SHJ VOL 7, NO 2

SHJ VOL 7, NO 2

 

CONTENTS

 

Table of Content

 

No abstract available for this article.   

 1

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REVIEW ARTICLE

 

Should we still have the COURAGE to perform elective PCI in patients with stable myocardial ISCHEMIA?

 

Abstract.

The main lesson to be learnt from COURAGE, BARI 2D and ISCHEMIA is that optimal medical therapy should be provided to all patients with coronary artery disease as the baseline upon which interventional treatment can be added. We also learnt that a significant percentage of
stable coronary artery disease don’t immediately progress into ACS and therefore it is safe and appropriate to not perform PCI upfront. Rather, this can be deferred until later if angina symptoms worsen or if ACS develops.

Hence, the importance of careful and close follow-up of patients who are medically treated. Elective PCI seems to provide better control of angina
symptoms compared to sole optimal medical therapy, and it also seems to reduce the future incidence of ACS admissions. The mortality data from all the three trials contained some uncertainties hence rendering unreliable any conclusions drawn from those data. As such the impact of elective PCI on ‘cardiac’ mortality so far remains controversial.

To answer this question, we suggest a new three-armed large clinical trial to randomize stable angina patients eligible for coronary angiography to receive optimal medical therapy alone or in combination with either PCI or CABG. The trial must include patient with higher risk cardiac profiles, like those with left main stenosis or poor left ventricular systolic function.

The three arms must have comparable baseline characteristics and the primary end point should be ‘cardiac’ mortality only, not all-cause or cardiovascular mortality.

 

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12-21

Telal Mudawi*^, Dara Al-Khdair*, Muath Al-Anbaei*, Assem Fathi*, Nikolay Lilyanov*, Asmaa Ali*, Ahmed Amin*, Dalia Besada*, Waleed Alenezi*, Waleed Shabanh*, Erica Ramon*

*Cardiology Centre, Hadi Clinic, Jabriya, Kuwait
^Corresponding Author: This email address is being protected from spambots. You need JavaScript enabled to view it.

PCI, myocardial, ISCHEMIA

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CASE REPORT

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Surgical Translocation of the Circumflex Aortic Arch with Tracheobronchial Compression; A Case Report and Review of the Literature.

 

Abstract.

Symptomatic Airway compression due to the circumflex aorta is a rare condition. This is a case of 9-year-old boy who had a longstanding history of swallowing problems and was diagnosed as a 22q11.2 deletion syndrome.

CT chest images showed a right aortic arch with a circumflex aorta that had looped behind the trachea and esophagus and had a mirror branching with left Subclavian artery arising from the left descending aorta.

The airway compression and dysphagia pose a challenge for those patients, as well as the anesthesiologist. We report a case of airway compression in a 9-year-old patient who underwent elective aortic arch reconstruction for the circumflex aortic arch, division, and ligation of the ligamentum arteriosum, and aortoplexy on deep hypothermic circulatory arrest and cardiopulmonary bypass.

 

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22-26

Author: Mohieldin M Mohieldin*^

^Corresponding Author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Surgical, Translocation, Circumflex, Aortic, Arch, Tracheobronchial, Compression

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Fulminant Legionella Myocarditis – A Rare Treatable Cause of Acute Heart Failure – Case Report and Review of Literature.
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Abstract.

Myocarditis is an inflammatory disease of cardiac muscle with necrosis of cardiac myocytes. The commonest etiology is viral infection followed by autoimmune disease. Rarely, bacterial infection can lead to myocardial involvement.

Diagnosing a bacterial cause is extremely important as prompt treatment with anti-microbial agents can lead to high cure rates. We present a rare case of Legionella Myocarditis presenting with refractory heart failure but early diagnosis and prompt treatment with appropriate antibiotic therapy saved the patient’s life.

 

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27-29

Sunil N Gurmukhani*^, Nikita B Chaturvedi*, Bhupesh R Shah*

*SNT NHLMMC, Ahmedabad, Gujarat, India

^Corresponding Author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Fulminant, Legionella, Myocarditis, Heart, Failure

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IMAGE

 

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Rheumatic Mitral Stenosis & Dilated Cardiomyopathy

 

Abstract.

No abstract available for this article.  

 5

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30-31

Mohammed Elzaki*, Mohammed Salaheldin*, Salaheldin A. Abusin^*

*Fedail Hospital, Khartoum, Sudan
^Corresponding Author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Rheumatic, Mitral, Stenosis, Dilated, Cardiomyopathy

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