Cardiology and Angiology: An International Journal
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ISSN: 2347-520X
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.sciencedomain.org/journal-home.php?id=26
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Item Sex Differences in Systolic Heart Failure in Patients with Acute ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Intervention(Ms. M. B. Mondal, 2025-03) Zahid, B; Azm, THA-E; Zaghloul, HG; Elnagar, A.Aims: Sex differences refer to the biological and physiological variations in the cardiovascular system that arise from distinct gene expressions associated with sex chromosomes. Notable and well-documented sex differences in ST-elevation myocardial infarction (STEMI) indicate that women tend to be elderly and present with a more significant number of comorbidities in comparison to men. The aim is to investigate sex-specific differences in systolic heart failure (SHF) among patients with acute STEMI who are undergoing primary percutaneous coronary intervention (PCI). This study also included a follow-up period of three months to assess the occurrence of major adverse cardiovascular events (MACE) and to conduct a conventional echocardiographic evaluation. Study Design: This investigation is a prospective cohort study. Place and Duration of Study: Department of Cardiology, Faculty of Medicine, Benha University, AlQalyubia, Egypt, between October 2023 and October 2024. Methods: We included 116 adult patients with SHF following STEMI undergoing primary PCI. The subjects were divided into two equal groups: male (58 cases) and female (58 cases). Results: Females exhibited significantly higher NT-proBNP levels and lower left ventricular ejection fraction (LVEF) than males (P<0.001, P=0.02, respectively). Readmission with acute heart failure (AHF) at three months was significantly increased in females compared to males (P => 0.001). Cardiovascular death and AHF at three months were significantly higher in females compared to males (P = 0.031). Females showed significantly higher MACE compared to males (P= 0.016). Conclusions: Female patients with SHF following STEMI who undergo primary PCI have a higher risk of cardiovascular mortality within the first three months compared to males. The observed difference in mortality suggests that female patients may require different clinical approaches and closer follow-up to improve outcomes.Item Cardio-protective Activities of Annona muricata Leaf Extract in Isoproterenol Myocardial Infarction-Induced Wistar Rats(Ms. M. B. Mondal, 2025-03) FC, C; MO, E; AA, O; OA, A; MA, A; UA, E; VC, E.Cardiovascular disease (CVD) is a severe heart condition characterized by impaired blood flow to the heart muscle, leading to tissue damage and dysfunction. Among different medicinal plants, Annona muricata is now becoming more attractive because of its therapeutic potentials, especially in the prevention and treatment of cardiovascular related disorders, particularly myocardial infarction. Hence, this study was carried out to evaluate the cardio-protective activity of Annona muricata in isoproterenol-induced myocardial infarction using animal model. Thirty (30) male wistar rats were randomly grouped into five classes (A, B, C, D and E) of six rats each. Groups A, B and C were orally pre-treated daily for fourteen (14) days with 100mg/kg, 200mg/kg and 400mg/kg of Annona muricata extract respectively. Group D was orally administered 10 mg of lisinopril (standard drug), this served as the positive control group while group E was orally administered 0.2 ml distilled water, and this served as the negative control group. All the rats were intraperitoneally induced with 150 mg of isoproterenol after fourteen days (two weeks) of pretreatment. Cardiac biomarkers (lactate dehydrogenase (LDH) and creatinine kinase (CK-MB)), were measured to assess cardiac injury, using standard method while lipid bioassay such as high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides (TG) were assayed using standard assay kits. Results showed that rats pre-treated with Annona muricata extract showed significant effect on cardiac biomarkers compared to the control group. Results further showed a significant increase (P<0.05) in low density lipoproteins (LDL) and triglyceride levels in a dose-dependent manner (100<200<400 mg/kg body weight) among the extract treated groups when compared to the untreated control group. This study has shown that extract of Annona muricata could help to mitigate cardiovascular diseases and could be used to produce plant based products to combat myocardial infarction, and consequently improving general wellbeing.Item Routine Health Checks and Implications among Staff of a Tertiary Health Facility in Nigeria(Ms. M. B. Mondal, 2025-03) O, O; EK, E.Background: Non-communicable disease is a globally recognized cause of significant morbidity and mortality with a rapidly increasing prevalence. Its rising burden among health workers, reduces their productivity and strains service delivery in the sector. Awareness and knowledge of important metabolic indices and regular monitoring is key to healthier living, early detection, prevention of complications and mortality from Non- communicable diseases. Objectives: This study aimed to assess the prevalence of non-communicable disease among staff at University of Port Harcourt Teaching Hospital (UPTH), to assess their knowledge and monitoring habit of important health Numbers. Methodology: A descriptive cross-sectional study was conducted among staff. Interviewer administered semi structured questionnaire was used to collect data on medical and family history, health screening habit, and awareness of complications of Non -communicable diseases. Data was analyzed using SPSS version 23. Results: A total of 102 staff participated. Most 73(71.6%) were females, 46(45.1%) were doctors and 85(82.5%) had attained tertiary level of education. 27(26.5%) had a known medical history, 58(56.9%) had family history of various medical conditions and 34(33.3%) were on medication. 44(43.6%) of participants were overweight and 19(18.8%) had class 1 obesity. Only 31(30.7%) had normal blood pressure, 34(34.0%) were pre-diabetic and 8(8.0%) were diabetic. Abdominal obesity was found in 44.8% of participants. Participants understood the implications of obesity, (41.2%) diabetes (36%) and hypertension (50%) Participants checked their numbers quite frequently, with weight and blood pressure having the highest frequencies within the previous one month while blood glucose was checked by more people within the previous 6 months. However, a significant knowledge gap about the implications of abdominal obesity was identified. Conclusion: The findings revealed a high prevalence of Non -communicable diseases among hospital staff. Though health numbers were checked regularly, varying levels of awareness about complications of non-communicable diseases were found with a significant gap in knowledge about abdominal obesity.Item Clinical, Electrocardiographic and Imaging Features of Acute Aortic Syndromes: A Retrospective Study(Ms. M. B. Mondal, 2025-03) F., KADDARI; MASRIOUI, JEL; MARDOULI, MEL; D., BOUMZEBRA; KARIMI, SEL; HATTAOUI, MEL.Introduction: Acute aortic syndromes (AAS) relate to a range of different entities, including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcers (PAU) and traumatic or iatrogenic aortic dissection. They require rapid diagnosis and a high level of clinical suspicion to identify thier symptoms. The aim of this study was to define the range of clinical presentations, electrocardiographic and imaging findings, in patients presenting with AAS. Materials and Methods: This study was a retrospective study of the clinical, electrocardiographic and imaging data in patients hospitalized for acute aortic syndromes from December 2021 to December 2024. Patients with traumatic or iatrogenic aortic dissection were excluded. Results: A total of 10 patients were included, with a mean age of 45 years, and 70% of patients were male. The most frequent symptoms were chest pain alone (50%) or chest pain associated with back pain (40%). Classical “tearing” pain, often associated with aortic dissection, was less frequently reported. Differential blood pressure was observed in 30% of cases. The electrocardiogram showed ST-segment depression in the apical, lateral and inferior leads, as well as ST-segment elevation in the AVR lead and T-wave changes, which were the most frequently observed abnormalities. The most frequent diagnosis was type A aortic dissection (TAAD) (70%), followed by type B aortic dissection (TBAD) (20%) and intramural hematoma (IMH) (10%). The initial diagnosis was made primarily by computed tomography angiography (CTA) in 70% of cases, and by transthoracic echocardiography (TTE) in 30%. Magnetic Resonance Imaging (MRI) was not performed in any of these patients. A diagnostic discordance was found between CTA and TTE in two patients, particularly in one patient with IMH and aortitis. In addition to one case of false-positive TAAD. Conclusions: In conclusion, this study is a reminder that patients with acute aortic syndromes have diverse clinical presentations and may not present with the symptoms typically reported. Relying on classical signs can lead to misdiagnosis. A well-structured approach combining imaging techniques improves diagnostic accuracy, reduces errors and improves patient outcomes.Item Knowledge and Attitude towards Cardiopulmonary Resuscitation among Community Members in Selected Communities of Obio/Akpor Lga, Rivers State, Nigeria(Ms. M. B. Mondal, 2025-03) Awajionye, EE; Oluwatosin, OA.The survival chances of an out of hospital cardiac arrest are significantly increased by provision of bystander cardiopulmonary resuscitation (CPR). Early bystander cardiopulmonary resuscitation has been documented as one of the most important predictors of out-of-hospital cardiac arrests survival. The study was designed to assess the knowledge and attitude towards cardiopulmonary resuscitation among community members in three selected communities in Obio-Akpor, Rivers State. Cross sectional descriptive design utilizing mixed method was adopted. A total of 427 participants were selected by purposive sampling. Structured questionnaire was utilized to assess community members “knowledge on cardiopulmonary Resuscitation. Mean score was determined and mean scores and above was categorized as good knowledge while below mean scores was categorized as poor knowledge. To access the attitude towards cardiopulmonary resuscitation, mean score was determined and mean scores and above was categorized as positive attitude while below mean scores was categorized as negative attitude. The data was analyzed using descriptive analysis and inferential statistics of chi- square to test the set hypothesis at p ?0.05. Most occurring age group of the respondents were between 31-40 years and 50.5% are single. The findings on knowledge of CPR from this study revealed that 59.8% had poor knowledge while 40.2% had good knowledge of CPR. Overall, 58.5% had negative attitude towards administering CPR while 41.5% of the community members had positive attitude towards administering CPR to out of hospital cardiac arrest victims. There is a significant association between sex, marital status, level of education, occupation and knowledge on CPR as well as marital status and attitude towards CPR. Also, there is statistically significant association between knowledge on CPR and attitude towards CPR.Item Rare ECG Dynamics in Acute Coronary Syndrome: Co-Occurrence of De Winter and Wellens' Signs in Proximal LAD Occlusion(Ms. M. B. Mondal, 2025-03) Kumar, P; Prasad, P; NK, RD.The present study explores about rare ECG Dynamics in Acute Coronary syndrome. De Winter sign and Wellens sign are two electrocardiogram patterns which have been described in acute coronary syndrome due to acute occlusion of left anterior descending coronary artery. A 69-year-old male with cardiovascular risk factors including hypertension, diabetes mellitus and a sedentary lifestyle presented with typical rest angina lasting more than 20 minutes. Initial ECG taken at nearby hospital showed de Winter’s pattern. Wellens’ syndrome has been described as occurring in 14% to 18% of patients with unstable angina 3,4, while the de Winter pattern is known to be in 2% of patients admitted with anterior wall infarction5. The coexistence of the De Winter and Wellens patterns in the same patient is an extremely rare finding.Item Spectrum, Treatments and Outcomes of Shock in Acutely-ill Children Seen at the Emergency Room of a Tertiary Hospital in Southern Nigeria(Ms. M. B. Mondal, 2025-03) Abiodun, MT; Sadoh, WE.Introduction: Shock is a state of inadequate tissue perfusion. The emergency care of shock in children is dynamic but fluid therapy remains its cornerstone, with variable effectiveness. We evaluated the spectrum, therapies and outcomes of shock in our Children Emergency Room. Methods: This was an analytic, cross-sectional study. Data were collected using a structured questionnaire comprising demography, clinical features, shock diagnoses, emergency care and outcomes. Co-existing morbidities in the participants were mainly infection-related. Both descriptive and inferential analyses were done; prognostic factors in children with shock were identified, using odds ratio (OR) and 95% confidence intervals (CI). Results: Five hundred and fifty-four acutely-ill children participated in the study. Their mean duration of illness was 13.5 days (± 4.7). The incidence of shock was 83 (15.0%). For the types of shock recorded (n = 42), hypovolemic shock was the commonest, 24 (57.1%). Septic shock occurred in 14 (33.3%) children, while cardiogenic shock was seen in 4 (9.6%) children. Among the affected children, 17 (40.5%) were fluid responsive, 5 (11.9%) were fluid refractory, and 20 (47.6%) were fluid refractory and dopamine dependent. The case fatality rate of shock was 57.8%. Children who presented with shock were more likely to die compared to others (OR = 11.811, 95% CI = 6.976–19.998, p < 0.001). Dopamine infusion was significantly associated with lower mortality risk, with an odds ratio of 0.039 (95% CI 0.008-0.196, p < 0.001). Conclusion: Circulatory failure especially hypovolemic shock is common in acutely-ill children with dire consequences. Fluid therapy and catecholamine infusion can improve survival in the emergency setting.Item A Rare Case of Aggressive Infected Atrial Myxoma(Ms. M. B. Mondal, 2025-03) Qadi, CAIT EL; Zaridi, I; A., Dicko; Massrioui, JEL; Yahya, AAIT; Houatti, REL; Karimi, SEL; Hattaoui, MEL.Cardiac myxomas are known to be the most common primary benign intracardiac tumors in adults, but infected myxomas represent a rare and challenging complication. We report here the case of a 50-year-old patient with no prior medical history, admitted for febrile ischemic stroke, which revealed an infected left atrial myxoma, treated by surgery and antibiotics. This case underscores the diagnostic and therapeutic challenges of infected cardiac myxomas, which can lead to severe complications such as systemic embolism. Given the rarity and nonspecific clinical presentation of this condition, timely diagnosis and management are crucial. While rapid surgical resection is often advocated due to the high embolic risk, careful assessment of the benefit-risk balance remains essential, particularly in patients with neurological compromise, as our patient. Further studies are warranted to establish a consensus on the optimal management of infected cardiac myxomas.Item Beyond the Kidneys: Cardiac Involvement in Anca Vasculitis(Ms. M. B. Mondal, 2025-03) Zerhoudi, R; Bourzeg, K; Eljazouli, H; Elmasrioui, J; Yahya, AA; Ztati, M; Eljamili, M; Elkarimi, S; Hattaoui, ME.Introduction: ANCA-associated vasculitis (AAV) is an autoimmune disease primarily affecting the kidneys and lungs; however, cardiac involvement, though rare, can present a significant diagnostic challenge. This complication is often underestimated and may manifest as myocarditis or heart failure, necessitating a thorough cardiological assessment. Diagnosis relies on echocardiography and advanced imaging techniques, while therapeutic management involves a combination of corticosteroids and immunosuppressants. Aim: This case report highlights the importance of rigorous cardiac monitoring in this systemic disease. Case Report: We report the case of a 40-year-old patient with seronegative ANCA-associated vasculitis complicated by severe renal insufficiency, previously treated with corticosteroids and immunosuppressants. The patient presented with worsening chronic dyspnea, episodes of hemoptysis, and a deterioration of general health status. Investigations revealed severe anemia, acute renal failure, and signs of alveolar hemorrhage on thoracic imaging. Cardiac assessment demonstrated a dilated hypokinetic cardiomyopathy with severe left ventricular dysfunction (LVEF of 36%), without evidence of right heart failure. The patient was managed with emergency hemodialysis, blood transfusion, corticosteroid therapy, and methotrexate, in addition to heart failure treatment with beta-blockers and angiotensin-converting enzyme inhibitors (ACEIs). A significant improvement in cardiac function was observed at the three-month follow-up, with an LVEF of 45-50%. Discussion and Conclusion: Cardiac involvement in ANCA-associated vasculitis is a rare but serious complication that requires early detection and a multidisciplinary approach. This case emphasizes the importance of systematic cardiac monitoring to improve patient prognosis. Echocardiographic evaluation and treatment with corticosteroids and immunosuppressants resulted in significant clinical improvement, highlighting the need for an appropriate diagnostic and therapeutic strategy.Item Association of Poor Sleep Quality with Ischemic Heart Disease(Ms. M. B. Mondal, 2025-03) Samajpaty, S; Zhuravlov, AK; Dmitrii, E; Sergeivich, IY.Sleep is a topic of current discourse in medical science. The twenty-first century lifestyle has contributed to changes in the pattern of human behavior manifold. Sleep cycle disruption, reduced sleep hours and decreased sleep quality is one of the most affected aspects and reality of the modern world. Multiple studies have already established that insomnia is a significant cause of mortality increment but discrepancies persist. Insomnia may not be a direct cause of mortality but a secondary etiological factor, giving rise to morbid disorders including cardiovascular changes. This is a nested case-control study that establishes a relationship between the quality of sleep quantified in PSQI scale and the risk of development of ischemic heart diseases. The study recruited patients in experimental and control groups and found the relationship to be statistically significant with p<0.001, OR = 5.76 at Ci 95% with 4.392 Z-score. The correlation between low sleep quality on PSQI and development of ischemic heart disease was found to have AR 60.97%.Item Predictive Value of Improved and Non-Improved LV Global Longitudinal Strain in Revascularized Acute Myocardial Infarction Patients(Ms. M. B. Mondal, 2025-03) Mohammed, MBEM; Abdelmoneum, MS; El-Rabbat, KEE; Elsayed, AAE.Background: Echocardiographic measures predict adverse outcomes in cardiac disease patients including prior ST-segment elevation myocardial infarction (STEMI). Aim: To assess the association between improved and non-improved global longitudinal strain (GLS) after three months of percutaneous coronary intervention (PCI)-treated acute myocardial infarction (AMI) and clinical outcomes over one year. Patients and methods: A prospective observational study was conducted at Damietta Cardiology Center (Jan 2022 – June 2023) on 100 patients (44–73 years). They were divided into Group A (improved GLS after revascularized AMI) and Group B (non-improved GLS) Results: GLS improvement, anterior STEMI, baseline Ejection Fraction (EF%) versus EF% after 3 months, baseline E/e ratio versus E/e ratio after 3 months, maximum Troponin T level, symptoms-to-needle time, and number of implanted stents are statistically significant predictors of Cardiovascular and Cerebrovascular Events (CCVE) occurrence (P<0.05), with an overall prediction accuracy of 92%. However, age, sex, and medical history are not statistically significant predictors of CCVE occurrence (P>0.05). Baseline (GLS) and GLS after 3 months are statistically significant predictors of CCVE occurrence (P=0.001), with cutoff points of -7.5 and -13.0, respectively. The sensitivity and specificity for predicting CCVE occurrence are 98.4% and 86.0% for baseline GLS, and 100.0% for both sensitivity and specificity for GLS after 3 months. Conclusion: GLS proved superior to LVEF in predicting CCVE in revascularized AMI, with baseline (-7.5) and 3-month GLS (-13) as key predictors. Improvement correlated with age, prior MI, and inferior STEMI, while non-improvement linked to anterior STEMI.Item Severe Tricuspid Valve Regurgitation Due to Chordal Rupture Following Blunt Chest Trauma: A Case Report(Ms. M. B. Mondal, 2025-03) Karmouchi, H; Tlohi, L; Maha, B; Drighil, A.Aims: Tricuspid valve injuries from blunt chest trauma are rare but can have serious consequences. The incidence of these injuries has significantly increased due to the high rate of road accidents and diagnostic progress. Despite this increase, these injuries continue to be underdiagnosed, which affects the timing and quality of treatment outcomes. The aim of this report is to highlight the importance of early diagnosis and intervention for tricuspid valve injuries, even when symptoms are not immediately evident. Presentation of Case: We report a case of a 56-year-old male with no significant medical history who developed severe tricuspid regurgitation following a motor vehicle accident. Initially, the patient exhibited no cardiac symptoms and was referred for cardiac evaluation only after a CT CAP (Chest, Abdomen, Pelvis) scan, performed 10 days after the accident, revealed minimal pericardial effusion. Echocardiography revealed severe eccentric tricuspid regurgitation due to anterior leaflet chordal rupture, along with moderate right ventricular dilation. Despite the recommendation for surgical repair, the patient declined surgery due to the absence of symptoms. Conclusion: This case emphasizes the importance of considering potential cardiac complications, even when symptoms are not specific. Rapid, accurate diagnosis and early surgical intervention can significantly improve prognosis and reduce long-term cardiac complications.Item The Incidence of Contrast-induced Acute Kidney Injury in Patients on Dapagliflozin Undergoing Percutaneous Coronary Interventions(Ms. M. B. Mondal, 2024-11) Ebaid, HH; Hafeez, ABEDAE; Rabat, KEEDE; Elakabawi, KBackground: Sodium glucose cotransporter 2 receptor inhibitor (SGLT2i) dapagliflozin protects the renal function of individuals with coronary artery disease (CAD) and reduces incidence of contrast-induced acute kidney injury (CI-AKI) among individuals having percutaneous coronary interventions (PCI). The purpose of this work was to assess the CI-AKI incidence across individuals on dapagliflozin underwent PCI. Methods: This single-center, prospective observational work had been conducted on 200 diabetic individuals ranging in age between 25 and 80 years old, both genders, with CAD were going to have elective coronary angiogram and PCI. We identified CI-AKI by the ESUR and KDIGO definition. Patients were divided into two equal groups: Group I: Type 2 diabetes mellitus (T2DM) were on dapagliflozin (SGLT2i) and group II: T2DM were on non SGLT2i glucose-lowering drugs. Results: CI AKI according to European society of urogenital radiology (ESUR) and kidney disease improving global outcome score were significantly higher among group II contrasted to group I (P<0.05). no significant correlations existed between contrast volume and creatinine post-PCI, estimated glomerular filtration rate (eGFR) post-PCI, high-density lipoprotein, total cholesterol, and hemoglobin A1c in both groups. Dapagliflozin use was significantly correlated with 76.2% risk reduction of AKI. Dapagliflozin usage had been correlated with a 72.6% risk reduction of AKI but with borderline significance (P = 0.064). eGFR post-PCI was significantly greater among group I cootrasted to group II (P <0.05). Conclusions: Regarding the predictors of AKI according to ESUR criteria, multivariate logistic regression analysis and demonstrated that using dapagliflozin was substantially correlated with 76.2% risk reduction of AKI controlling for age, sex, hypertension, smoking, and dyslipidemia.Item Type A Aortic Dissection: A Call for Vigilance in Chest Pain Diagnosis(Ms. M. B. Mondal, 2024-02) Zahri, S; Khaldi, M; El Jaouhari, Z; Zeroual, MA; Bouziane, M; Haboub, M; Arous, S; Bennouna, G; Drighil, A; Azzouzi, L; Habbal, RIntroduction: Acute aortic dissection (AD) is a rare and life-threatening condition associated with high mortality rates in the absence of prompt intervention. This article provides an in-depth examination of the clinical presentation, diagnostic approach, and management of Stanford type A AD in a 62-year-old hypertensive female patient with atypical symptoms. Case Report: The patient presented with retrosternal chest pain and rapidly worsening dyspnea, demonstrating a 3/6 diastolic murmur over the aortic area. Diagnostic findings included negative T-waves on ECG, significant mediastinal widening on chest X-ray, and transthoracic echocardiography revealing an intimal flap, ascending aorta dilation, and acute aortic insufficiency. Computed tomography confirmed a Stanford type A aortic dissection. Discussion: Acute AD poses a diagnostic challenge, as atypical presentations can lead to misdiagnoses. The case emphasizes the importance of considering AD in the differential diagnosis of chest pain and conducting thorough investigations, especially when faced with unusual symptoms. Management strategies, encompassing both pharmacological and surgical interventions, are crucial for addressing AD promptly. Conclusion: This case underscores the significance of recognizing both typical and atypical presentations of AD to ensure timely intervention and avoid potentially catastrophic outcomes. A comprehensive understanding of diagnostic approaches and management protocols is essential in the emergency setting. Overall, this article contributes to the growing body of knowledge surrounding acute aortic dissection and emphasizes the critical need for awareness and rapid intervention in clinical practice.Item An Extremely Rare Case of Cardiac Hydatid Cyst Co-infected with Brevundimonas Nasdae: Diagnostic Challenges and Management(Ms. M. B. Mondal, 2024-11) KADDARI, F; ELMASRIOUI, J; ARAFAOU, D; THIOMBIANO, A; MHIRIG, I; BOUCHTELLA, Y; MARDOULI, ME; SORAA, N; HOUATI, RE; ELKARIMI, S; ELHATTAOUI, MCardiac hydatid cyst (HC) is a rare localisation of hydatidosis. The main preoperative diagnostic tools are serology, Transthoracic Echocardiography (TTE), Cardiac Tomography (CT) and Nuclear Magnetic Resonance Imaging (MRI). MRI is the key examination for diagnosing cardiac masses. It enables anatomical relationships to be studied and a reliable etiological orientation to be made. We report a challenging case of pericardial hydatid cyst associated to a rare infection to Brevundimonas nasdae clinically revealed by chronic dyspnea and atypical acute chest pain evolving in a febrile context. In our case, the HC presented as a cardiac mass, with an atypical appearance on echocardiography suggestive of a rhabdomyosarcoma. The MRI rectified the diagnosis, which was subsequently confirmed on operative finding, and on anatomo-pathological examination. The Patient was successfully managed after multidisciplinary treatment including combined surgical, antibiotics and antiparasitic treatments.Item A Case Study of Chronic Coronary Syndrome Revealing a Proximal Left Anterior Descending Artery Aneurysm(Ms. M. B. Mondal, 2024-11) Amal, E-N; Abdellah, B; Saleh, O; Alaa, A; BOUZIANE, M; HABOUB, M; Habbal, RContext: Coronary artery aneurysms (CAA) are rare entities associated with significant clinical consequences, including thrombotic occlusions. Chronic coronary syndrome (CCS) may reveal CAA, complicating patient management, particularly when associated with coronary thrombosis. This case discusses a 55-year-old male presenting with angina and dyspnea, later found to have a proximal left anterior descending artery (LAD) aneurysm with thrombotic occlusion. Case Presentation: A 55-year-old male with a history of hypertension, diabetes, and hyperlipidemia presented with exertional chest pain and dyspnea over three months. Coronary angiography revealed a large proximal LAD aneurysm with thrombotic occlusion of the mid-LAD (type B1). Initial management included thromboaspiration and stent placement, followed by dual antiplatelet therapy (DAPT). Despite recanalization, the patient developed a no-reflow phenomenon, managed with vasodilators and anticoagulation. Conclusion: CAA can complicate the course of coronary syndromes, especially when associated with thrombosis. Percutaneous intervention can be successful, but complications like reocclusion and no-reflow may require intensive management strategies.Item Exploring Cardiac Variability in Hypereosinophilia: Clinical Insights and Echocardiographic Findings(Ms. M. B. Mondal, 2024-11) ZERHOUDI, R; ROUAM, H; BENNEJMA, K; ELMASRIOUI, J; ELKARIMI, S; ELHATTAOUI, MIntroduction: The cardiac manifestations of hypereosinophilia include mainly endomyocardial fibrosis, which is the most frequently observed form. However, eosinophilic cardiopathy can manifest itself in different ways, affecting the various layers of the heart and presenting a variety of clinical and echocardiographic presentations. Aim: The aim of our study is to describe the various aspects of cardiac involvement observed in hypereosinophilia, based on our case series and data from the literature. Methods: This is a retrospective, descriptive study of five observations illustrating the diversity of eosinophilic cardiopathy, from the cardiology department of the Mohammed VI University Hospital in Marrakech, over a period of 12 months. Results: Over the period of the study, five patients presented with cardiac damage in the context of hypereosinophilia. The mean age was 53.8 years, with a predominance of women (sex ratio 0.66). In the majority of cases, the discovery of cardiac involvement was incidental to a cardiovascular check-up requested during the course of their medical condition. All cases had high levels of hypereosinophilia, with an average of 5681. These observations illustrate the wide variety of aetiologies of hypereosinophilia, all of which were represented: 3 cases of Churg-Strauss syndrome, 1 case of idiopathic hypereosinophilia syndrome, and 1 case of DRESS syndrome. The cardiac disorders observed were hypokinetic cardiomyopathy at the dilated stage in 60% of cases, acute eosinophilic myocarditis in 20%, and acute pericarditis in the remaining cases. The outcome was marked by an improvement in the FE in 60% of cases, stabilisation in 20%, and a fatal outcome in the remainder. Treatment is based on symptomatic therapy of the CHF and treatment of the underlying aetiology. Discussion and Conclusion: Eosinophils are cytotoxic through the release of granular proteins that initially attack the endocardium, leading to thrombosis and embolic events. Subsequently, this aggression contributes to fibrosis and valvular complications. Cardiac damage can also manifest itself as potentially serious acute myocarditis or pericarditis, which can progress to cardiac tamponade. These cardiac disorders and the diversity of possible aetiologies serve as a reminder that vital prognosis may be at stake in the acute phase, and to emphasise that functional prognosis depends on early echocardiographic screening and rapid initiation of treatment to limit the risk of thrombo-embolic and fibrosing complications.Item Left Ventricular Ultrasound Diastolic Parameters in Postmenopausal Breast Cancer Patients Treated with Adjuvant Anthracycline and Trastuzumab(Ms. M. B. Mondal, 2024-11) Chitadze, T; Sharashidze, N; Lomia, N; tsiklauri, MBackground: Breast cancer remains the leading cause of cancer-related deaths among women of all ages. As age increases, so does the risk of both cancer and cardiovascular diseases, heightening the likelihood of short-term and long-term cardiovascular side effects. Therefore, strategies for early diagnosis and prevention of cardiotoxicity are crucial. he optimal use of conventional echocardiographic parameters is important, especially given the limited access to advanced echocardiography in developing countries. Aims: To evaluate changes in left ventricular (LV) ultrasound parameters, including diastolic parameters, in postmenopausal women with breast cancer (BC), as a high-risk group receiving anthracycline-trastuzumab-containing regimens. Study Design: A prospective 24-month single-center study. Place and Duration of Study: From December 2019 to March 2024 at the ultrasound laboratory of Tbilisi State University Medical Center, Tbilisi, Georgia Methodology: Seventy-four postmenopausal patients with primary BC receiving anthracycline or anthracycline-trastuzumab were assessed for LV systolic and diastolic parameters before the anticancer therapy and at six subsequent visits. Cardio-protection was administered to high-risk patients preventively and to others when cardiotoxicity developed. Multiple regression was used to estimate relationships between various independent and dependent variables. Cardiotoxicity was assessed using survival analysis tools (Kaplan-Meier curves and Cox proportional model). Results: The two-year CTRCD survival rate was 63.5%. During the 2-year follow-up, the mean E/e' increased across the entire cohort, but remained within the normal range. E/e' >15 was noted only in CTRCD patients at 6th month mark (4.1%, n=3, P=.056) within the high-risk group, peaking at 9th month (10.8%, n=8, P< .00). Multiple regression indicated a significant association of IVRT baseline value with late cardiotoxicity (adj. beta-coefficient= 0.32; t = 2.73, P=.008) and DT baseline value with early cardiotoxicity (adj. beta-coefficient = -0.25; t = -3.31, P=0.002). GLS demonstrated predictive value from the first month in 13.5% of the cohort and in 34.5% of patients with CTRCD (P< .00). Conclusion: Our 2-year longitudinal prospective study of anthracycline–trastuzumab-containing regimens in postmenopausal women with early BC revealed that: 1) Predictive association of E/e' with cardiotoxicity was not detected. 2) A reliable association with late cardiotoxicity (T7) from the diastolic parameters was revealed only by IVRT baseline value 3) A reliable association with early cardiotoxicity (T4) from diastolic parameters was revealed only by DT baseline. 4)GLS is superior to E/e' in its prognostic value and diagnostic ability of cardiotoxicity .Item The Global Burden and Risk Factors of Cardiovascular Diseases in Adolescent and Young Adults: A Systematic Review(Ms. M. B. Mondal, 2024-11) Ojukwu, VE; Ndoh, CU; Okolo, D; Jegede, AO; Okobi, OE; Aniekwe, CE; Aboyeji, A; Odozi, MI; Olaniyi, MBackground and Objectives: Globally, cardiovascular diseases (CVDs), mainly stroke and ischemic heart disease (IHD) remain the leading and major causes of mortality in addition to being the key contributors to disabilities. The objective of this systematic review entails the evaluation of the global burden and the risk factors associated with CVDs in adolescents and young adults. To attain this objective, the study will examine the various underlying causes of CVD mortality and the associated risk factors. Methodology: The study entailed an in-depth search of various online databases for original studies focusing on the global burden of CVDs and risk factors in adolescents and young adults. The search was conducted on databases that included Embase, PubMed, Google Scholar, SCOPUS, and Web of Science. The identified studies were subjected to evaluation and screening, and the selection of the apt studies was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 15 studies were selected and included in this systematic review Results: CVD prevalence and incidence rates in adolescents and young adults are highest in low and low-middle socio-demographic index (SDI) nations, despite the CVD burden progressively increasing in high and high-middle SDI countries. Male adolescents and young adults have the highest prevalence, incidence, and disability-adjusted life year (DALY), and mortality rates for endocarditis, even as females aged 30 to 39 years have the highest atrial fibrillation and atrial flutter-related DALY and mortality rates. Conclusion: The global CVD burden in adolescents and young adults remains a major global health challenge. Therefore, it is important that factors that include disparities observed in the SDI levels amongst the nations, age and gender attributes of the populaces, the primary CVD types, and the various attributable risk factors are taken into consideration during the formulation and execution of prevention strategies and interventions.Item Value of CHA2DS2-VASC Score as Predictor of Contrast-Induced Nephropathy in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention(Ms. M. B. Mondal, 2024-01) Khalil, DS; Khalil, SS; Elbarbary, MA; Ashmawy, MMBackground: PCI necessitates the usage of iodinated contrast agent which in some cases is accompanied by CIN and the potential for worse outcomes. The current study aimed to use the CHA2DS2-VASc score with its simple and available components as a predictor of risk of developing CIN in NSTEMI cases who will undergo PCI. Methods: This single center observational study was conducted on 200 cases diagnosed with NSTEMI who were subjected to primary PCI. The basic level of serum Cr was detected at time of admission followed by monitoring for 48?h, and seven days following the approach to detect the occurrence of CIN. Electrocardiogram (ECG) and transthoracic echocardiography are assessed to all patients. Results: At cut off ?2 (area under curve (AUC)=0.649), CHA2DS2-VASc could be used as a predictor for post-PCI CIN with sensitivity and specificity, PPV, NPV and accuracy of 77.6%, 52.3%, 34.5%, 87.8% and 58.5% respectively. There was a statistically significant correlation between occurrence of CIN and all the studied factors (female sex, HTN, DM, anemia, CHF, hemoglobin (HBG), pre-existing renal disease, previous stroke, pre-creatinine, 48hrs and 7 days post-creatinine, pre glomerular filtration rate (GFR) and cha2ds-vasc score and dehydration) with exception of age and vascular disease (p>0.05) being non-significant. Contrast volume, CHA2DS VASC score, metformin use, eGFR after 48h and ACEI /ARB II antagonists ’inhibitor use were significant independent predictors for CIN. Conclusions: In NSTEMI cases who are subjected to PCI, CHADS2 VASC score ? 2 is accompanied by a high risk for CIN and in hospital morbidity and mortality. CHA2DS2-VASC score is considered a useful novel, easy, and reliable method to anticipate CIN in NSTEMI cases undergoing urgent P.