{"title":"Cardiac arrhythmias in pregnancy","authors":"P. Mkoko, A. Chin","doi":"10.24170/19-3-5688","DOIUrl":"https://doi.org/10.24170/19-3-5688","url":null,"abstract":"Cardiac arrhythmias are common in pregnancy. The approach to the diagnosis of arrhythmias in pregnancy requires a detailed clinical history and examination and documentation of the arrhythmia preferably on a Holter or electrocardiogram. Treatment of arrhythmias is arrhythmia specific and may require antiarrhythmic drug therapy. However, the risks and benefits of antiarrhythmic drugs must be carefully considered. Catheter ablation remains a treatment option but is seldom required during pregnancy.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86312654","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}
A. Esmail, A. Doubell, H. Piek, J. Janson, A. Pecoraro
{"title":"Zoonotic Endocarditis: Is the feather mightier than the sword?","authors":"A. Esmail, A. Doubell, H. Piek, J. Janson, A. Pecoraro","doi":"10.24170/19-1-5359","DOIUrl":"https://doi.org/10.24170/19-1-5359","url":null,"abstract":"The common causes of infective endocarditis (IE) in South Africa are Staphylococcus aureus, the viridans streptococci and Bartonella species. Infection with Erysipelothrix rhusiopathiae is a rare cause of IE that is usually associated with occupational exposure and can be acquired from humans and animals. It was fi rst reported in 1912 by Gunthar, and thereafter fewer than 60 cases have been reported. We describe a case of Erysipelothrix rhusiopathiae induced endocarditis in Cape Town, South Africa. S","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90924812","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}
Dike B Ojji, V. Ansa, B. M. Ale, M. Sani, Austine Obasahan, Sola Alagbe, Rotimi Williams, Tony Aknitomide, I. Okoye, E. Umuerri, Eze Nwafor, A. Mbakwem, C. Amadi, Lamkur Shedu, Ranti Familoni, T. Olunuga, Francisca Inofomoh, U. Osuji, Godwin Omejua, Benjamin Azubuike, E. Ohihoin, Raphael Anakwe
{"title":"Effectiveness and tolerability of Perindopril plus Amlodipine single pill combination in Nigeria: The 13 City Hypertension Study","authors":"Dike B Ojji, V. Ansa, B. M. Ale, M. Sani, Austine Obasahan, Sola Alagbe, Rotimi Williams, Tony Aknitomide, I. Okoye, E. Umuerri, Eze Nwafor, A. Mbakwem, C. Amadi, Lamkur Shedu, Ranti Familoni, T. Olunuga, Francisca Inofomoh, U. Osuji, Godwin Omejua, Benjamin Azubuike, E. Ohihoin, Raphael Anakwe","doi":"10.24170/19-1-5357","DOIUrl":"https://doi.org/10.24170/19-1-5357","url":null,"abstract":"Background: There is no large-scale study that has shown the efficacy of single pill combination (SPC) antihypertensive medications in black African population. We therefore evaluated the blood pressure (BP) lowering efficacy and the tolerability of Perindopril plus Amlodipine SPC in black African patients. Methods: It was a multi-centre, prospective, observational programme among hypertensive patients using different doses of Perindopril and Amlodipine. Primary endpoint was assessed as the change in mean sitting systolic and diastolic BPs from baseline to 3 months. Results: 937 patients (55.7% female) were analysed, and the mean age was 56.4 ± 12.7 years. Systolic and diastolic BPs were significantly reduced by 17.3/ 9.4mmHg, 21.1/10.8mmHg mmHg and 24.6/12.7mmHg at 4, 8 and 12 weeks respectively compared to baseline value (p<0.0001). Dry cough was seen in 0.64% and angioedema 0.1% of the patients. Conclusions: Perindopril plus Amlodipine SPC provided clinically meaningful BP reductions and is well tolerated in a black African population.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75788571","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":"Unpacking the mysteries of Parvovirus B19 Myocarditis","authors":"K. Hassan, A. Doubell, P. Herbst","doi":"10.24170/19-1-5361","DOIUrl":"https://doi.org/10.24170/19-1-5361","url":null,"abstract":"Myocarditis is an inflammatory disease of the heart muscle, most often caused by viral infections. Its diagnosis can be difficult due to the heterogeneity of presentations that often mimic other common cardiological conditions, such as acute coronary syndrome (ACS) and heart failure. Although most cases are benign and self-limiting, it can also take on a more malignant course complicated by life-threatening arrhythmias, cardiogenic shock, and sudden cardiac death (SCD). A certain proportion of patients progress to develop dilated cardiomyopathies (DCMO). The developed world has experienced a shift in viral pathogens detected in patients with acute myocarditis over the past 20 years, and Parvovirus B19 (PVB19) and human herpesvirus-6 (HHV6) are currently the most commonly identified viruses in the myocardium of patients with viral myocarditis. The clinical relevance and pathological roles of these viruses however remain questioned. This focused review aims to use 2 cases of PVB19 myocarditis managed by our unit to explore issues related to the clinical presentation, diagnosis, treatment and prognosis of PVB19 myocarditis along with controversies surrounding the pathogenic role and clinical relevance of PVB19 in myocarditis.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88365195","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}
P. Sanzgiri, M. Agarwal, C. Reddy, Priytanka Potdar
{"title":"Clinical profile of heart failure in Beta-Thalassaemia Major (ß-TM): Case studies with current consideration and future perspectives","authors":"P. Sanzgiri, M. Agarwal, C. Reddy, Priytanka Potdar","doi":"10.24170/19-1-5358","DOIUrl":"https://doi.org/10.24170/19-1-5358","url":null,"abstract":"Background: Cardiac involvement is a major cause of mortality in Beta-Thalassaemia Major (ß-TM) patients. Despite many advances in therapeutic management of ß-TM, cardiac involvement remains the primary cause of mortality in ~70% of the cases. Chronic iron overloading results in thalassaemic cardiomyopathy, leading to diastolic dysfunction and overt heart failure (HF). Serial electrocardiography (ECG), 2D-echocardiography (2DECHO) and cardiovascular magnetic resonance (CMR) help in early detection and risk stratification of ß-TM patients, to prevent complications, such as arrhythmias and sudden cardiac death. An established network of care between thalassaemia centres and local health providers is essential for optimal management. Case presentation: We report 2 cases of HF in ß-TM of varied etiology, and different approaches undertaken for its early diagnosis and treatment. Conclusion: It is important to differentiate various phenotypes of cardiomyopathy in ß-TM. Since, the management of each varies accordingly. ß-TM patients require a multi-disciplinary approach that includes HF specialists, haematologist, hepatologist, endocrinologist, psychologist, transfusion experts and nursing personnel to maximise benefits from the application of the modern HF therapeutic strategies in evaluation, monitoring and treatment.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78517129","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":"Pacing for complete heart block in pregnancy","authors":"C. Viljoen, J. Hoevelmann, K. Sliwa, A. Chin","doi":"10.24170/19-3-5692","DOIUrl":"https://doi.org/10.24170/19-3-5692","url":null,"abstract":"Whereas sinus tachycardia and paroxysmal supraventricular tachycardia are common during pregnancy, bradyarrhythmias are infrequent. Moreover, bradyarrhythmias are generally well tolerated during pregnancy. Nevertheless, a 12-lead ECG is indicated for pregnant women who present with bradycardia, to rule out sinoatrial (SA) node dysfunction or AV conduction abnormalities. Third-degree AV block (complete heart block, CHB) requires multidisciplinary care during pregnancy, with combined input from Cardiologists and Obstetricians. As CHB is associated with increased mortality and morbidity if left untreated, permanent pacing is usually indicated during pregnancy, even if the patient remains asymptomatic. However, not all pregnant patients with CHB require urgent pacing. In a pregnant patient who has CHB with an escape rhythm with narrow QRS complexes and rate of >50bpm, permanent pacemaker implantation can be delayed until after delivery, as described in this case report.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81158124","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":"Cardiac obstetric care in Botswana","authors":"J. Mwita, M. Goepamang, K. Sliwa","doi":"10.24170/19-3-5687","DOIUrl":"https://doi.org/10.24170/19-3-5687","url":null,"abstract":"Cardiovascular diseases (CVD) in pregnancy are significant causes of maternal mortality in Botswana. Like other developing countries, acquired CVD such as hypertensive disorders, rheumatic heart disease and cardiomyopathy are common in Botswana. CVD-related maternal deaths are often attributed to failure to provide risk-appropriate care. A multidisciplinary pregnancy heart team is an essential approach in managing CVD in pregnancy and improving maternal and foetal outcomes. Given that more women with CVD are becoming pregnant in Botswana, we review the current practice, gaps, and potential areas of improvement.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86700999","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":"Carotid endarterectomy: A case study and literature review","authors":"Tebogo Tabane, A. Oosthuizen","doi":"10.24170/19-1-5360","DOIUrl":"https://doi.org/10.24170/19-1-5360","url":null,"abstract":"Carotid endarterectomy (CEA) is a preventative surgery that is performed in patient populations at risk of emboli due to an atherosclerotic plaque, located at the carotid bifurcation. Despite the advances in overall treatment, no consensus has been reached on the preferred anaesthetic for CEA. Improved procedural outcomes are due to the advances in medical therapy, cerebral monitoring, improved timing of surgery with improved surgical techniques and the use of ultrasound guided regional techniques. However, the choice of anaesthetic should consider the patient, the hospital’s resources and the preferences of the anaesthesiologist and surgeon.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86424037","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}
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