartviews_34_24","DOIUrl":"10.4103/heartviews.heartviews_34_24","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure with reduced ejection fraction (HFrEF) in Qatar has not been well characterized in the outpatient setting.</p><p><strong>Objective: </strong>To describe the characteristics of patients with HFrEF who had improvement in their left ventricular ejection fraction (LVEF) and independent predictors of improvement.</p><p><strong>Methods: </strong>This retrospective cohort study conducted at the advanced heart failure (HF) clinic in Qatar recruited patients who visited the clinic between January 2017 and December 2018. Adult patients were eligible if they were diagnosed with HFrEF (LVEF < 40%) and had two echocardiograms separated by at least 6 months.</p><p><strong>Results: </strong>Of 582 eligible patients, 161 (27.7%) had improved LVEF. They were younger (53.4 vs. 57.3 years, <i>P</i> = 0.002) and had shorter duration of HF diagnosis (4.3 vs. 5.6 years, <i>P</i> = 0.001). They experienced lower rates of all-cause hospitalization (20.5% vs. 38.0%, <i>P</i> = 0.001) and emergency department visits (25.5% vs. 35.9%, <i>P</i> = 0.001), without a difference in hospital mortality rate, than those without LVEF improvement. Decreased odds ratio of improved LVEF was associated with per year increase in age (adjusted odds ratio [aOR]: 0.98, 95% confidence interval [CI]: 0.97-0.99, <i>P</i> = 0.03), presence of left bundle branch block (aOR: 0.40, 95% CI: 0.20-0.80, <i>P</i> = 0.001), duration of HF diagnosis (aOR: 0.85, 95% CI: 0.78-0.94, <i>P</i> = 0.001), and ischemic HF etiology (aOR: 0.50, 95% CI: 0.30-0.77, <i>P</i> = 0.001; compared with dilated etiology). Beta-blocker therapy was associated with higher odds of LVEF improvement (aOR: 2.65, 95% CI: 1.02-6.88, <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Patients with HFrEF with improved LVEF were younger, had a nonischemic cardiomyopathy, and had significantly fewer hospitalizations and emergency department visits.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"117-126"},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543083","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}

{"title":"Concealed Truths Always Hide behind the Shadows of the Not So Obvious: Deadly Chest Pain Presentation.","authors":"Khalid Sawalha, Angel Lopez-Candales","doi":"10.4103/heartviews.heartviews_44_24","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_44_24","url":null,"abstract":"<p><p>Acute aortic dissection (AAD) is a critical condition characterized by the tearing of the aortic wall, posing significant diagnostic challenges due to its diverse clinical presentations. We present the case of a 61-year-old male with hypertension and dyslipidemia who presented with acute abdominal and chest pain, initially raising suspicion of myocardial infarction. Despite an unremarkable electrocardiogram and initially normal troponin levels, the patient experienced ventricular fibrillation, prompting further evaluation. The patient's clinical course was complicated by recurrent cardiac arrests. Subsequent imaging revealed AAD, which was not initially recognized, emphasizing the importance of maintaining a broad differential diagnosis and the critical need for prompt recognition and management of AAD. This case underscores the necessity of considering AAD in patients with atypical presentations and the pivotal role of advanced imaging techniques in facilitating timely diagnosis and appropriate intervention.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"25 3","pages":"169-173"},"PeriodicalIF":0.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543390","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}