Rhena Delport, A. Vachiat, A. Snyders, D. Kettles, H. Weich
{"title":"Decline in acute coronary syndrome hospitalisation rates during COVID-19 lockdown in private hospitals in South Africa","authors":"Rhena Delport, A. Vachiat, A. Snyders, D. Kettles, H. Weich","doi":"10.24170/17-3-4388","DOIUrl":"https://doi.org/10.24170/17-3-4388","url":null,"abstract":"We conducted a study of admission rates of acute coronary syndrome (ACS) in all Mediclinic hospitals in South Africa. The aim of the study was to quantify the extent of change in admission rates of ACS subtypes and to establish the degree of change in subtype proportions in the private sector assumed to be related to COVID-19 and/or lockdown implementation. Time intervals were demarcated by lockdown measures (March: pre-lockdown versus April: post-lockdown implementation), and comparisons were performed with equitable time periods (2019 versus 2020). For the comparison of proportions, data for April and May were summated.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90176861","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}
N. Tsabedze, S. Kraus, J. Hitzeroth, M. Ntsekhe, Martin Mpe, M. Makotoko
{"title":"COVID-19 and heart failure","authors":"N. Tsabedze, S. Kraus, J. Hitzeroth, M. Ntsekhe, Martin Mpe, M. Makotoko","doi":"10.24170/17-3-4393","DOIUrl":"https://doi.org/10.24170/17-3-4393","url":null,"abstract":"Acute and chronic heart failure patients have a 2- to 3-fold increased risk of complicating with severe COVID-19, and these patients tend to have multiple comorbidities which are the primary aetiologies for the heart failure clinical syndrome. Furthermore, the incidence and prevalence of heart failure increases with advanced age, and advanced age is an independent risk factor for poor prognosis and mortality. The SARSCoV-2 infection also has multiple mechanisms that cause acute heart failure and precipitate acutely decompensated chronic heart failure. Additionally, the optimal management of these patients has been marred with the controversy around the use of the renin-angiotensin-aldosterone system blockers. This review provides an update on how heart failure patients should be managed during COVID-19 and summarises the existing evidence, focusing on heart failure.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88701436","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":"Hypercoagulability in COVID-19","authors":"Pieter Wessels","doi":"10.24170/17-3-4372","DOIUrl":"https://doi.org/10.24170/17-3-4372","url":null,"abstract":"COVID-19 is associated with a hypercoagulable state that may present as pulmonary thrombosis, pulmonary embolism, and venous and arterial thrombosis. Suggested pathogenesis include direct infection of the endothelial cell with subsequent endothelial cell dysfunction, leading to increased procoagulant activity, decreased anticoagulant activity and decreased fibrinolysis. The severe immune inflammatory response in the lungs with cytokine release also plays a critical role (immunothrombosis). Hypoxia has a local and systemic effect on coagulation. Various markers of this state have been described, and especially the D-dimer level (and rapid changes in the D-dimer level) as a reliable prognostic marker. It is also used as indicator for initiation of anticoagulation by some experts. Due to the pleotrophic effects of heparin, it is the anticoagulant of choice for these patients (most often low molecular weight heparin, due to decreased risk of heparin induced thrombocytopenia, ease of use). No clinical trial data is available at the time of writing (28 May 2020), and suggested guidelines of experts in different countries are discussed.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74093767","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":"Cardiovascular magnetic resonance in endomyocardial fibrosis","authors":"Petronella Samuals, S. Jermy, S. Moosa, N. Ntusi","doi":"10.24170/17-2-4150","DOIUrl":"https://doi.org/10.24170/17-2-4150","url":null,"abstract":"Endomyocardial fibrosis (EMF) is an idiopathic disorder of the tropical and subtropical regions of the world, considered endemic in tropical and subtropical Africa and is characterised by development of restrictive cardiomyopathy. Although accurate epidemiological data are lacking, EMF is estimated to be the most common form of restrictive cardiomyopathy globally. We report on a young patient presenting with a stroke diagnosed with EMF and review the role of cardiovascular magnetic resonance in evaluation of EMF.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87116158","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":"Overview of cardiovascular manifestations of COVID-19 and echocardiographic features","authors":"R. Meel, R. Gonçalves","doi":"10.24170/17-2-4148","DOIUrl":"https://doi.org/10.24170/17-2-4148","url":null,"abstract":"COVID-19 or SARS-CoV-2, a novel coronavirus, has rapidly spread across the globe, resulting in millions of infections and thousands of deaths. In this short review we describe the pathophysiology, clinical and echocardiographic manifestations of the virus, with specific reference to the cardiovascular system. We conclude with a case summary reflective of the most common cardiovascular presentation in severely ill patients.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"65 17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83460057","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":"Leadless cardiac pacing in resource limited settings: A Groote Schuur hospital experience with the Micra leadless pacemaker","authors":"P. Mkoko, K. Govender, B.V.R. Gouws, A. Chin","doi":"10.24170/17-2-4147","DOIUrl":"https://doi.org/10.24170/17-2-4147","url":null,"abstract":"Background: Cardiac pacemakers improve survival and quality of life in patients with atrioventricular (AV) block. However, conventional pacemakers carry a small risk of both acute and chronic lead and pacemaker generator complications. Leadless pacemakers negate these risks by not having a pacing lead and a subcutaneous generator. We report our Groote Schuur Hospital experience with the Medtronic Micra transcatheter pacing system (TPS). Methods: We report a consecutive case series of patients that received the Micra leadless pacemaker. The Micra transcatheter pacemaker, a single chamber ventricular pacemaker, is inserted using a TPS via the femoral vein into the right ventricle. Implantation data were obtained, and medical records were reviewed for the 6 weeks and 1-year follow-up visits. Results: A total of 5 patients were implanted with a Micra leadless pacemaker from 11 March 2015 - 2 November 2016. Four patients were male and 1 female, with an average age of 64 years. Four patients received the pacemaker for a second- or third-degree AV block and 1 patient received the pacemaker for unexplained syncope and right bundle branch block. The Micra leadless pacemaker was successfully implanted in all patients with no acute implantationrelated complications. One-year follow-up was available for 4 patients with good pacing thresholds, sensitivity and impedance. One patient demised after 9 months post Micra implantation due to unrelated causes (acute myeloid leukaemia). Conclusion: The Micra leadless pacing system is safe and effective and shows good short-term results in a real-world, resource-limited setting. This form of pacing offers a viable option for patients who require pacing for AV block, especially in patients with vascular access problems or who are at high risk of lead or pacemaker generator complications.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"522 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83916756","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":"Bicuspid aortic valve with dissecting aortic aneurysm in an African","authors":"E. Ogbemudia, A. Ogbomo","doi":"10.24170/17-2-4152","DOIUrl":"https://doi.org/10.24170/17-2-4152","url":null,"abstract":"Bicuspid aortic valve (BAV) is a relatively rare congenital heart disease (CHD) in Africans compared to caucasians and it is an independent risk factor for aortic aneurysm and dissection. We therefore report a case of a 51-year old farmer who presented with clinical features of heart failure (HF). He had a diastolic murmur loudest in the aortic area. Echocardiography revealed BAV with regurgitation. The aortic root and ascending aorta were dilated with dissection flaps which mimicked a double aortic valve. Computed Tomography angiography of the aorta confirmed Debakey’s type 1 (Stanford A) dissecting aortic aneurysm (DAA). He was managed for HF due to chronic aortic regurgitation and referred for surgery. BAV is a relatively rare CHD in Africans and is a strong risk factor for DAA. Long-term monitoring of the aorta and timely surgical intervention are recommended when indicated.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77639313","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}
K. Ray, U. Laufs, F. Cosentino, M. Lobo, U. Landmesser
{"title":"The year in cardiology: cardiovascular prevention. The year in cardiology 2019.","authors":"K. Ray, U. Laufs, F. Cosentino, M. Lobo, U. Landmesser","doi":"10.24170/17-1-4022","DOIUrl":"https://doi.org/10.24170/17-1-4022","url":null,"abstract":"","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78693169","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}
G. P. Baztarrica, Andres Wong Baros, Nadia Chiriboga, Andres Felipe Gil, Jenny Ramos Negrete, Xavier Centeno Cevallos, Marco José Maldonado de la Torre, Michaelly Erique, Ines Hernàndez Aviles, Reneiro Neptali Vélez Solórzano, A. V. Moran, Fabio Oscar Domborovski Goncalves, R. Porcile
{"title":"Unusual case of a myxoma atrial left presenting with recurrent monoparesis","authors":"G. P. Baztarrica, Andres Wong Baros, Nadia Chiriboga, Andres Felipe Gil, Jenny Ramos Negrete, Xavier Centeno Cevallos, Marco José Maldonado de la Torre, Michaelly Erique, Ines Hernàndez Aviles, Reneiro Neptali Vélez Solórzano, A. V. Moran, Fabio Oscar Domborovski Goncalves, R. Porcile","doi":"10.24170/16-4-3847","DOIUrl":"https://doi.org/10.24170/16-4-3847","url":null,"abstract":"Usually, embolism is described from cardiac or large artery disease. Atrial fibrillation is the most common cause of cardiogenic emboli in stroke. Myxoma is responsible in only a few cases. We describe here a case of a patient who presented with recurrent pure left brachial monoparesis as a manifestation of a cardiac myxoma.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85417539","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}