Cardiology Research

Cardiovascular diseases (also known as CVD) are a group of disorders of the heart and blood vessels. With almost 20 million deaths from heart attacks and strokes in 2022, cardiovascular diseases (CVDs) are the world’s leading cause of death. In low- and middle-income nations, more than 75% of deaths take place, and many of them are preventable. A poor diet, inactivity, alcohol and tobacco use, air pollution, and diseases like obesity, diabetes, and high blood pressure are all major risk factors. Changes in lifestyle, early detection, and appropriate medical care can prevent the majority of CVDs.

Background: Patients with history of herpes zoster (HZ) infection were found to have an increased long-term risk of major cardiovascular events. The association between myocardial infarction (MI) and HZ infection is an area of rising research interest. While HZ infection primarily has both dermatological and neurological manifestations, studies have increasingly shown that it may also be linked to increased cardiovascular risk, particularly acute MI and stroke.

Case presentation: Here we report a case of acute MI in a 68-year-old male patient who has a history of HZ infection and received the booster dose of HZ vaccine (Shingrix) 24 hours prior to his presentation with acute MI. Moreover, this case report of acute myocardial injury secondary to acute None-ST segment elevation MI following Shingrix vaccine in a patient with history of HZ infection helps in establishing the relationship between HZ infection and its cardiovascular effects.

Conclusion: To conclude, health care providers should be aware of the increased risk of cardiovascular events in patients with history of HZ infection and the rare side effect of vaccines to properly evaluate patient who presented with suspicious symptoms following vaccine administration.

With rapid spread of severe acute respiratory syndrome- corona virus-2 (SARS-COV-2) globally, some new aspects of the disease have been reported. Recently, it has been reported the incidence of Kawasaki-like disease among children with COVID-19. Since, children had been known to be less severely affected by the virus in part due to the higher concentration of Angiotensin converting enzyme (ACE)-2 receptor, this presentation has emerged concerns regarding the infection of children with SARS-COV2. ACE2 has anti-inflammatory, anti-fibrotic and anti-proliferative characteristics through converting angiotensin (Ag)-II to Ang (1-7). ACE2 receptor is downregulated by the SARS-COV through the spike protein of SARS-CoV (SARS-S) via a process that is tightly coupled with Tumor necrosis factor (TNF)-α production. TNF-α plays a key role in aneurysmal formation of coronary arteries in Kawasaki disease (KD). Affected children by COVID-19 with genetically-susceptible to KD might have genetically under-expression of ACE2 receptor that might further decrease the expression of ACE2 due to the downregulation of the receptor by the virus in these patients. It appears that TNF- α might be the cause and the consequence of the ACE2 receptor downregulation which results in arterial walls aneurysm. Conclusion: Genetically under-expression of ACE2 receptor in children with genetically-susceptible to KD who are infected with SARS-CoV-2 possibly further downregulates the ACE2 expression by TNF-α and leads to surge of inflammation including TNF-α and progression to Kawasaki-like disease.

Keywords: ACE2 receptor; Downregulation; Kawasaki disease; Kawasaki-like disease; SARS-CoV2; TNF- α.

Los factores de riesgo coronario son características biológicas que aumentan la probabilidad de padecer una enfermedad cardiovascular. Objetivo: Caracterizar la presencia de algunos factores de riesgo modificables en pacientes remitidos desde Pinar del Río al Hospital CIMEQ para coronariografía, en el contexto del síndrome coronario agudo. Método: Estudio retrospectivo con los pacientes atendidos en el Laboratorio de Hemodinámica del CIMEQ, entre octubre de 1997 y agosto del 2008. La población de estudio estuvo constituida por los 5.297 pacientes a los que se les realizó coronariografía en el período señalado, de los cuales se analizaron los 147 remitidos de urgencia desde la provincia Pinar del Río, con el diagnóstico de síndrome coronario agudo, con y sin elevación del segmento ST. Los datos se obtuvieron de la base de datos ANGYCOR. Resultados: El factor de riesgo más prevalente en los 126 pacientes con dicho síndrome, sin elevación del ST (85,7%), fue la hipertensión arterial (64 %); y el hábito de fumar (61,9 %) en aquellos con elevación del ST. Los pacientes entre 50 y 70 años (66,7 %) y los del sexo masculino (75,5 %) fueron los más afectados. Conclusiones: Predominó el sexo masculino y el grupo de edades de 50-70 años en ambos grupos. Nueve de cada diez pacientes tienen al menos dos de los factores de riesgo clásicos, y el hábito de fumar y la hipertensión arterial fueron los más frecuentes. Palabras clave: Factores de riesgo coronario, Cardiopatía isquémica, Coronariografía ABSTRACT Introduction: Coronary risk factors are biological characteristics that increase the likelihood of cardiovascular disease. Objective: To characterize the presence of modifiable risk factors in patients referred for coronary angiography from Pinar del Rio to the CIMEQ Hospital, in the context of

A mis padres, Maria Teresa y Amadeu, por haberme enseñado a vivir. Por darme todo su amor y dedicarme todo su tiempo, esfuerzo y trabajo. Son las personas más importantes de mi vida. Ellos siempre han supuesto el ejemplo a seguir. Sin ellos nada en mí hubiera sido posible. A Gemma, por aguantar estoicamente mis ausencias diarias en el hospital. Por llenar de felicidad mis atardeceres. Por estar a mi lado y ser mi compañera y mi cómplice cada día. Recordatorio a mis abuelos, Anita, Martí, Antonia y Josep, por mirarme siempre con especial ternura y por haber sido un estímulo constante en todo lo que he hecho. Y por supuesto, a la Cirugía Cardíaca, una de las pasiones de mi vida. C5a-Factor de complemento activado 5. C3a-Factor de complemento activado 3. C3d-Factor de complemento derivado de C3. Quimiocina. CCL-Chemokine ligand. Ligando de quimiocina. CCR-Chemokine receptor. Receptor de quimiocina. CD-Cluster of differentiation. Cúmulo de diferenciación. CEC-Circulación extracorpórea. CMI-Cirugía mínimamente invasiva. CTC-Complejo terminal del complemento. CK-Creatina quinasa. CK-MB-Isoenzima MB de la creatina quinasa. CX3CR1-Chemokine X3 receptor 1. Receptor 1 de la subfamilia X3 de quimiocinas. DA-Arteria descendente anterior. EAC-Enfermedad aterosclerótica coronaria.

JUSTIFICATIVA E OBJETIVOS: As novas diretrizes contêm modificações significativas para tentar melhorar a prática da reanimação e a sobrevida de pacientes com parada cardíaca. Este artigo teve por objetivo revisar as principais alterações na reanimação praticada pelo profissional de saúde. CONTEÚDO: São várias as novas recomendações quanto à reanimação cardiopulmonar (RCP), a maioria com a finalidade de prover boa circulação durante a parada cardíaca. A alteração mais importante é a ênfase na qualidade das compressões torácicas. A rela-Atualização em Reanimação Cardiopulmonar: O que Mudou com as Novas Diretrizes!* Update on Cardiopulmonary Resuscitation: What Changed with the New Guidelines!*

Nonalcoholic fatty liver disease (NAFLD) is one of the common causes of chronic liver disease worldwide and is an emerging important cause of liver disease in India. In the general Indian population, the prevalence of NAFLD is approximately 9-30% but much higher estimates are reported in obese and patients with type 2 diabetes mellitus. Total of 185 diabetic and 105 non-diabetic patients were randomly selected from diabetic and medicine OPD. After taking informed consent, all patients undergone history, examination and routine laboratory investigations, LFT, lipid profile, HbA1c, serum ferritin, C-reactive protein and USG. The results of cases and control were compared with unpaired t -test and p value <.05 was considered significant. The study group (n=185) was divided into a NAFLD group (n=102) and a non-NAFLD group (n=83) and nondiabetic control (n=105). The prevalence of NAFLD in DM was 55.68% and in non-diabetic was 20%. The NAFLD was significantly associated with high BMI, waist circumference and waist hip ratio, higher HbA1c, higher triglyceride levels, hypercholesterolemia, low HDL levels. Serum CRP level (p<0.00001) and serum ferritin level (p<0.0001) were significantly high in NAFLD patients with DM-2. This study showed that patients with central obesity, Poor Glycemic control and dyslipidemia are at increased risk of developing NAFLD. Serum ferritin and Serum CRP could be good noninvasive marker for screening of NAFLD in asymptomatic patients.

Objective: We sought to determine the spectrum of heart diseases among adult patients at the Bamenda Regional Hospital in the North West Region of Cameroon. This is a chart review of echocardiographic records. In total, 673 records were included in our study, of which 506 had a definite heart disease. Of the 506, 93 had mixed cardiopathies. Their ages ranged from 18 to 105 years with a median age of 64.0 (Interquartile range = 47-75) years. Females accounted for a greater proportion (55.3%) of the study population. The most common echocardiographic diagnoses were hypertensive heart disease (41.1%), valvular heart disease (22.3%) and cardiomyopathies (11.4%). The prevalence of heart failure was 17.5%, with hypertensive heart disease being the leading cause.

Pocket hematoma remains a common complication of pacemaker procedures, causing patient discomfort and functional limitation while predisposing to device infection. A cutaneous phototherapy device known as X39 ® (LifeWave Inc., Draper, Utah, United States) activates endogenous stem cells through the elevation of glycyl-L-histidyl-L-lysine (GHK) and is found to increase healing rate by 50% following pacemaker extraction. The Carnosine ® device (LifeWave Inc., Draper, Utah, United States) activates carnosine dipeptides throughout the body, which act as a high-energy phosphate system that enhances muscle function. The Glutathione ® device (LifeWave Inc., Draper, Utah, United States) dramatically boosts levels of glutathione, which supports tissue development and renewal. These skin patches contain natural substances that reflect rays of infrared light from the body's biofield, each having unique biological activity. The present study explores whether the combination of X39 ® , Carnosine ® , and Glutathione ® devices may further accelerate wound healing. A case of pacemaker pocket hematoma complicating the treatment of pneumothorax following a challenging pacemaker implantation procedure was presented in this report. In addition to standard care, devices were placed around the wound and replaced daily. Complete hematoma resolution was achieved after six days, which was >500% faster than expert consensus estimates. In conclusion, amplification of stem cells, carnosine, and glutathione activity appeared to perform synergistically, as healing occurred sixfold faster with this adjunctive therapy. This drug-free technology may be used to accelerate healing following surgical procedures.

Background and Aim: Cardiogenic embolism (CE) is a common complication of feline hypertrophic cardiomyopathy (HCM), leading to severe clinical symptoms. This study compared the effects of rivaroxaban and enoxaparin combined with clopidogrel on cats. This was a single-center, prospective, randomized controlled trial. In this study, rivaroxaban or enoxaparin plus clopidogrel was prescribed to 23 cats for at least one of the following events: Abnormal movement of the anterior mitral leaflet during systole, enlargement of the left atrium, spontaneous echocardiographic contrast, or presence of arterial thromboembolism. Oral rivaroxaban (2.5 mg, q24 h) was prescribed to six cats. Subcutaneous injections of enoxaparin (1 mg/kg, q24 h) plus oral clopidogrel (3 mg/kg, PO q24 h) for 60 days were administered to 17 cats. Renal insufficiency and bleeding complications were observed. Plasma concentrations of D-dimer, prothrombin time (PT), partial thromboplastin time, and international normalized ratio (INR) were evaluated. We analyzed the relationship between echocardiography parameters and the effects of coagulation. Blood samples were collected from all cats at baseline and at 1 and 2 months post-treatment. Results: Rivaroxaban alone and in combination with enoxaparin and clopidogrel significantly affected PT and INR. In cats treated with 2.5 mg/kg rivaroxaban for 60 days, no bleeding or recurrence of thrombus formation was observed. These data support the use of rivaroxaban for the treatment of HCM-associated thromboembolism in cats. Treatment of HCM-associated thromboembolism with rivaroxaban alone demonstrated clinical effectiveness with no clinical complications in cats.

A major worldwide cause of death is cardiovascular disease (CVD), which continue to rise in prevalence as compared to previous decades due to ageing of the overall population. Progress in biomarker discovery and developments over the years associated with CVD have been the result of steadily responsive screening techniques, a greater focus on early detection and diagnosis and improvements in treatments that contribute to increasingly successful network clinical outcomes. This review focuses on a number of promising biomarkers which provide indicative and predictive data. The tissue-specific myocardial biomarker cardiac troponine, high sensitivity tests for cardiovascular troponine and the cardiovascular fatty acid binding protein are used in the early hours following the manifestation to evaluate myocardial infarction (MI). High-sensitivity C-sustainable protein, fibrinogen, and uric acid anticipate IM and extinction, including growth differentiation factor-15. The threat of acute coronary artery disease is pregnantrelated plasma protein A, myeloperoxidase, and metalloproteinase matrix. Incidents and repeated cardiovascular events are predicted to occur with lipoprotein-related phospholipase A2 and secretive phospholipase A2. Finally, high natural peptides have all been accepted to predict death and cardiac insufficiency. For example, the assessment of micro-RNA is also investigated in increasingly increasing new areas. In any event, the use of biomarkers for different purposes in CVD continues to be a relevant field of research that researchers have been exploring over the years and many new innovations still exist.

Background: Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with significant morbidity and mortality. The improved recognition or of other factor, the incidence and prevalence of heart failure due to cardiomyopathy appears to be increasing. Aims & Objectives: To study the prevalence, clinical profile and outcome of patients with cardiomyopathies and to study the echocardiographic profile. Material & methods: It is retrospective observational study of 65 patients, with age >15 years and admitted in medical ICU and ward of KIMSU, karad. This study was conducted over period of one year. All eligible subjects underwent relevant investigations including echocardiogram, Doppler study, electrocardiogram, chest radiogram and coronary angiogram. Proforma included age gender presenting complaints, past history, history of medications, clinical examination and laboratory investigations. Trans-thoracic 2-dimensional echocardiogram and Doppler study was done according to the standard protocol. Statistical analysis: Results were given as mean ± SD. Means are compared by unpaired Students t-test. Chi-square was used as appropriate. The observations and data were analyzed in the statistical package social sciences (SPSS) trial version 11. The level of significance was set at P<0.05. Results: A total of 65 patients were admitted from Jan 2010 to Dec 2012 who were diagnosed with cardiomyopathy with mean age of 58.76 years (SD±15.98). Out of the total 65 cardiomyopathy patients admitted 27 (41.53%) had Dilated cardiomyopathy (idiopathic), 15 (23.07%) patients were diagnosed with Ischemic cardiomyopathy. Total 42 (64.61%) patients had Dilated cardiomyopathy (i.e. idiopathic and ischemic dilated cardiomyopathy). A total 11 (16.92%) had Hypertrophic cardiomyopathy (HCM), 2 (3.07%) patients had Hypertrophic obstructive cardiomyopathy (HOCM) with LVOT significant gradient, 5 (7.69%) patients had Restrictive cardiomyopathy (RCMP), 4 (6.15%) had Peripartum cardiomyopathy (PPCM) and 1 (1.53%) patient had miscellaneous (alcohol induced) Cardiomyopathy. Out of 27 patients diagnosed with Dilated Cardiomyopathy (DCM), 15 (55.55%) were male patients and 12 (44.45%) were females. Out of 15 patients diagnosed with Ischemic cardiomyopathy, 7(46.66%) were males and 8(53.33%) were females. Out of 11 patients diagnosed with HCM, 9(81.81%) were males and 2(18.18%) were females. Out of 2 patients diagnosed with HOCM 1(50%) was a male patient and 1(50%) was a female patient. There were 4 female patients who were diagnosed with PPCM. A total of 5 patients were diagnosed with RCMP, out of which 1(20%) was a male patient 4(80%) patients were females. There was 1 male patient diagnosed with cardiomyopathy secondary to chronic alcohol consumption. In present study breathlessness 89.23% was most common presenting symptom and palpitations (81.53%) and cough (58.46%) were next to it with 'p' <0.001. Overall VPC's (36%) were the most common ECG abnormality in patients with cardiomyopathy in present study with 'p' value <0.01. The LBBB (35.71%) was more frequently seen in patients with dilated cardiomyopathy with 'p' <0.02. The atrial flutter/ fibrillation found more commonly in patients with restrictive cardiomyopathy (80%) with 'p' value < 0.02. Total 74.07% of DCM, 86.67% of ischemic cardiomyopathy, 50% of PPCM, 81.82% of HCM, 100% of HOCM, RCMP and alcoholic cardiomyopathy patients had diastolic dysfunction. Idiopathic Dilated cardiomyopathy had 22% (±7.7) of lowest left ventricular ejection fraction (LVEF). Out of total 65 patients two patients with dilated cardiomyopathy succumbed with overall mortality 3.08% and case fatality rate for DCM was 4.76%. Total 96.92% patient were discharged after treatment from the hospital. Conclusion: Present study highlights significant burden of Idiopathic dilated cardiomyopathy and next to it was ischemic cardiomyopathy. A total 6 (9.23%) patients had potentially reversible cardiomyopathy like peripartum, alcoholic and myocarditis. The cardiomyopathy is asymptomatic in the early stages hence early diagnosis and management is of vital importance in the form of judicious use of anticoagulant, digoxin, diuretics, ACE inhibitors and betablocker is mandatory to reduce complications, morbidity and mortality associated cardiomyopathies. Trans-thoracic echocardiogram is an important, simple and noninvasive modality of investigation which can be reproducible for the diagnosis and fallow up of most of the cardiomyopathies.

Cannon A waves are prominent, high-amplitude jugular venous pulsations resulting from atrial contraction against a closed tricuspid valve, reflecting a pathophysiologic hallmark of atrioventricular (AV) dyssynchrony. They are most commonly encountered in rhythm disturbances such as complete heart block, ventricular tachycardia, and pacemaker syndrome. Clinically, these exaggerated A waves manifest intermittently and are best appreciated on physical examination of the jugular venous pulse. However, the detection of Cannon A waves requires an astute understanding of the jugular waveform and its correlation with electrocardiographic and hemodynamic findings. While these waves are often irregular, they may present regularly in junctional or supraventricular rhythms. Differentiation from other venous waveform abnormalities, particularly giant A waves or V waves in tricuspid valve disease, is essential. Evaluation involves comprehensive rhythm assessment via ECG and structural assessment via echocardiography. Management focuses on correcting the underlying arrhythmia or AV dyssynchrony, often necessitating pacemaker therapy or rhythm control strategies. This review aims to elucidate the pathophysiology, clinical recognition, differential diagnosis, and interprofessional management strategies related to Cannon A waves, underscoring their diagnostic value in bedside medicine.

Chest pain is a common general practice presentation that requires careful diagnostic assessment because of its diverse and potentially serious causes. However, the evaluation of acute chest pain remains challenging, despite many new insights over the past two decades. The percentage of patients presenting to the emergency departments because of acute chest pain appears to be increasing. Nowadays, there are two essential chest pain-related issues: 1) the missed diagnoses of acute coronary syndromes with a poor short-term prognosis; 2) the increasing percentage of hospitalizations of low-risk cases.It is well known that hospitalization of a low-risk chest pain patient can lead to unnecessary tests and procedures, with an increasing trend of complications and burden of costs. Therefore, the significantly reduced financial resources of healthcare systems induce physicians and administrators to improve the efficiency of care protocols for patients with acute chest pain. Despite the effo...

The manifestation of cardiovascular diseases in healthy individuals & patients of CKD differ, the latter owing more than 50% of the mortality to cardiovascular disease, should be diagnosed early of their cardiovascular condition, which is highly conducive in early treatment and reduction in mortality. The standardized tests don’t apply to patients of CKD. The independent way of diagnosis is the elevation of the cardiac enzymes. In the present study, 30 CKD patients and 30 healthy controls were included to find status and cutoff values of the cardiac markers. Findings indicate significant rise in CK-MB and LDH to be an early marker to diagnose CVD in CKD patients. There was no significant rise in the TnI and AST levels, these markers seem to be unavailing in early diagnosis of CVD in CKD patients. No correlation was found between any of the cardiac markers. Considering the difference in the homeostasis and functioning of various organ systems in the control and CKD patients, these cu...

Purpose: The study aimed to determine the prevalence of electrocardiographic abnormalities in black stroke patients and to find out if the black race predisposes to increased electrocardiographic abnormalities as well as specific electrocardiographic abnormalities among the study population.

The increase in the prevalence of congenital heart disease remains a major contributing factor to childhood morbidity and mortality in Africa. The study describes the clinical features of children with CHD that presented to a general pediatric hospital, to improve on early recognition and management of the diseases. The prevalence of CHD from the study was 2 per 100 (30 per 1577 or 1 in 52) i.e. (2/100 or 20/1000). A higher incidence in females (53.3%) with M: F = 1:1.14, the majority presented with difficulty / fast breathing (70%), cough(40%), other presenting symptoms are poor weight gain (26.7%), delayed milestones(13.3%). On examination, 60% had dyspnea, 56.7% had murmur. Packed cell volume for acyanotic heart disease ranged 28-30%, and 50-61% for cyanotic heart disease. The majority had comorbid bronchopneumonia (46.6%), and heart failure (23.3%). Echocardiographic findings revealed VSD in 26.7%, 20.0% had PDA and tetralogy of Fallot in 6.7%, Transposition of Great Arteries in 3.3%, and Dextrocardia in 3.3%. The outcome showed that 30% had no symptoms on follow-up, 23.3% were referred for surgery, 10% dropped from follow-up and 3.3% died. These findings which are comparable to the findings of other researchers showed that congenital heart disease has a place in childhood morbidity and mortality, therefore appropriate attention should be directed to improve on early recognition and management of the diseases.

Introduction: Despite the target set by WHO, Africa still falls short when it comes to individuals' use of COVID-19 vaccines. There is a similar pattern of low vaccine usage for the hepatitis B virus (HBV) and yellow fever (YF). Aim and objective: The objective of our study is to compare the awareness, attitude, and uptake of vaccinepreventable diseases (VPD), COVID-19, HBV, and YF, between a rural and an urban community in Nigeria. Methodology: The study was a descriptive cross-sectional study carried out between January 2022 and December 2022 in a rural community, Okada, and an urban community, Benin, in Edo State, Nigeria. A total of 283 rural participants and 483 urban participants were interviewed. SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.) was used for data collection and analysis. The significant value was set at P<0.05. Results: A major percentage of both populations, 98.3% urban and 90.1% rural, reported being aware of COVID-19 vaccines (indicated by P<0.001). There was a similar pattern with HBV vaccine awareness. However, awareness of YF vaccines was more common in the rural (63.3%) community than in the urban (55.0%) community. A complete dose uptake of COVID-19 vaccines was reported by 7.7% of the rural and 2.2% of the urban respondents. The major reason for the refusal of vaccine uptake was the fear of possible side effects. Conclusion: The study showed that vaccine uptake for COVID-19, HBV, and YF is low despite seemingly good awareness of these vaccines. The number one reason for any vaccine refusal is the possibility of experiencing side effects.

Background: Liver cirrhosis (LC) is a common complication of chronic liver disease. Its prevalence has increased markedly over the last few years. With liver cirrhosis comes cardiovascular morbidity and mortality. It is important that the detection of the abnormalities by echocardiography be given priority, as this can change the clinical outcome of these patients with cardiovascular abnormalities in liver cirrhosis. Aim: This study aims to determine the prevalence of pulmonary hypertension in LC patients. Methods and materials: A cross-sectional analytical study was carried out at JUTH (Jos University Teaching Hospital) over a period of one year. We recruited 210 adult patients with liver cirrhosis from the gastroenterology clinic and wards for this study. Data from these patients were collected with questionnaires administered by the interviewer and analysed using SPSS 23 statistical software (IBM Corp., Armonk, NY). The data obtained are presented in tables and charts. Categorical variables were expressed as proportions and frequencies, while continuous data were expressed as the median, mean, and standard deviation. Results: Pulmonary hypertension was found in 30.5% of the participants, with mild pulmonary hypertension being the most common. No one had severe pulmonary hypertension. There was an increased risk of developing pulmonary hypertension in patients with coughs, easy fatigability, bilateral leg swelling, abdominal swelling, and ascites (P<0.05). Conclusion: The result showed that there is a high prevalence of pulmonary hypertension in patients with liver cirrhosis.

Background: In patients with chronic liver disease, the common endpoint of its course is liver cirrhosis which is a cause of cardiovascular morbidity and mortality. These abnormalities in the cardiovascular system, especially the heart, can be detected by echocardiography. Identifying and acting on these abnormalities can have an impact on their management thereby reducing morbidity and mortality of patients with liver cirrhosis. The aim of this study was to determine the prevalence of right ventricular systolic and diastolic dysfunction in liver cirrhosis patients. Methods and materials: A hospital-based cross-sectional study was conducted among adult patients of the gastroenterology unit (ward and clinic) diagnosed with liver cirrhosis. A total of 243 patients were recruited and 210 were evaluated for this study. This study was carried out over one year. Cardiology studies, including electrocardiography and echocardiography, were conducted on patients to assess right ventricular function. Results: Among the participants, 44.8% had right ventricular hypertrophy and 3.8% had right ventricular dilatation. Using Tricuspid Annular Plane Systolic Excursion (TAPSE), 17.1% were found to have right ventricular systolic dysfunction and 51.4% had systolic dysfunction using FAC. Diastolic dysfunction was found in 61% of the participants and grade 2 diastolic dysfunction was the commonest. Conclusion: From this study, a high prevalence of right ventricular systolic and diastolic dysfunction was recorded among patients with liver cirrhosis.

Background: Third dose of SARS-CoV-2 vaccine is a new strategy to fight COVID-19 variants, we report a case of acute Takotsubo Cardiomyopathy (TC) following vaccination. 90-year-old woman presented with sudden shortness of breath following her vaccination, echocardiogram showed apical ballooning with new reduction in left ventricular ejection fraction, emergent coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance imaging confirmed TC Diagnosis of vaccine associated Takotsubo was made given the temporal relationship and absence of other triggers. TC may occur after booster COVID-19 vaccination and being aware of this this potential life-threatening rare association is essential for evaluating vaccine safety. Objective: Takotsubo Cardiomyopathy (TC) should be considered in patients who present with cardiac symptoms within days of receiving mRNA BNT162b2 SARS-CoV-2 vaccination, especially after the third dose. Further studies are warranted to determine the mechanisms by which mRNA vaccines may cause Cardiomyopathy and for potential long-term cardiovascular injury.

Rationale: Diagnosis of ST-segment elevation myocardial infarction in the presence of left bundle branch block (LBBB) is a challengeable and infarction equivalent. Therefore, the intravenous infusion of thrombolytic may be a crucial step. Emergent Sgarbosa criteria and their modification are guided advantageous guide keys. Atrial fibrillation represents the risk of arrhythmia in the presence of a left bundle branch block. Interestingly, the presentation of myocardial infarction with atrial fibrillation and left bundle branch block has a risk impact on both morbidity and mortality of patients. Patient Concerns: A middle-aged married Painter heavy smoker Egyptian male patient was admitted to the intensive care unit with acute chest pain with rapid atrial fibrillation and left bundle branch block. Diagnosis: Left bundle branch block with atrial fibrillation and inferior Yasser's criterion (Discrepancy criteria) ST-segment deviations as a new description in suspected acute myocardial infarction.

Rotor vibration control during start-up, acceleration and deceleration phases are one of the key problems besides stable levitation, in high-speed applications of bearing less switched reluctance motor (BSRM) . Global sliding mode controller (GSMC) is proposed to control the speed and position of BSRM. Sensor less operation is achieved with sliding mode observer. Rotor displacement tracking error functions were used in the sliding mode switching functions. New sliding mode displacement control and speed tracking equations obtained using extra exponential fast decaying nonlinear function and conventional linear sliding mode switching. Simulation is carried on hybrid 12/14 BSRM with the proposed controller and observer. 12 stator poles and 14 rotor poles were selected. Pole arc was 25.71. FEM analysis showed Torque pole arc was 12.85. Air gap length was 0.25 -0.5 mm. Stator diameters -112/60.2, stator yoke thickness 7.7 mm, shaft diameter of 18 mm, coil width of 4 mm, rotor pole arc of 12.85, axial stack length of 40 mm, rotor yoke thickness of 9.7 mm-were the major design parameters. FEM of motor parameters under different loads for speed, torque load, switching angle, voltage, phase resistance and moment of inertia was performed. Separated single winding, wide suspending force region, higher power density, natural decoupling of torque from suspending force, low magnetic motive force, low core cost of hybrid 12/14 BSRM makes it ideal as motor for total artificial heart as destination therapy.

This manuscript is a preprint hypothesis paper exploring a theoretical link between rejection-sensitive dysphoria, interoception, and Takotsubo syndrome. It has not yet been peer reviewed.

This preprint proposes a novel hypothesis linking rejection-sensitive dysphoria (RSD) in ADHD to Takotsubo Syndrome (stress-induced cardiomyopathy). Drawing from professional experience as a neurodiversity coach and interdisciplinary theory, it suggests that the intense emotional pain reported by many individuals with ADHD may share physiological mechanisms with acute cardiac stress responses. This includes a possible catecholaminergic surge, autonomic dysregulation, and altered interoceptive feedback. The paper integrates coaching insights, emerging neuroscience, and embodied cognition, proposing that RSD may produce somatic outcomes akin to Takotsubo in some neurodivergent individuals. It highlights the urgent need for research that bridges emotion, embodiment, and cardiovascular health—particularly within underrepresented neurodivergent populations.

Introduccion: la cardiopatia isquemica es la causa mas importante de muerte en el mundo y se manifiesta de diferentes formas, las mas graves son el infarto agudo de miocardio, la angina de pecho y la muerte subita. Objetivo: caracterizar el infarto agudo del miocardio en pacientes mayores de 19 anos y menores de 65 anos. Metodo: se realizo un estudio retrospectivo de serie de casos en el Servicio de Terapia Intensiva del Hospital General Docente Guillermo Dominguez Lopez del municipio de Puerto Padre entre el periodo de junio del 2017 a diciembre de 2018. Se realizaron calculos de estadistica descriptiva: frecuencia absoluta y relativa, media y desviacion estandar. Resultados: el sexo masculino represento un 61,76% (63 casos). Por grupo de edad en ambos sexos fueron mas frecuentes los casos en el grupo de 56 a 65 con un 65,08% (41 casos) en el masculino y un 48,72% en el femenino (19 casos). La media de la edad fue de 59 anos para los hombres y de 55 anos para las mujeres; siendo de...

The aortic ring abscess is a rare and serious complication of infectious endocarditis. Echocardiography remains the diagnostic key, the treatment is expensive and the prognosis is generally dark .we report the case of a 29 years old patient with multiple value diseases who presented an aortic ring abscess. Observation: This is Miss M. D, 29, known with a rheumatic multiple valve disease: a combined mitral and tricuspid disease and an aortic regurgitation for over 15 years, with a history of multiple hospitalizations. At admission, she was in bad condition, suffered significant weight loss, was pale, a congestive heart failure, mitral regurgitation and stenosis signs, aortic regurgitation and pulmonary hypertension on a background of fever in the long course. The biology test noted anon specific inflammatory syndrome and negative blood cultures. Echocardiography showed, in addition to the multiple valve disease, a fluid collection at the valsalva sinus, suspicious of an abscess and multiple vegetation at the aortic valves. The patient received probabilistic anti biotherapy and congestive heart failure treatment. Surgery was indicated. Under probabilistic anti biotherapy, evolution was favorable at first then the clinical condition has deteriorated resulting in the death of the patient. The check up echo cardiographic noted a significant increase in the volume of the abscess. Conclusion: The aortic ring abscess is a serious complication of infectious endocarditis on native and prosthetic valve. Diagnosis is based mainly on Transthoracic and transosoephagial echocardiography. Surgery is indicated.

Tamponade is one of the major complications of pericarditis which is immediately life threatening. The objective of the study was to evaluate the diagnostic and evolutive aspects of pericardial tamponade in a cardiology department of Dakar. We included 40 patients who had a tamponade with a file that could be exploited over a period of 3 years and 6 months (January 2010 to June 2014). The mean age of the patients was 41 years (range between 15 and 80 years). There was a male predominance with a sex ratio (23/17) of 1.35. Signs were dominated by dyspnea (95.0%), pain (85.0%) and fever (40%). Signs of poor hemo dynamic tolerance were evidenced by weak peripheral pulses (21.16%), paradoxical pulse (5%), and hypotension and/or shock (15.0%). The diagnostic means, besides the clinic examination, was mainly by conducting an echocardiography. Thus, there was a proto-mesodiastolic collapse of RV in 82.5% of cases, a telediastolic collapse of the right atrium in 87.5% of cases, a fibrin network in 55% of cases. Emergency treatment with per cutaneous pericardiocentesis was performed in all our patients using the subxiphoid approach. There was a favorable evolution in 77.5% of cases. Were corded 8 cases (or 20%) of death in all admitted cases. Pericardial tamponade is a medical emergency. The diagnosis is easy using echocardiography but the etiological diagnosis is always problematic in our working context.

This is a mini review article of tetralogy of Fallot. This review article will discuss historical, anatomical, pathophysiologic, clinical and surgical management of tetralogy of Fallot. Author also discussed his experience with postoperative follow up in 45 patients with tetralogy of Fallot. Incidence of congenital heart defect is 8 per 1000 life birth. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect (CHD) constitutes 5-10% of all CHD. Prevalence of TOF ranges from 0.26-0.48 percent per 1000 live birth.

As if to rhyme with the famous Hollywood movie titled,
'Sleepless in Seattle', I saw a 64-year old man in my office
in cardiac consultation who after having dinner with his
son and daughter-in-law in Seattle was extremely short of
breath while walking up a few stairs to his hotel room. He
is from upstate New York area and was visiting them in
Seattle. He never had any symptoms like this before. He
did have some chest discomfort at the time but the
shortness of breath was quite concerning to him. He did
not have palpitations, dizziness, diaphoresis or syncope.
He did not seek any medical help in Seattle and made an
appointment to visit his primary care physician upon
return to Upstate, NY. He was then requested to come and
see me the next day. This event of shortness of breath in
Seattle took place a month before coming to see me.

We report the case of a 63 year old woman who comes to an ajmaline challenged. After 8 minutes of infusion her baseline ECG showed significant QRS complex prolongation and switched over to the typical coved-type ECG. Subsequently a sustained monomorphic ventricular tachycardia was developed, followed by a sustained polymorphyc VT onset, which finally degenerated in a hemodynamically non relevant sustained monomorphic VT. Finally, a 200J defibrillation was required to terminate the arrythmia. Sustained ventricular arrhytmia (SVA) is infrequent but not an exceptional event (0.1-18%) and ajmaline is considered a valuable drug. In addition, provocation testing must be performed in an appropiate environment with advanced life support facilities. The evidence shows that the occurrence of ajmaline-induced sustained ventricular arryhtmia in patients with BS might not identify a category at higher risk for further arrhythmic events during follow-up.

Understanding of the atherosclerosis process has evolved from simple plaque build-up causing blockage to inflammation and endothelial dysfunction. The underlying etiology for endothelial dysfunction and vascular inflammation is autonomic imbalance. Autonomic imbalance also causes hormonal dysregulation and cellular receptor sensitivity. Therefore, dysautonomia is the underlying etiology behind type2 diabetes and vascular inflammation that predispose to atherosclerosis. Regulating dysautonomia is a more definitive and long-term solution to effectively treat type2 diabetes and vascular atherosclerosis.

Quadricuspid pulmonary valve is a rare congenital cardiac entity. Because of its usual asymptomatic course, it has been almost exclusively diagnosed after death or at cardiac surgery, and few cases have been documented in living patients by trans thoracic echocardiography or computed tomography, let alone by cardiac magnetic resonance imaging (MRI). We report the case of a young European male diagnosed with quadricuspid pulmonary valve detected on cardiac MRI.

Due to the demographic progression of our societies and the increasing prevalence with age of coronary artery disease, we will increasingly face the treatment of acute coronary syndrome in elderly patients (> 70 years). Very little data has been published in Africa, particularly in the South of the Sahara. This series shows the severity of coronary lesions in subjects aged over 70 years admitted to the cardiology department of the Aristide Le Dantec hospital and the interest of the invasive strategy in this population. Introduction: Coronary artery disease in the elderly is often more diffuse and severe. The objective of our study was to describe the results of coronary angiography and angioplasty in the elderly in Senegal. Methodology: A monocentric, retrospective and descriptive study over a period of 39 months from 1 May 2013 to 31 July 2016 was carried out within the cardiology department of the teaching hospital: Aristide Le Dantec in Dakar. Were included all patients who had coronary angiography with a complete clinical record. Results: A total of 380 records were collected during the study period. The prevalence of subjects over 70 years of age was 12.7% (n = 38). The mean age was 74.37 +/-4.1 years. The sex ratio was 2.35 in favor of men. The main risk factors were hypertension (51%), sedentary lifestyle (46.8%) and diabetes (27.7%). The main indications were SCA ST + in 14 cases (29.8%) and the angina of effort in 11 cases (23.4%). Nearly half (51.1%) of the patients had angina pain at discharge. LV systolic dysfunction was noted in 21 patients (58.3%). Nine (19.1%) patients were able to benefit from thrombolysis. Coronary angiography was programmed in most of our patients (80.9%), the right femoral approach was preferred (70.2%). The average duration of the procedure was 66.24 min.

As if to rhyme with the famous Hollywood movie titled,
'Sleepless in Seattle', I saw a 64-year old man in my office
in cardiac consultation who after having dinner with his
son and daughter-in-law in Seattle was extremely short of
breath while walking up a few stairs to his hotel room. He
is from upstate New York area and was visiting them in
Seattle. He never had any symptoms like this before. He
did have some chest discomfort at the time but the
shortness of breath was quite concerning to him. He did
not have palpitations, dizziness, diaphoresis or syncope.
He did not seek any medical help in Seattle and made an
appointment to visit his primary care physician upon
return to Upstate, NY. He was then requested to come and
see me the next day. This event of shortness of breath in
Seattle took place a month before coming to see me.

Las variables preoperatorias en la cirugía de reemplazo valvular mitral permiten realizar una evaluación preoperatoria objetiva de cada paciente. Objetivo: Determinar la influencia de los factores de riesgo preoperatorios en la mortalidad y las complicaciones mayores que ocurren en la cirugía de sustitución valvular mitral. Método: Estudio analítico, longitudinal, de seguimiento prospectivo en 158 pacientes intervenidos quirúrgicamente por enfermedad valvular mitral en el Cardiocentro "Ernesto Che Guevara", de Villa Clara, durante los años 2007-2010. Se realizó un estudio bivariado por cada variable independiente, las variables dependientes fueron la mortalidad y las complicaciones mayores. Resultados: La edad media fue de 65,2 años, predominó el sexo femenino, y el hábito de fumar, los trastornos ventilatorios, la hipertensión pulmonar y la fibrilación auricular fueron los factores de riesgo que se destacaron. La mayoría de los pacientes se operaron de forma electiva, con clase funcional II, fracción de eyección del ventrículo izquierdo mayor del 50 % y predominio de la estenosis mitral. Las variables que se asociaron con el riesgo de sufrir complicaciones mayores, fueron: la insuficiencia cardíaca, la edad mayor de 50 años, la cirugía de urgencia, el uso de hemoderivados, la fibrilación auricular, los trastornos ventilatorios en la espirometría y el tiempo de aceleración pulmonar. Las que se relacionaron con el hecho de morir, fueron: la fracción de eyección del ventrículo izquierdo disminuida, el tiempo de aceleración pulmonar, la insuficiencia cardíaca, el uso de hemoderivados, creatinina > 1,5 mg/dl, la cardiomegalia y la fibrilación auricular. Conclusiones: La relación entre las variables preoperatorias y la morbilidad y mortalidad postoperatoria se comportó indistintamente para cada centro quirúrgico. ABSTRACT Introduction: Preoperative variables in mitral valve replacement surgery allow an objective preoperative assessment of each patient. Objective: To determine the influence of preoperative risk factors on mortality and major complications occurring in mitral valve replacement surgery. Method: Analytical, longitudinal, prospective follow-up study of 158 patients who underwent surgery for mitral valve disease at the Cardiocentro Ernesto Che Guevara of Villa Clara, from 2007 to 2010. A bivariate study was conducted for each independent variable. Mortality and major complications were the dependent variables. Results: The mean age was 65.2 years, female patients predominated. Smoking, ventilatory disorders, pulmonary hypertension and atrial fibrillation were the most important risk factors. Most patients underwent surgery electively, in functional class II, with left ventricular ejection fraction greater than 50% and predominance of mitral stenosis. The variables that were associated with the risk of major complications were: heart failure, age over 50 years, emergency surgery, the use of hemoderivatives, atrial fibrillation, ventilatory disorders in spirometry and pulmonary acceleration time. Those related to death were: reduced left ventricular ejection fraction, pulmonary acceleration time, heart failure, the use of hemoderivatives, creatinine > 1.5 mg/dl, cardiomegaly and atrial fibrillation. Conclusions: The relationship between preoperative variables and postoperative morbidity and mortality behaved indistinctly in each surgical center.

Diabetes Mellitus is one of the most important causes of cardiovascular disease in the United States and worldwide. Few antidiabetic drugs (e.g. Rosiglitazone) have faced cardiovascular (CV) safety related controversies in the recent past. The FDA mandatory advisory states that the CV safety concerns of any new antidiabetic drug should be thoroughly addressed in a dedicated longitudinal outcome trial. Liraglutide, a long-acting GLP-1 agonist, approved as a 2nd line agent in the treatment of type 2 diabetes mellitus (DM), has shown some promising effects on the cardiovascular system in various preclinical and early clinical studies. In accordance with the FDA recommendation, a large, multicenter trial (LEADER) was undertaken in 2010 to look for long-term CV outcome data on liraglutide. Primary outcome (Death due to CV causes, nonfatal MI or, nonfatal stroke) occurred in significantly fewer patients in the liraglutide group, with a lower incidence of cardiovascular and all-cause mortality. Besides, a better glycemic control, fewer hypoglycemic events, significant weight loss, and beneficial effects on nephropathy were observed in patients on Liraglutide. ELIXA trial on Lixisenatide did not reveal any significant CV benefit. So, Results from the ongoing CV outcome trials on other GLP-1 agonists (EXSCEL for Exenatide, HARMONY for Albiglutide, and REWIND study for Dulaglutide) will guide us better to determine whether the observed benefit is indeed a class effect or a molecule effect. Here we have summarized all the cardiovascular outcome data so far available on liraglutide, with special reference to the recently published LEADER trial results.

Background: Coronavirus is a pandemic disease that emerged in China in 2019 with severe respiratory syndromes in conjunction with organ failure and advanced mortality rate where it has attracted worldwide interest. The pathogenicity of the virus increases by exacerbated oxidative stress that leads to the accumulation of free radicals in the body. Frequently, those free radicals are neutralized by antioxidants, especially glutathione. Objective: Thus, this study aimed to evaluate the role of glutathione in the pathogenicity of the virus alongside certain blood parameters. Materials and Methods: In this study, 90 participants were examined for glutathione levels using a specific enzyme-linked immunosorbent assay (ELISA) kit in addition to the levels of hemoglobin (Hb). Ferritin and vitamin D3 were also measured as they are linked to the level of glutathione in coronavirus disease-2019 (COVID-19). Result: The lowest level of Reduced glutathione in COVID-19 hospitalized patients especially male patients alongside with vitamin D3 and Hb levels. Whereas a significant (P < 0.05) increase in ferritin level was recorded. However, a significant (P < 0.05) increase in ferritin level was recorded. Conclusion: This study showed a significant relationship between glutathione level and disease severity in hospitalized patients with COVID-19, where the depletion of the glutathione level may have a central role in COVID-19 severity and pathophysiology.

Introduccion:  A pesar de los indiscutibles beneficios en cuanto a calidad y expectativa de vida en los pacientes con indicaciones precisas de marcapasos, existen un grupo de ellos con efectos deletereos en la funcion y geometria ventricular izquierda.  Objetivo:  Identificar modificaciones ecocardiograficas en pacientes con estimulacion cardiaca permanente realizada desde punta de ventriculo derecho.  Metodos:  Se realizo estudio descriptivo longitudinal prospectivo a 84 pacientes que requirieron implantacion de marcapasos permanente con estimulacion desde punta del ventriculo derecho. Se recolectaron datos ecocardiograficos antes y despues del implante.  Resultados:  El 53,65 % fueron del sexo masculino, edad media 68,25. Las medias de las variables ecocardiograficas incrementaron sus valores, excepto, la fraccion de eyeccion del ventriculo izquierdo que disminuyo, el grupo con estimulacion secuencial presento 4 casos mas con disfuncion diastolica grado II que al inicio, el grupo ...

La estimación del riesgo quirúrgico preoperatorio puede hacerse a través de los modelos matemáticos o escalas de predicción clínica. El objetivo fue validar el Euroscore para evaluar los resultados inmediatos de la cirugía de sustitución valvular mitral. Método: Estudio analítico, longitudinal, de seguimiento prospectivo en 158 pacientes intervenidos quirúrgicamente por enfermedad valvular mitral en el Cardiocentro Ernesto Che Guevara, de Villa Clara, durante los años 2007-2010. Se calculó el valor del Euroscore a todos los pacientes. La calibración del modelo se evaluó mediante la prueba de bondad de ajuste de Hosmer-Lemeshow. La capacidad de discriminación se analizó a través del cálculo del valor del área bajo la curva COR. Resultados: El valor medio del Euroscore fue de 2,1 con una desviación típica de 1,45. La mortalidad esperada fue del 3,9 %, inferior a la observada que fue de 4,4 %. Los fallecidos presentaron medias del Euroscore de 5,9 vs. 1,95 de los que no fallecieron (p=0.00). Los que tuvieron complicaciones graves mostraron una puntuación media mayor que ante la ausencia de estas, 3,45 vs. 1,84, diferencias estadísticamente muy significativas (p=0.000). El área bajo la curva COR fue de 0,97, con significación de 0.000 para los que fallecieron, y la presencia de complicaciones graves con un área bajo la curva de 0,70 y significación de 0.002. Conclusiones: El Euroscore es confiable para predecir la mortalidad precoz en los pacientes a los que se les ha realizado cirugía de sustitución valvular mitral en nuestro Hospital. El Euroscore no predijo morbilidad grave precoz. Palabras clave: Cirugía cardíaca, Válvula mitral, Euroscore

Lymphatic filariasis, commonly known as elephantiasis, is a neglected tropical disease which causes hidden damage to the lymphatic system resulting in disfigurement, suffering, and poor quality of life. Lumbar sympathetic block is routinely used by pain physicians for vascular insufficiency, sympathetically mediated pain, hyperhidrosis, and discogenic pain as usual indications. There is no report in literature of performing a sympathetic block for filarial lymphedema. The author would like to report this case of a patient of filarial lymphedema and pain who benefitted with a lumbar sympathetic block.

IntroductIon Delude, Wahn, Delire or Delusion. Whether put in Latin, German, French, or English, this phenomenon continues to elude authors across the world. The incidence of delusional disorders is 3 per 100,000 people, with many subtypes such as persecutory, grandiose, somatosensory, jealous, and erotomanic. The erotomanic subtype is extremely rare. In this erotomanic subtype of delusional disorders, also called "De Clérambault's syndrome," or "Les psychoses passionnelles," the patient (generally a woman) believes that a man or woman of higher social status and age is intensely in love with her. There is little contact between them due to social circumstances. This condition in men is rare and underdiagnosed. [1] We report an unusual case of multiple erotomanic delusions in a middle-aged man, whose love objects include women from a wide age group, including an underage girl. case report A 42-year-old single male (Mr. B), with no family history of psychiatric disorders, was brought to the outpatient psychiatric clinic by his mother with complaints of him claiming to be in love with a 15-year-old girl. In 2019, Mr. B had been to a woman's (W1-age 35 years) apartment as an electrician. He had visited the apartment thrice that year in a professional capacity, with minimal interaction between Mr. B and Ms. W1. He then confessed to his mother that they were deeply in love and desired to get married. Both visited W1's apartment, in the hope of asking her hand in marriage. To the mother's astonishment, W1 was already married, and her husband resided abroad. A police complaint was filed. On questioning, Mr. B just smiled and remained firm that Ms. W1 was lying about her marriage. He was then allowed to return home, with a warning. Both Mr. B and his mother increased their visits to temples, in the hope that religion would cure his ailment. Here, he found new love interests, W2 (age: 24 years) and W3 (age: 32 years), both married. There was no interaction with them, but his firm delusion resulted in hospitalization in 2022. During this hospitalization, he claimed that W4 (his doctor, age-38 years, who was also married) was in love with him. After 2 weeks, he was discharged and admitted to a Les psychoses passionnelles, or simply put, erotomanic delusions, is a rare, cryptic psychiatric entity with a wide range of presentations in history. Mostly seen in women, this condition has no known etiology and has a variable prognosis and response to treatment. We present a rare case of multiple erotomanic delusions in a man hailing from Southern India. He has lived with this condition for the past 5 years and has been nonresponsive to antipsychotics. The behavior of such patients can lead to the social embarrassment of friends and family. Serious cases in men also result in violence, although this is very rare. This necessitates the need to get to the core of this syndrome. More research is needed to understand the cause of this condition and find an effective treatment.

) and was more common in chronic bronchitis than with emphysema (10.5% vs.9.1%). In the present study out of the total 60 patients 5 (8.33%) were found to have pericardial effusion. In the present study, 5 cases were found to be having co-existent dilated cardiomyopathy, which was statistically insignificant (p=0.643) and 11 patients had diminished LV ejection fraction (<50%) suggesting a systolic LV dysfunction, of which 5 had dilated cardiomyopathy. Conclusion: Echocardiographic as well as ECG findings were found in most of the patients suffering from chronic bronchitis and emphysema.

Artículo recibido el 18 de Octubre de 2011 y aceptado para publicación el 30 de Diciembre de 2011. Introducción: en Cuba, al igual que en el resto del mundo, las enfermedades isquémicas cardiacas ocupan las primeras causas de muerte con un incremento del número de cirugías de revascularización miocárdica. El amplio uso de autopsia en Cuba y su eficacia, motivó establecer la correlación clínico patológica de los pacientes fallecidos operados de revascularización miocárdica como herramienta de control de la calidad en el quehacer profesional. Objetivo: determinar la correlación clínico patológica de los fallecidos en el postoperatorio de revascularización miocárdica en cirugía cardiovascular del Hospital "Hermanos Ameijeiras" entre 2006 a 2009. Materiales y métodos: se realizó un estudio descriptivo, retrospectivo y de corte transversal, se analizaron causas básicas y directas de muerte, clínicamente y por autopsia; se compararon según parámetros de anatomía patológica para evaluar calidad del diagnóstico en coincidentes (total o parcial) o no coincidentes. Se obtuvieron 682 pacientes operados en este período; la muestra quedó constituida por 59 fallecidos para un 8,6% de mortalidad. Se contó con la aprobación del comité de ética. Resultados: más del 70% del total de fallecidos corresponde a mayores de 60 años. Se observó un incremento de fallecidos masculinos sobre femeninos con relación 7:2. Existe prevalencia en factores de riesgo como hipertensión arterial e infarto cardíaco previo. La primera causa directa de muerte tanto clínica como por autopsia fue el fallo multiorgánico seguido del choque cardiogénico. Según causas básicas de muerte la ateroesclerosis ocupó el primer lugar con 91,5% y 98,3% clínicamente y por autopsia respectivamente. No existió correlación clínico patológica en 20,3% de causas directas de muerte, y 8,5% en causas básicas de muerte. Conclusiones: los parámetros fueron adecuados para discrepancias diagnosticas en este estudio, con rango de aceptabilidad de 10 al 40%. Se diagnosticaron 20 infartos agudos del miocardio, solo siete pasaron desapercibidos. Las discrepancias para infarto agudo de miocardio, mundialmente oscilan entre 20 a 74%, en el estudio fue del 26%. Se diagnosticaron tres casos de tromboembolismo pulmonar y dos dejaron de diagnosticarse. Las discrepancias para tromboembolismo pulmonar, mundialmente oscilan del 50 a 89%, en este caso fue del 40%. (MÉD.UIS. 2011;24(3):239-45).