Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
RESULTS OF HEART VALVE HOMOGRAFT IMPLANTATION IN A MAJOR REFERRAL CENTER IN IRAN
6
16
EN
M.Y.
Aarabi
VALIASR AVE TEHRAN- IRAN
P. N.
Davari
M.
Meraji
a.
Shahmohammadi
M.
Dalir Rooyfard
M. A.
Yousefnia
G.R.
Omrani
M. B.
Tabatabaee
A.
Zavarehee
Background- Heart Valve homografts have been used in reconstructions of right and left ventricular outflow tract (RVOT and LVOT) for nearly 50 years now with varying results. Methods- The outcome of homograft implantation was analyzed in 101 patients who received 108 cryopreserved homografts for the reconstruction of RVOT and LVOT between April 1993 and March 2003. Results- 88.2% aortic valve and 11.7% pulmonic valve homografts were used. Median age at implantation was 10.0 years (Mean: 13.1 ± 10.6 years, range: 5 months to 57 years). Endpoints included: (1) patient survival, (2) homograft failure (valve explant or late death) and (3) homograft dysfunction (homograft insufficiency or homograft stenosis). Mean follow up duration was 2.9 ± 2.4 years. There were 11 homograft dysfunctions requiring reoperation with the mean longevity of 4.4 ± 2.3 years. We had only one late death due to congestive heart failure (CHF), and all the other deaths (23.7% of the patients) occurred perioperatively. The quality of life of most of the survivors is good. Conclusion- Early and mid-term results of homograft implantation are good, but long-term results remain to be investigated (Iranian Heart Journal 2003; 4 (4):6-15).
HOMOGRAFT A CONGENITAL HEART SURGERY
http://journal.iha.org.ir/article_83650.html
http://journal.iha.org.ir/article_83650_63ae3f90fc72bff3e2679679126f6840.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
IMMEDIATE OUTCOME OF CORONARY ANGIOPLASTY IN CHRONIC TOTAL OCCLUSIONS WITH BRIDGING COLLATERAL VESSELS
17
22
EN
Y
RASTEHARI
Department of Cardiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences,
Tehran, Iran
A
GHAEMIAN
MASOUD
GHASEMI
FARIBA
HENDESSI
Background- In angioplasty of chronic total occlusion, categorizing lesion characteristics may be useful for their impact on procedural success. There is controversy about the role of bridging collateral vessels in chronic total occlusion procedural outcomes. This study investigated the effect of bridging collateral vessels on the success of coronary angioplasty in patients with chronic total occlusions. Methods- Seventy-seven consecutive patients undergoing coronary angioplasty for chronic total occlusion were classified into two groups. Group I patients had chronic total occlusion with bridging collateral vessels (27 patients), and patients in group II had no such vessels (50 patients). Results- Procedural success was achieved in 11 patients in group I and in 41 patients in Group II (40.7% vs. 82%; p=0.0002; relative risk 3.9; 95% confidence interval 1.7 - 6.4). Of 52 patients with successful angioplasty, patients with an estimated duration of occlusion of less than 3 months had more successful results than patients with occlusions of over 3 months (63.5% vs. 47.5%; p=0.0001; relative risk 1.8; 95% confidence interval 1.3-2.6). The presence of a side branch 2mm or less from the occlusion point was a predictor of an unsuccessful result (p=0.0007; relative risk 2.9; 95% confidence interval 1.5-5.6). Conclusion- There are some morphologic variables which may be useful in guiding angioplasty in patients with chronic total coronary occlusion. Presence of bridging collateral vessels is one of them, which appears to be inversely related to procedural success (Iranian Heart Journal 2003; 4 (4):16-21).
ANGIOPLASTY N CORONARY OCCLUSIONS COLLATERAL CIRCULATION
http://journal.iha.org.ir/article_83599.html
http://journal.iha.org.ir/article_83599_a0564389e76c77e6980b0b962c69f30f.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
A COMPARISON BETWEEN PTCA ALONE AND STENT IMPLANTATION IN MULTI-VESSEL DISEASE
22
24
EN
I
NAZERI
Tehran Medical Center, Daryaye Noor Str., Shahid Beheshti Ave., Tehran, Iran
A.R
NAZERI
SH
SHOKOUFI MOGHIMAN
K
HASHEMI
<strong>A COMPARISON BETWEEN PTCA ALONE AND STENT IMPLANTATION IN MULTI-VESSEL DISEASE</strong>
MULTI-VESSEL CORONARY DISEASEM PTCAM STENT IMPLANTATION
http://journal.iha.org.ir/article_83600.html
http://journal.iha.org.ir/article_83600_c95b1f9f76e366bcf391d812914331f4.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
A METHOD FOR BETTER ESTIMATING BLOOD PRESSURE IN HYPERTENSIVE PATIENTS
25
30
EN
M.
Moazenzadeh
Assistant Professor of Cardiology, Cardiovascular Research Committee, Jomhuri Islami Blvd.,
Kerman, Iran
A.
IRZAZADEH
Background- An elevated arterial pressure is probably the most important public health problem in developed countries. Although the measurement of blood pressure in the clinic has been the cornerstone of the diagnosis and management of hypertension, it has some limitations. Ambulatory blood pressure monitoring (ABPM) is a method of blood pressure assessment which compensates for some of the limitations and errors of clinical values such as the white coat phenomenon. Methods- In this cross sectional study, we enrolled 42 (20 male, 22 female) hypertensive patients who were under treatment. Each patient s BP was measured in clinic twice at 5minute intervals. ABPM having been set up, each patient s blood pressure was measured at 30- minute intervals during the day and 60- minute intervals during the night. The patients were advised to do regular daytime activities and record unusual activities. Results- The mean clinic BP 137.95±14.28/88.66±9.53 (mmHg) compared with a mean awake ambulatory BP (ABP) of 132.90±12.27/80.51±7.39 (mmHg). A white coat effect (Clinic-Ambulatory BP > 20/15mmHg) was present in 33.3% (19.15%-47.55%, CI 95%) of the individuals. The correlation coefficient of systolic pressure, diastolic pressure and heart rate between clinic and awake ambulatory measurements was 0.55, 0.48 and 0.57, which indicated a linear relationship (P<0.001). Multiple regression models showed that age, gender, occupation and the duration of hypertension (by year) after diagnosis have no significant effects on estimating awake ABP by clinical measurements but could lead to a better estimation.<br />Conclusion- The frequent occurrence of white coat phenomenon in these patients suggests that clinic BP assessment may not always represent usual awake ambulatory BP in patients receiving antihypertensive therapy. We also suggest that physicians who do not have the availability of ABPM use this model to estimate average awake BP by clinic BP measurements: awake systolic BP (mmHg)=0.52 x clinic systolic BP + 66; awake diastolic BP (mmHg) = 0.46 x clinic diastolic BP + 42; and awake heart rate (p/min) _ 0.33 x clinic heart rate + 52(Iranian Heart Journal 2003; 4 (4):25-30).<br />
HYPERTENSION M WHITE COAT EFFECT M MERCURY SPHYGMOMANOMETERSAMBULATORY BLOOD PRESSURE MONITORING (ABPM)
http://journal.iha.org.ir/article_83640.html
http://journal.iha.org.ir/article_83640_f476e8ddb927fef8c937b626bc747428.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
SURFACE ECG: AN ACCEPTABLE METHOD FOR EVALUATING LV FUNCTION IN LBBB CASES
31
34
EN
Mahmood
Shabestari
MASHHAD , IRAN
L.
ALI ZADEH
Background- Electrocardiography is one of the oldest, easiest, simplest and most important inexpensive paraclinical tools in cardiology. Being able to use this easy method with enough sensitivity would be a great aid to the cardiologist in evaluating a common problem like congestive heart failure (CHF).<br />Method- Two hundred cases with left bundle branch block (LBBB) were chosen and divided into two groups: QRS duration less than 120msec in the first group, and more than 120msec in the second group. Left ventricular ejection fraction (LVEF) was studied by 2D, M-mode and Doppler echocardiography as an index of LV systolic function. Results- In cases with QRS duration less than 120msec, LVEF averaged between 40-50%. In the other group with QRS duration more than or equal 120mseconds, LVEF was between 30-40%. Finally, when QRS duration exceeded 160msec, almost all of the patients had LVEF less than 30%.<br />Conclusion- LV systolic function could be estimated with an acceptable sensitivity by observing surface ECG in LBBB cases. This observation may lead to conceptual support for attempts at normalizing QRS duration by biventricular or multi-site ventricular pacing in patients with severe LV systolic dysfunction (Iranian Heart Journal 2003; 4 (4):31-34).<br />
QRS COMPLEX DURATIONO LBBBM LV FUNCTION
http://journal.iha.org.ir/article_83641.html
http://journal.iha.org.ir/article_83641_8497908d8a1bc382154e6f1674876cba.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
SURGICAL OUTCOME IN CORONARY ARTERY FISTULA REPAIR IN CHILDREN
35
38
EN
Mohammadreza
Malek Ahmadi
Assistant Professor of Pediatric Cardiology, Shahrekord University of Medical Sciences
Akbar
Shahmohammadi
Associate Professor of Pediatrc Cardiology, Shaheed Rajaie Cardiovascular Medical Center
A. Hussein
Tabatabaei
Associate Professor of Pediatrc Cardiology , Dr. Shariati Hospital, Tehran University of Medical Sciences
Background- Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction or coronary aneurysms. The purpose of this article is to review the clinical characteristics and surgical outcome in 10 patients with CAF.<br /> Methods- From 1990 to 2000, ten patients (aged 6 months to 15 years with a mean of 8.5 years) were diagnosed with CAF via echocardiography and cardiac catheterization. Six were female and 4 were male. All the patients with isolated CAF (9) were asymptomatic. One patient with associated anomaly (MVP with severe MR) had dyspnea on exertion and palpitation.<br /> Results- Five fistulas originated from the right coronary artery, three from the left and two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2) and pulmonary artery (1). The ratio of pulmonary to systemic flows ranged between 1 to 1.6. All the patients had surgical ligation. In the symptomatic patient, in addition to ligation, mitral valve replacement was performed. There was no operative or late death. Follow-up evaluation ranging from 1 year to 6 years with a mean of 4.2 years showed no evidence of recurrent or residual CAF.<br /> Conclusion- Surgical management of CAF is a safe and effective treatment, resulting in 100% closure rate (Iranian Heart Journal 2003; 4 (4):35-38).<br />
Background- Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction or coronary aneurysms. The purpose of this article is to review the clinical characteristics and surgical outc,4 (4):35-38).
http://journal.iha.org.ir/article_83643.html
http://journal.iha.org.ir/article_83643_debf4020e2fd1128fcbca25c71847247.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
THE EFFECT OF ONE-DAY RAMADAN FAST ON BLOOD PRESSURE OF HYPERTENSIVE PATIENTS
39
43
EN
Shahdad
Khosropanah
Department of Internal Medicine, Nemazee Hospital, P. O. Box 71345-1414, Shiraz
Medical Sciences University, Shiraz, Iran
Farnoosh
Ashraf
Ali Mohammad
Handjani
Background- The month of Ramadan is the ninth lunar month of the Islamic calendar, during which every year millions of Muslims fast from sunrise to sunset. These fasting episodes are associated with changes in sleeping pattern, medication timing, and extra prayers at night, etc. The goal of this work was to evaluate the safety of Ramadan fast with respect to blood pressure for treated hypertensive patients.<br /> Method- This study included 21 controlled hypertensive patients on single or twice-daily medications; each volunteered to perform 24-hour ambulatory blood pressure monitoring (ABPM) twice: during Ramadan and 2 months after Ramadan during a non-fasting day. Mean average awake/asleep and 24-hour blood pressure, also systolic and diastolic load, dipper vs. non-dipper were compared between the two groups. Result- There were no significant changes between any of these variables (P=1.00) in the two measurement periods.<br /> Conclusion- It seems that treated hypertensive patients can be safely assured that with the continuation of pervious medication(s), Ramadan fast can be observed without the need for further work up (Iranian Heart Journal 2003; 4 (4):39-43).
RAMADAN M FASTING M BLOOD PRESSURE N HYPERTENSION
http://journal.iha.org.ir/article_83644.html
http://journal.iha.org.ir/article_83644_4866fa26201cdb539e7db84c41573c85.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
PRESCRIBED DRUGS FOR SECONDARY PREVENTION IN POSTMYOCARDIAL INFARCTION PATIENTS IN SHIRAZ
44
48
EN
M. J.
Zibaeenezhad
Cardiovascular Research Center, Nemazi Hospital,
School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
A.
Mowla
A.
Zareefar
M. A
. Babaei
Background- Coronary artery diseases are the leading cause of death in the developing countries, including Iran. Continued advances in medical and surgical techniques, combined with effective and focused programs in cardiac rehabilitation, are critical to reduce the overall incidence of coronary artery diseases. Now it is recommended that all survivors of acute myocardial infarction receive antiplatelet drugs, beta-adrenergic blocking agents, ACE inhibitors and statins. However, studies show that the ratio of prescribing these drugs is far lower than ideal. This study has been designed to evaluate these ratios in Iran.<br /> Methods- In a descriptive, cross-sectional retrograde study, the ratio of prescribing the above-mentioned drugs in 912 randomly selected patients from Shiraz University hospitals who met WHO criteria for myocardial infarction from March 2000 to March 2001 were studied. Trained medical students recorded demographical data, location of infarction, risk factors and pharmacologic therapy at the time of the discharge of the patients from the medical recording files in a standardized questionnaire.<br /> Results- The mean age of the studied patients was 61±12 years. The most frequently prescribed drugs were antiplatelet agents and the least frequent ones were statins. There were statistically significant relationships between cigarette smoking and beta-adrenergic blocking agents administration, hyperlipidemia and statins administration and hypertension and ACE inhibitors administration.<br /> Conclusion- There is a need for improvement in secondary prevention in patients with myocardial infarction at the time of hospital discharge, and risk factor evaluation and suitable drug therapy is necessary for secondary prevention in Shiraz University hospitals (Iranian Heart Journal 2003; 4 (4):44-48).
POST-MI N DRUGS N SECONDARY PREVENTION
http://journal.iha.org.ir/article_83645.html
http://journal.iha.org.ir/article_83645_9aa7b6979ab0baa91c693664dbb31407.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
PATIENT SELECTION FOR CARDIAC RESYNCHRONIZATION THERAPY
49
56
EN
Mohammad
Ali Sadr-Ameli
Arash
Arya
Shaheed Rajaie Cardiovascular Medical Center, Mellat Park, Vali Asr Avenue, Tehran, Iran
Majid
Haghjoo
Zahra
Emkanjoo
Left or biventricular (BiV) pacing, or cardiac re synchronization therapy (CRT) is a new treatment for patients with advanced congestive heart failure (CHF) and left bundle branch block (LBBB). This therapy is based on the theory that synchronous BiV pacing is able to reduce atrioventricular (AV), inter- and intraventricular dyssynchrony (DYS). Although there is convincing evidence that CRT increases the left ventricular ejection fraction (LVEF), decreases mitral regurgitation (MR), and improves symptoms caused by heart failure, and reduces combined end points of all-cause mortality and hospitalization, the proportion of non responders (NR) to this therapy has been described and high as about one third to one half of patients with heart failure and LBBB. Here we review factors that may be responsible for this relatively high prevalence, and the ways for more accurate patient selection (Iranian Heart Journal 2003; 4 (4):49-.56).
CARDIAC RESYNCHRONIZATION,NON-RESPONDER,DYSSYNCHRONY,Patient Selection
http://journal.iha.org.ir/article_83647.html
http://journal.iha.org.ir/article_83647_9d89519dee7361203ce4aa7e1ab0c693.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
AN EXAMINATION OF THE PATIENTS PERSONALITY PROFILES BEFORE ANGIOGRAPHY OR HEART SURGERY
57
59
EN
Nozar
Givtaj
Tehran , Iran
Ahmad
Mohebbi
Kamal
Raissi
Farhad
Houshangi
Zahra
Mirmohseni
Parvindokht
Moghimi
Background-Scientists have long been puzzled by the fact that many heart attacks occur in patients who do not have any predisposing factors such as high blood pressure, smoking, and high cholesterol, and they have always wanted to ascertain what causes these heart attacks. The answer, according to some, may lie not merely in physiology but behavior. In the last 30 years, a small group of scientists has held steadfastly to the hypothesis that the way people think, feel, and act as they cope with the daily stresses of life can have a profound and some times deadly- effect on their heart. In this study we wanted to evaluate the patient s personality profile before angiography or heart surgery.<br /> Methods-Two hundred and ten patients who needed angiography or heart surgery were selected to complete the following questionnaires - SCL 90 personality test, general knowledge, demographic questionnaire, and surgical questionnaire. Results- The personality traits of patients are susceptible to change before angiography and heart surgery, but according to the GSI standard, these changes are limited to the neurotic phase.<br /> Conclusion-The presence of psychiatrists and clinical psychologists are useful and the employment of psychotherapy, psychoanalytic techniques, and education of patients can maximize the result of heart surgery as well (Iranian Heart Journal 2003; 4 (4):57-59).
PERSONALITY .ANGIOGRAPHYM HEART SURGERY
http://journal.iha.org.ir/article_83648.html
http://journal.iha.org.ir/article_83648_2fd62188959c65a6254b8ce48f189166.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
INTIMA-MEDIA THICKNESS OF CAROTID VESSELS AND CAROTID ARTERY STENOSIS AND THEIR RELATION WITH CORONARY ARTERY DISEASE
60
62
EN
Marzieh
Motevalli
Valiasr Ave , Tehran , Iran
Fereidoun
Noohi
Mahshid
Ojaghi
Ramin
Eskandari
Background- Atherosclerosis is a generalized process of vessels which involves coronary arteries and carotid vessels in a similar fashion. In this study we evaluate the relationship of coronary artery disease (CAD) with intima-media thickness (IMT) of carotid vessels and carotid artery stenosis.<br /> Methods- 120 patients were subdivided into four groups: normal coronary; single vessel (SVD) and two-vessel (2VD); and three-vessel disease (3VD), established by means of coronary angiography. The groups were then prospectively evaluated with color duplex ultrasound (CDUS) examination during a 1-year period to assess the relationship of carotid artery stenosis and intima-media thickness (IMT) with CAD. Results- from the 120 patients who underwent examination, two cases showed above 75% carotid stenosis, and 62.8% of the patients with three vessel disease exhibited more than 1.2 mm intima-media thickness with p value < 0.001. <br /> Conclusions- We have not found a statistically significant relationship between significant coronary artery disease and carotid artery stenosis but a remarkable correlation with the degree of coronary artery disease and increased intima-media thickness. Auscultation of a bruit in the neck is not a reliable indicator of carotid artery Stenosis (Iranian Heart Journal 2003; 4 (4):60-62(.
CORONARY ARTERY DISEASE W INTIMA-MEDIA THICKNESS M CAROTID ARTERY STENOSIS
http://journal.iha.org.ir/article_83651.html
http://journal.iha.org.ir/article_83651_84cce3844579c370a5184648abec107e.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
COMPARISON OF SERUM DIGOXIN LEVEL AND CLINICAL RESPONSE IN PATIENTS WITH CHRONIC ATRIAL FIBRILLATION IN TWO DIFFERENT WAYS OF CONTINUOUS AND INTERRUPTED USE
63
67
EN
Ebrahim
Nematipour
Fahimeh
Sabour
Soha
Namazi
Background- Digoxin prescription with an interruption of one or two days a week is frequently used in Iran. We compared this kind of digoxin prescription with an uninterrupted one through the determination of serum digoxin level and clinical response in Iranian patients<br />. Methods- This study was designed as a crossover clinical trial on 28 patients suffering from chronic atrial fibrillation (AF), and the two different methods of digoxin prescription were compared through achieving therapeutic range of serum digoxin level and clinical response as control of heart rate in patients with chronic AF. Results- The serum digoxin concentration in interrupted consumption, the day before (0.885 ± 0.29 ng/ml) and after (0.614 ± 0.35 ng/ml) interruption was significantly lower than the continuous form (1.157 ± 0.3 ng/ml), p < 0.05. About 35% of the patients in the interrupted schedule of digoxin had plasma levels lower than 0.8 ng/ml (minimum therapeutic range), compared with no one in the continuous schedule. Also none of the patients in the continuous consumption group showed clinical and/or electrocardiographic signs of digoxin toxicity. The mean heart rate in interrupted use on the day before (84.82 ± 7.2 beats/min) and after (86.5 ± 3.8 beats/min) interruption was significantly higher than that in the continuous form (75.9 ± 5.2 beats/ min), p < 0.05. <br /> Conclusion- This study showed that the continuous use of digoxin has the advantage of achieving the therapeutic range and better controlling the heart rate in patients with AF rhythm and could be the preferred form of prescription in the majority of our patients, as it is in nearly all the countries around the world (Iranian Heart Journal 2003; 4 (4):6367).
DIGOXIN .ARRHYTHMIA .TRIAL FIBRILLATION .PRESCRIPTION
http://journal.iha.org.ir/article_83652.html
http://journal.iha.org.ir/article_83652_10d14d822997db286e96c3c4c3e6ee18.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
THE EFFECT OF GROWTH HORMONE ON IDIOPATHIC DILATED CARDIOMYOPATHY
68
71
EN
K. A.
Mohseni
Imam Khomeini Hospital, Sari, Iran
V.
Mokhberi
S.
Abdi
Objective- Idiopathic dilated cardiomyopathy (IDCM) is currently an important cause of mortality and morbidity due to chronic heart failure. The aim of our study was to assess whether there could be any clinical and /or echocardiographic improvement in patients with IDCM who had undergone treatment of recombinant human growth hormone (GH). <br /> . Methods- Fourteen patients with IDCM and moderate heart failure (e.g. New York Heart Association functional class II-III) were studied at base line, immediately and 3-months after treatment with GH. The study was a double-blind clinical trial. Traditional treatment (e.g. digoxin, ACEI, B-blocker and diuretics) was continued during the study. Cardiac performance was evaluated with clinical and echocardiographic examinations.<br /> Results- In spite of statistical improvements in the left ventricular ejection fraction (LVEF)(mean ±SD from 35.6±5.9% at the base line of this study to 39.6%f6.7% immediately and 39.3%f7.9% three months after treatment, p value <0.05), other data of the clinical and echocardiographic findings were not significantly different between base line and post-treatment.<br /> Conclusion- We conclude that 3-months of GH therapy in patients with idiop thic dilated cardiomyopathy had little beneficial effects on cardiac mass and performance (Iranian Heart Journal 2003; 4 (4):68-71(.
IDIOPATHIC CARDIOMYOPATHY M GROWTH HORMONE M CARDIAC PERFORMANCE
http://journal.iha.org.ir/article_83653.html
http://journal.iha.org.ir/article_83653_b2cc4313b87754d9d9cf10a1c24c6157.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
DYNAMIC LEFT VENTRICULAR MMID-CAVITARY OBSTRUCTION COMPLICATING ANTEROSEPTAL MYOCARDIAL INFARCTION
72
74
EN
Majid
Maleki
Shaheed Rajaie Cardiovascular Medical Center, Mellat Park, Vali Asr Avenue, Tehran, Iran
Majid
Haghjou
Dynamic left ventricular outflow tract (LVOT) and mid-cavitary obstruction has been associated with hypertrophic obstructive cardiornyopathy. . Acute LVOT and mid - cavitaryobstruction has been described as a complication of myocardial infarction (MI). In the latter situation, this unusual form of dynamic obstruction occurs as a result of compensated hyperdynamic basal wall motion in patients with apical infarction. We describe a patient who developed mid-cavitary obstruction following silent anteroseptal MI.
http://journal.iha.org.ir/article_83655.html
http://journal.iha.org.ir/article_83655_d7790530555717853b4f18b4cf65886e.pdf
Iranian Heart Association
Iranian Heart Journal
4
4
2003
06
01
CONGENITAL GIANT INTRAPERICARDIAL ANEURYSM OF LEFT ATRIAL APPENDAGE: A VERY RARE BUT POTENTIALLY DANGEROUS ENTITY
75
78
EN
A. A.
Rafighdoust
Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences,
Mashhad, Iran
A.
Hamedanchi
Imam Reza Hospital, Mashhad University of Medical Sciences,
Mashhad, Iran.
A
. Mirzaei
Imam Reza Hospital, Mashhad University of Medical Sciences,
Mashhad, Iran.
A case of left atrial appendage (LAA) aneurysm misdiagnosed previously as partial pericardial defect is presented. This previously totally asymptomatic young multiparous woman was referred to us because of intermittent sharp chest pain and an abnormal CXR. Complementary imaging modalities revealed a large mass behind the left ventricle causing anterolateral hypokinesis. Although relatively symptomless, because of potential hazardous complications such as paroxysmal supraventricular tachycardia, syncope, sudden cardiac death, embolic phenomena and strangulation, the patient s LAA aneurysm was resected shortly after the confirmation of diagnosis. The postoperative course has been uneventful, and she is currently asymptomatic .
http://journal.iha.org.ir/article_83656.html
http://journal.iha.org.ir/article_83656_903fd772087f1c0163205a660c868b31.pdf