Day 1 :
- Clinical Cardiology |Heart Diseases | Heart Failure | Cardiovascular Medicine | Cardiac Surgery | Hypertension | Pediatric Cardiology | Cardiac Nursing and Healthcare | Devices / CRT / ICD / Surgery | Clinical Cases reports in Cardiology
Suresh K Vatsyayann
Waikato University, New Zeland
College of physicians and surgeons, Pakistan
Reema Qayoom is a final-year FCPS Cardiology trainee at Tabba Heart Institute Karachi, Pakistan. She has done her two years General Medicine training at Liaquat National Hospital, Karachi, Pakistan. She received a bachelor’s degree from Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan. She is currently working on 4 research papers in variable fields related to cardiovasular medicine
Inferior wall myocardial infarction accounts for 40-50% of all acute myocardial infarctions.Association of acute inferior wall myocardial infarction and third degree atrioventricular block(AVB)was established, but the effect modifiers are still not known. We assessed the predictors of patients presenting with acute inferior wall myocardial infarction and third degreeatrioventricular block. We conducted a prospective cross sectional studyon patients presented within <12 hours with sign & symptoms of acute inferior wall myocardial infarction at, Liaquat National Hospital, Karachi from February to August 2018 . Third degree AVB was assessed through ECG. The diagnosis of inferiror wall myocardial infarction was established by the presence of ST segment elevation in leads II,III,aVF or Q waves of >0.04 sec in duration in lead II,III and aVF with reciprocal ST segment depression in the lateral and/or high lateral leads ( I, aVL, V5 and V6). Out of 115 patients with acute inferior wall myocardial infarction, 70(80.5%)patients were male. Mean age was 47.5 ±7.47 yearsand duration of symptoms was 4.6 ±1.28 hours. Diabetes was found in 57.4% patients, 72.2% were hypertensive, and 50.4% patients were smokers. Third degree AVBwas observed in 13.0% patients. Smoking status was significantly associated with third degree AVB (OR: 2.1, 95%CI: 87% , p-value: 0.01). Among patients with acute inferior wall myocardial infarction, third degree AVB occurred in 15(13%),and has significant association with smoking. Generalizabilty of results is limited because it was a single centre, non randomized study with small size.
Philippine Heart Center, Philippines
Camille-Marie Go-Cacanindin has obtained her Medical Degree at the age of 25 years from University of Santo Tomas Faculty of Medicine and Surgery and Pediatric Residency Training from Philippine Children’s Medical Center. She is currently a Pediatric Cardiology Fellow in training at Philippine Heart Center, a tertiary cardiovascular referral center.
Anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) occur in 1 in 300 000 live births. The most common origin of the abnormal LCA is from the pulmonary truncal sinuses. The rarest form of ALCAPA presents with anomalous left coronary artery arising from the right pulmonary artery. This is a case of 1 month old female presenting with Dyspnea , 2D echocardiography revealed ALCAPA. Intraoperativley, the Left Coronary Artery was found to be originating from the Right Pulmonary Artery. The patient underwent coronary implantation and LeCompte procedure.
In the most common form of ALCAPA, the abnormal coronary artery arises from the adjacent pulmonary valvar sinus, rather than the pulmonary trunk. In this case, the Anomalous Left Coronary Artery originated the Right Pulmonary Artery. Such case has an incident of 1 in 2,000,000 live births. This is the first reported case in a tertiary cardiovascular referral center. In fetal life, this has no detrimental effect since pressures and saturations are similar in the aorta and pulmonary artery. After birth, however, the pulmonary artery contains desaturated blood at pressures that rapidly fall below systemic pressures. The left ventricle is perfused with desaturated blood at low pressures leading to infarction with ventricular dysfunction. Coronary translocation and Lecompte maneuver was done which provided relief for the patient’s condition.