A study of ECG pattern, cardiac structural abnormalities and familial tendency in patients with early repolarisation syndrome in South India
Conclusions
We found that exaggeration of the ER pattern during chest pain may lead to inadvertent thrombolysis. A notched/slurred ER pattern is found in only a third of patients, who need to be grouped separately, as they may constitute a high-risk category. Patients with ER had MVP at a higher prevalence (almost double) than the general population, probably explaining the high incidence of sudden cardiac death associated with MVP. A familial tendency to an ER pattern was found in more than half of first-degree relatives, with different ER patterns, even the Brugada pattern, found in the same family. This may be because B...
Source: Heart Asia - December 8, 2014 Category: Cardiology Authors: Madhu, K. G., George, V., Binu, T. G., Ranjith, R., Kunju, S., Baiju, R., Mohanan, K. S., Jayaram, R., Radhakrishnan, V. V., Mamman, Nair, Divakaran, Velayudhan, Jose, Viswanathan Tags: Original research Source Type: research
Permanent pacing in patients without upper limb venous access: a review of current techniques
Permanent transvenous cardiac pacing is usually accomplished through the upper limb veins. When these are occluded, several other vascular access options exist which include the internal jugular, external jugular, femoral and iliac veins as well as more proximal access of the subclavian veins. Anterograde and retrograde techniques to restore subclavian venous patency has been described. A review of these approaches is undertaken, with a discussion of their pros and cons. Familiarity with these techniques will enable the implanter to perform transvenous pacing when faced with limited vascular access. (Source: Heart Asia)
Source: Heart Asia - November 27, 2014 Category: Cardiology Authors: Seow, S.-C., Lim, T.-W., Singh, D., Yeo, W.-T., Kojodjojo, P. Tags: Practice viewpoint Source Type: research
Aspirin and clopidogrel resistance using the cone and plate(let) analyser in Indian patients with coronary artery disease
Conclusions
Resistance to aspirin and clopidogrel and dual antiplatelet resistance are prevalent in Indian patients, comparable with the prevalence worldwide. The CPA is a feasible assay to determine antiplatelet resistance. (Source: Heart Asia)
Source: Heart Asia - November 7, 2014 Category: Cardiology Authors: Koshy, S. K., Salahuddin, S., Karunakaran, B., Nalakath, S. Y., Bhaskaran, J., Haridas, P. V., Mandalay, A., Faizal, A. Tags: Original research Source Type: research
Influence of ApoB100 3' hypervariable repeats on acute myocardial infarction
Conclusion
Patients with 3'ApoB-VNTR large repeats (>37) are more susceptible to acute MI development. (Source: Heart Asia)
Source: Heart Asia - November 7, 2014 Category: Cardiology Authors: Singh, N., Sinha, N., Kumar, S., Pandey, C. M., Agrawal, S. Tags: Original research Source Type: research
A change in QRS morphology in right ventricular apical pacing: is it a red flag sign?
A 74-year-old man with symptomatic complete heart block underwent right ventricular apical permanent pacemaker implantation. The postoperative ECG showed, as expected, completely paced left bundle branch block QRS morphology. However, at the 2-month follow-up examination, his ECG showed paced right bundle branch block (RBBB) QRS morphology, although the patient was asymptomatic. On evaluation, pacemaker functioning was normal with no evidence of lead displacement. This case report highlights that RBBB morphology of paced QRS complex is not always a red flag sign. (Source: Heart Asia)
Source: Heart Asia - October 23, 2014 Category: Cardiology Authors: Jain, R., Mohanan, S., Haridasan, V., Rajesh, G. N., Mangalath Narayanan, K., Sajeer, K. Tags: Practice viewpoint Source Type: research
A rare presentation of idiopathic right subclavian artery aneurysm successfully tackled by endovascular stent-grafting
A 32-year-old woman presented with symptoms of dysphagia to solid food for 6 months. She had no significant past medical history or trauma. Examination revealed a subtly palpable pulsatile swelling at the root of right side of the neck. Contrast-enhanced CT showed a complex saccular aneurysm of the proximal right subclavian artery (figure 1A, B). The involved aneurysmal segment contained three separate saccules, the largest of which measured 4.7x2.3 cm. A selective digital subtraction angiography was done contemplating the possibility of endovascular intervention (figure 1C). In a cross-section image, the aneurys...
Source: Heart Asia - October 3, 2014 Category: Cardiology Authors: Mohanan, S., Jain, R., Krishnan, M. N., Desabandhu, V. Tags: Images in cardiovascular medicine Source Type: research
Arrhythmogenic right ventricular cardiomyopathy (ARVC): case report and review of literature
We report a case along with the review of literature, of a 63-year-old man who presented (atypical) with a history of palpitations, dizziness and raised cardiac enzymes associated with ECG changes in the inferior and anterior leads. Further investigation helped in confirming this rare and potentially fatal cardiac condition. (Source: Heart Asia)
Source: Heart Asia - October 1, 2014 Category: Cardiology Authors: Rao, U., Agarwal, S., Gilbert, T. J. Tags: Review in cardiovascular technology Source Type: research
Use of polytetrafluoroethylene (PTFE)-covered stent in treatment of RCA aneurysm
A 55-year-old man presented to the emergency room with acute severe retrosternal chest pain radiating to his left arm. His past medical history includes coronary artery disease (CAD) with multiple percutaneous coronary interventions (PCI). The patient was asymptomatic before this episode. He was haemodynamically stable, and physical exam was unremarkable. EKG showed sinus bradycardia without ischaemic changes. Cardiac biomarkers were normal. He underwent cardiac catheterisation, which showed a 10 mm right coronary artery (RCA) aneurysm at the site of a previously placed drug eluting stent (figure 1 and online suppleme...
Source: Heart Asia - September 30, 2014 Category: Cardiology Authors: Neupane, S., Dass, K. Tags: Images in cardiovascular medicine Source Type: research
Left ventricular pseudoaneurysm in dengue fever
Dengue fever is a disease with clinical manifestations ranging from asymptomatic infection to a severe disease. A 4-year-old boy was admitted with serologically proven dengue haemorrhagic fever, with clinical features of heart failure. ECG was suggestive of pericarditis (figure 1A); chest X-ray PA view showed cardiomegaly (figure 1B); echocardiography (figure 1C–E) and MRI (figure 1F) showed pericardial effusion with evidence of pseudoaneurysm of left ventricle. Mechanism of pseudoaneurysm was thought to be due to severe myocarditis which led to cardiac rupture and contained within the pericardium. As the relatives w...
Source: Heart Asia - September 30, 2014 Category: Cardiology Authors: Madhavan, S., Narayanapillai, J. Tags: Images in cardiovascular medicine Source Type: research
Academic training in radiation safety awareness and practice among Iranian residents/fellows
Conclusions
Awareness/practice of Iranian cardiology/radiology residents/fellows about radiation exposure safety issues is not acceptable currently. Those who received formal training courses at their academic centres about the safety measures had significantly better knowledge compared with those who did not. It is suggested that radiation safety training be offered at the beginning of residency/fellowship for residents/fellows in a comprehensive and uniform way throughout medical universities. (Source: Heart Asia)
Source: Heart Asia - September 9, 2014 Category: Cardiology Authors: Safi, M., Aerab-Sheibani, H., Namazi, M. H., Vakili, H., Saadat, H. Tags: Original research Source Type: research
A meta-analysis of proinflammatory cytokines in chronic heart failure
Conclusions
Concentrations of TNF-α, IL-6, IL-1β and CRP are significantly higher in CHF patients than in control subjects. Proinflammatory cytokines play an import role in the pathogenesis of CHF. (Source: Heart Asia)
Source: Heart Asia - September 8, 2014 Category: Cardiology Authors: Liu, M., Chen, J., Huang, D., Ke, J., Wu, W. Tags: Original research Source Type: research
Successful placement of a deflectable decapolar catheter via the right femoral vein approach in a patient with coronary sinus ostial atresia and persistent left superior vena cava
The authors illustrate the successful ablation of a left-sided posterior accessory pathway via a retrograde aortic approach in a patient with coronary ostial atresia associated with persistent left-sided superior vena cava. This is an extremely rare anomaly which should be considered by cardiac electrophysiologists when there is difficulty cannulating the coronary sinus via the right atrial route. Awareness of this route obviates the need for additional venous access. (Source: Heart Asia)
Source: Heart Asia - September 4, 2014 Category: Cardiology Authors: Ng, C. T., See, J., Lee, C. W., Ching, C.-K. Tags: Practice viewpoint Source Type: research
Prevalence and clustering of cardiovascular risk factors in adults in Northeast China
Conclusions
There is a high prevalence of cardiovascular risk factors in adults in Northeast China: one out of three has at least two risk factors. Prevalence was higher in men than in women. Clustering of risk factors is more common with increasing age and body mass index in both men and women. Prevention of the development of risk factors should be an extremely high priority in this region. (Source: Heart Asia)
Source: Heart Asia - September 2, 2014 Category: Cardiology Authors: Wang, X., Yang, F., Bots, M. L., Guo, W., Zhao, D., Hoes, A. W., Vaartjes, I. Tags: Original research Source Type: research
Differential diagnosis of intracoronary lesions
A 39-year-old man presented with a non-ST segment elevation myocardial infarction which was treated with thrombolysis, and he made an uneventful recovery. His only risk factor was smoking for 5 years. Echocardiogram showed an ejection fraction of 55%. He denied previous episodes of chest pain, unusual childhood illnesses and inflammatory diseases. A month later he underwent coronary angiography (figures 1–3). All three coronary arteries had similar lesions. Auto antibody screening was negative, inflammatory markers were insignificant and CT scans of his chest and abdomen were normal. He underwent an uneventful c...
Source: Heart Asia - September 1, 2014 Category: Cardiology Authors: Carr, C. S., Bhat, A., Alkhulaifi, A. M. Tags: Images in cardiovascular medicine Source Type: research
Out of the frying pan into the fire--the never forgiving complex congenital heart: a case of liquefied splenic infarct post-electrophysiology ablation
A 36-year-old man born with pulmonary atresia intact ventricular septum, atrial septal defect and Ebstein anomaly with hypoplastic right heart (figure 1 and online supplementary video). Waterson shunt had been performed in childhood, but over a period of time it had occluded with pulmonary circulation being dependent on bronchopulmonary collaterals. He is on targeted therapy for pulmonary hypertension. He was symptomatic with intermittent focal atrial tachycardia, despite amiodarone therapy. Coumarin therapy was avoided due to risk of massive haemoptysis. At electrophysiology, he had an atrial flutter circuit, which was re...
Source: Heart Asia - August 27, 2014 Category: Cardiology Authors: Rafiq, I., Deaville-Lees, D., Freeman, L. J. Tags: Images in cardiovascular medicine Source Type: research
