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SHJ VOL 8, NO 2

CONTENTS

Table of Content

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ORIGINAL ARTICLE

Frequency of atrial fibrillation and atrial high rate episodes in  Sudanese patients with dual chamber pacemakers.

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52-62

Emadaldein MA Ahmed, Ahmed AA Suliman

frequency, atrial fibrillation, dual chamber pacemarkers, sudan

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ORIGINAL RESEARCH

Patterns of infective endocarditic in children in a Sudanese referral hospital

Abstract:
Background: Infective endocarditis (IE) is an important cause of morbidity and mortality in children with heart disease. In Sudan, cardiac services are improving , however, data about IE is scarce. This study aims to evaluate the clinical and echocardiographic (echo) patterns of children admitted to cardiology ward with IE. Methods: A cross sectional descriptive observational study was conducted in Jafar Ibn Ouf (JIO) Children’s Hospital- Khartoum-Sudan. There were retrospective (January 2013- November 2018) and prospective (December 2018-November 2019) parts where clinical and echo data were collected. IE was diagnosed according to the Dukes Criteria. Standard echo/Doppler studies were done by pediatric cardiologist.
Results:
The prevalence of IE was 51 per 1000 cardiology ward admissions. The mean age at diagnosis was 9.2 years with male: female ratio of 1.3:1.The most common underlying cardiac lesion was congenital heart disease (CHD) in 74.3% followed by rheumatic heart disease (RHD) in 25.7% of patients. Prior cardiac interventions (surgery and catheterization) were reported in 15.7 %. The most common presenting symptoms were fever (98.6%), followed with arthralgia (21.4%) and neurological manifestations (11.4%).Prior use of antibiotics was detected in 68.6% of patients. Only 25.7% had positive blood culture results, and the most common isolated organism was Staph species in (44.5%).Echo features include vegetations in 74.3%, most commonly seen on mitral and tricuspid valves (14.3% each). Mortality was 10% mainly due to heart failure and neurological complications.
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Conclusion: IE is an important cause of morbidity and mortality in children. The most common underlying lesions are CHD, with a significant proportion of the cases who had preceding cardiac interventions. Low yield of blood culture and increased rate of prior antibiotics were found. The rates of RHD and mortality decreased in comparison with previous studies.

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63-72

Rabeaa Elnour , Sulafa KM Ali

Infective Endocarditis, children, Sudan

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CASE REPORTS

Hazardous Wide Complex tachycardia Misinterpretation!.

Abstract
Background: Implantable cardioverter defibrillators trouble shooting including inappropriate shock therapy has been a problem that manufacturers and literature tackles and aim to minimize due to its psychological and physical effect on patients. In the present report we address this issue with one of our patients who received 71 inappropriate ICD shocks for SVT misinterpreted as VT.
Case report: A 55 year old gentleman presented with 71 shocks delivered by his ICD. The device was implanted for tachycardia causing syncope. Device interrogation showed supra-ventricular tachycardia and inappropriate shock therapy. Invasive electrophysiological study was done with induction and ablation of AVNRT. Patient didn't receive further shocks.
Conclusion: Thorough tackling of tachycardia by history and investigations is an important consideration prior to any device implantation. Device trouble shooting and complications are very important aspect to be considered in every patient. Each episode of tachycardia to be checked and analyzed. The episodes revealed in our case clearly diagnose SVT.

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73-81

Susan B. Labib MSc, Anwer S. Alzurfi MSc, Mohamed A. El Alfy MSc, Salaheldin H. Alahwany MSc, Hamza A. Jaser Fellow , Mervat N. Aboulmaaty

Supra-ventricular tachycardia, Implantable cardioverter defibrillator, Inappropriate shocks

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Reversible high degree AV block following phenytoin infusion

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82-89

Galaledin Ibrahim, Mustafa Mahmood

high degree AV block, phenytoin, infusion rate, case report

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CARDIOLOGY IMAGES

Biatrial masses in a patient with hypertrophic cardiomyopathy resolving with anticoagulation

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90-90

Makram Ebied, Altayeb Ahmed, Salah Mohamed

Biatrial masses, hypertrophic cardiomyopathy, resolving with anticoagulation,

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CARDIOLOGY NEWS

Sudan Heart Journal would like to congratulate the newly graduated cardiology fellows of batch 6 of the Sudan Medical Specialization Board cardiology program

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91-92

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