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   Table of Contents - Current issue
Coverpage
July-September 2017
Volume 18 | Issue 3
Page Nos. 77-114

Online since Wednesday, November 8, 2017

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ORIGINAL ARTICLE  

Gender differences among patients with acute coronary syndrome in the Middle East p. 77
Aliah Ali Khesroh, Faisal Al-Roumi, Ibrahim Al-Zakwani, Sreeja Attur, Wafa Rashed, Mohammad Zubaid
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_10_17  
Background: There is controversy regarding the relationship between gender and acute coronary syndrome (ACS). Objective: To study the impact of gender on presentation, management, and mortality among patients with ACS in the Middle East. Methodology: From January 2012 to January 2013, 4057 patients with ACS were enrolled from four Arabian Gulf countries (Kuwait, Oman, United Arab Emirates, and Qatar), representing more than 85% of the general hospitals in each of the participating countries. Results: Compared to men, women were older and had more comorbidities. They also had atypical presentation of ACS such as atypical chest pain and heart failure. The prevalence of non-ST-segment elevation myocardial infarction (49 vs. 46%; P < 0.001) and unstable angina (34 vs. 24%; P < 0.001) was higher among women as compared to men. In addition, women were less likely to receive evidence-based medications such as aspirin, clopidogrel, beta-blocker, and angiotensin-converting enzyme inhibitors on admission and on discharge. During hospital stay, women suffered more heart failure (15 vs. 12%; P = 0.008) and were more likely to receive blood transfusion (6 vs. 3%; P < 0.001). Women had higher 1-year mortality (14 vs. 11%; P < 0.001), the apparent difference that disappeared after adjusting for age and other comorbidities. Conclusion: Although there were differences between men and women in presentation, management, and in-hospital outcomes, gender was shown to be a nonsignificant contributor to mortality after adjusting for confounders.
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CASE REPORTS Top

Idiopathic fascicular left ventricular tachycardia p. 83
Yaser Alahmad, Nidal Ahmad Asaad, Salaheddin Omran Arafa, Shahul Hameed Ahmad Khan, Alsayed Mahmoud
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_145_15  
Idiopathic left fascicular ventricular tachycardia (ILFVT) is characterized by right bundle branch block morphology and left axis deviation. We report a case of idiopathic left ventricular fascicular tachycardia in a young 31-year-old male patient presenting with a narrow complex tachycardia.
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Mobitz Type II atrioventricular block following tramadol and fentanyl in a patient with acute coronary syndrome and systolic heart failure p. 88
Alaa A Rahhal, Amer H Aljundi, Abdulrahman Arabi
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_32_17  
Serotonin syndrome is a potentially fatal condition allied with increased serotonergic activity in the central nervous system. There are published data reporting serotonin syndrome induced by either tramadol or fentanyl in combination with selective serotonin reuptake inhibitors in adult patients; however, there are no reports of serotonin syndrome resulting from the combination of tramadol and fentanyl. We report a case of a 52-year-old woman who was admitted to cardiology service and who developed Mobitz Type II atrioventricular (AV) block after administration of oral tramadol and intravenous fentanyl.
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Hybrid completion of aortic repair after type A aortic dissection in a patient with Marfan's syndrome p. 91
Terri-Ann Teisha Russell, James Shue-Min Yeh, Antonios Kourliouros, Christoph A Nienaber
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_62_16  
Medicine and engineering are in collaboration to assist in the tackling of daunting surgical techniques which are associated with high rates of morbidity and mortality, in exchange for minimally invasive approaches with lower procedural risk. Endovascular procedures in general have already reduced the risk of surgery by limiting the extent of open surgery and often replacing it with purely percutaneous or hybrid procedures. Here, we describe a patient who had complex staged surgery with open repair of a proximal portion of a type A aortic dissection followed by a staged endovascular reconstruction of the arch and descending aorta by means of a fenestrated stent-graft to secure the left subclavian artery and the posterior cerebral circulation.
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Acute atrial fibrillation complicating organophosphorus poisoning p. 96
Monika Maheshwari, Shreekant Chaudhary
DOI:10.4103/1995-705X.217856  
Organophosphorus (OP) pesticide poisoning is a major clinical and public health problem in a developing country like India. Cardiac injury is a strong predictor of death in these patients. Cardiac complications usually described include cardiac arrest, pulmonary edema, and arrhythmia. Rarely, myocardial infarction has also been reported. The possible mechanisms for myocardial injury include sympathetic/parasympathetic overactivity, hypoxemia, acidosis, dyselectrolytemia, and direct cardiotoxicity. We describe herein one case of OP poisoning, recently admitted in our emergency department and which was complicated by acute onset atrial fibrillation which reverted to sinus rhythm following detoxification of OP compound.
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Off-pump coronary artery bypass surgery in a patient with dextrocardia and situs inversus: Anesthetic, surgical consideration and role of transesophageal echocardiography p. 100
S Subash, Parimala Prasanna Simha, N Manjunatha
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_5_17  
Coronary artery bypass surgery (CABG) in dextrocardia with situs inversus patients is reported less in literature. Due to abnormal looping and associated other congenital anomalies, anesthetic implications and surgical difficulties become challenging in these patients. Transesophageal echocardiography examination (TEE) needs multiplane angle adjustments compared to normal heart to obtain the images. Here, we describe a 53-year-old female patient having dextrocardia with situs inversus who underwent CABG and discuss the perioperative management and multiplane adjustments during TEE examination.
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GUIDELINES Top

Guidelines to writing a clinical case report p. 104

DOI:10.4103/1995-705X.217857  
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A PICTURE IS WORTH A THOUSAND WORDS Top

Large pericardial mass mimicking pericardial effusion p. 106
Shilpa Jayaprakash, Shivakumar Byrappa, SS Prakash, S Shankar
DOI:10.4103/1995-705X.217854  
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ART AND MEDICINE Top

Painting with bacteria p. 108
Rachel Hajar
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_105_17  
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HISTORY OF MEDICINE Top

Risk factors for coronary artery disease: Historical perspectives p. 109
Rachel Hajar
DOI:10.4103/HEARTVIEWS.HEARTVIEWS_106_17  
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