Background Up to over half of the patients with ST-segment elevation myocardial infarction (STEMI) are reported to undergo spontaneous reperfusion without therapeutic interventions. Our objective was to evaluate the applicability of T wave inversion in electrocardiography (ECG) of patients with STEMI as an indicator of early spontaneous reperfusion. Methods In this prospective study, patients with STEMI admitted to a tertiary referral hospital were studied over a 3-year period. ECG was obtained at the time of admission and patients underwent a PPCI. The association between early T wave inversion and patency of the infarct-related artery was investigated in both anterior and non-anterior STEMI. Results Overall, 1025 patients were included in the study. Anterior STEMI was seen in 592 patients (57.7%) and non-anterior STEMI in 433 patients (42.2%). Among those with anterior STEMI, 62 patients (10.4%) had inverted T and 530 (89.6%) had positive T waves. In patients with anterior STEMI and inverted T waves, a significantly higher TIMI flow was detected (p value = 0.001); however, this relationship was not seen in non-anterior STEMI. Conclusion In on-admission ECG of patients with anterior STEMI, concomitant inverted T wave in leads with ST elevation could be a proper marker of spontaneous reperfusion of infarct related artery.
Most maternal cardiac disease in Western societies is now congenital in origin. This relates to the significant improvements in congenital cardiac surgery during the last years. Some patients will present for the first time in pregnancy with symptoms and learn that they have congenital heart disease. So all patients should have a detailed evaluation and appropriate counseling before pregnancy. Ebstein anomaly is a rare and complex congenital heart disorder occurring in 1 per 200 000 live births and, first described by a German physician Wilhelm Ebstein in 1866 in a report titled, "Concerning a very rare case of insufficiency of the tricuspid valve caused by a congenital malformation. This anomaly accounts for 0.5%-0.7% of cases of congenital heart disease. The average life duration of patients with Ebstein's anomaly is 25-30 years. The malformation consists of apical displacement of the tricuspid valve with resultant regurgitation and enlargement of the right heart chambers, resulting in arrhythmias and heart failure. The common cardiac anomalies associated with the condition are atrial septal defect (ASD) in 90% of patients, anatomic or functional tricuspid atresia in 30%, Wolff-Parkinson-White (WPW) syndrome in 15% and less commonly ventricular septal defect (VSD), pulmonic stenosis or atresia and mitral valve prolapse. Survival into adulthood is common and patients present with cyanosis, dyspnea and palpitations.
IntroductionPulmonary embolism is a challenging critical cardiovascular disease with high morbidity and mortality. Surgical embolectomy has favorable results in patients with massive pulmonary embolism.AimTo study the outcome of embolectomy in patients with massive pulmonary embolism.Material and methodsIn this single-center, retrospective study, 36 patients including 14 male and 22 female patients with a mean age of 50.80 ±18.89 years with acute pulmonary embolism who underwent surgical pulmonary embolectomy from January 2011 to January 2016 were included. The medical records of all patients were reviewed for demographic and preoperative data and postoperative outcomes.ResultsCommon risk factors for acute PE were major surgery within 3 months and deep vein thrombosis. The most common presenting symptoms of patients were dyspnea, followed by chest pain and syncope. Mean duration of hospitalization was 14.76 ±8.69 days and mean operation duration was 4.47 ±1.54 h. Mean time from admission to embolectomy was 6.58 ±1.13 h. Ten (27.8%) patients died during the operation including 3 cases with cardiopulmonary resuscitation prior to surgery and 2 cases with severe cardiogenic shock. Patients who survived were followed for 6 months. The mortality rate during follow-up was 15.4%; all 4 patients died during follow-up period due to metastatic cancer. No pulmonary embolism recurrance were seen.ConclusionsAlthough surgical embolectomy mostly was done for high risk patients, it had good in-hospital and excellent mid-term outcomes.
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