Title: Editorial
Authors: Brink, A.J.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 4
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Abstract: The Cardiovascular Journal of Africa
(CVJA) is increasingly gaining recognition as a
medical science journal of standing. It is
widely distributed and indexed, with at least 3
000 full-text articles downloaded a month via
PubMed alone. This is apart from South African
and African tertiary institutions, which have
access to full-text capabilities on the SABINET
system.
Title: The 30-year cardiovascular
risk profile of South Africans with diagnosed
diabetes, undiagnosed diabetes, pre-diabetes or
normoglycaemia : the Bellville, South Africa
pilot study : cardiovascular topics
Authors: Matsha, Tandi E.; Hassan, Mogamat S.;
Kidd, Martin; Erasmus, Rajiv T.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 5-11
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DOI Number: 10.5830/CVJA-2010-087
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-087
Abstract: The aim of this pilot study was to
assess the 30-year risk for cardiovascular
disease (CVD) in the South Africa population of
mixed-ancestry in individuals with non-diabetic
hyperglycaemia, and undiagnosed and
self-reported diabetes. Participants were drawn
from an urban community of the Bellville South
suburb of Cape Town. In total, 583 subjects
without a history of CVD were eligible for
lifetime CVD risk estimation. Gender-specific
prediction for CVD risk was calculated using the
30-year CVD interactive risk calculator. High
CVD risk (> 20%) was evident in normoglycaemic
and younger subjects (under 35 years). The
significant predictors of CVD were sibling
history of diabetes, and triglyceride,
low-density lipoprotein cholesterol and glycated
haemoglobin levels (p < 0.001). The high
lifetime risk in normoglycaemic and younger
subjects may be considered a warning that CVD
might take on epidemic proportions in the near
future in this country. We recommend the
inclusion of education on CVD in school and
university curricula.
Title: Contractile effect of
Sclerocarya birrea (A Rich) Hochst
(Anacardiaceae) (Marula) leaf aqueous extract on
rat and rabbit isolated vascular smooth muscles
: cardiovascular topics
Authors: Mawoza, Tariro; Ojewole, John A.O.;
Owira, Peter M.O.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 12-17
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DOI Number: 10.5830/CVJA-2010-098
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-098
Abstract: Background : Sclerocarya birrea
(Anacardiaceae) is traditionally used for
treating hypertension. The pharmacological
effects of S birrea leaf aqueous extract (SBE)
on rabbit and rat vascular smooth muscles were
investigated in this study.
Methods : Fresh S birrea leaves (1 kg) were air
dried at 26 ± 1°C, milled, macerated in 2.5 l of
distilled water for 48 hours, filtered, and the
filtrate was concentrated in a rotary
evaporator. Rat isolated portal vein
preparations, as well as rabbit isolated
endothelium-denuded and endothelium-intact
descending thoracic aortic ring preparations
were mounted in 30-ml Ugo Basile organ baths
under physiological conditions, and challenged
with SBE (50-400 mg/ml). The contractile effects
of SBE and/or other reference drugs on the
isolated vascular smooth muscle preparations
were recorded by means of Ugo Basile's
force-displacement transducers and Gemini
recorders.
Results : SBE (50-400 mg/ml) caused a
significant, concentration-dependent upward
shift in baseline tone in the aortic ring
preparations (p < 0.01-0.001). Indomethacin (20
µM) markedly attenuated the contractile effects
of SBE in both the endothelium-intact and
-denuded aortic rings, while NG-nitro-L-arginine
methyl ester (L-NAME, 100 µM) significantly (p <
0.05) increased the contractile tension of the
endothelium-intact aortic rings. Verapamil (1-3
µg/ml) partially inhibited the contractile
effects of SBE. SBE also elicited significant (p
< 0.05-0.01) increases in the amplitude of the
myogenic contractions of the portal veins. These
contractions were abolished by verapamil (1-3
µg/ml) in a concentration-dependent manner,
while prazosin (1-3 µg/ml) did not affect the
SBE-induced contractions.
Conclusion : SBE possessed spasmogenic effects
on vascular smooth muscle preparations in vitro.
It may induce and/or exacerbate hypertension,
contrary to the folkloric, ethnomedical use of S
birrea.
Title: Amlodipine attenuates
oxidative stress in the heart and blood of
high-cholesterol diet rabbits : cardiovascular
topics
Authors: Salehi, I.; Mohammadi, M.; Mirzaei, F.;
Soufi, F.G.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 18-22
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DOI Number: 10.5830/CVJA-2010-091
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-091
Abstract: Introduction : Oxidative stress is a
key component of atherosclerosis. It has been
suggested that amlodipine inhibits oxidative
stress. In this study, we evaluated the effects
of amlodipine on the total antioxidant capacity
of heart tissue and blood in 36 control and
cholesterol-fed male New Zealand white rabbits.
Methods : The rabbits were divided into four
groups (n = 9). Group 1 rabbits were fed a
regular diet, group 2 were fed a diet with 2%
cholesterol, group 3 were fed a regular diet
plus 5 mg/kg/day oral amlodipine, and group 4
were fed 2% cholesterol diet plus amlodipine 5
mg/kg/day. At the end of eight weeks, blood
samples were drawn and at the same time heart
tissue was isolated and frozen in liquid
nitrogen. After homogenisation, the solution was
centrifuged and the light supernatant was stored
at -80°C. This was used for determination of
glutathione peroxidase (GPX), superoxide
dismutase (SOD) and (MDA) levels.
Results : Eight weeks of amlodipine treatment
significantly reduced the levels of total
cholesterol, low-density lipoprotein cholesterol
and triglycerides in the group on the
hypercholesterolaemic diet (p < 0.05). In the
blood, the level of thiobarbituric acid-reactive
substances increased in the rabbits on the 2%
cholesterol diet (group 2) and 2%
cholesterol-plus-amlodipine diet (group 4) and
decreased in the amlodipine-only group (group 3)
(p < 0.05). Lipid peroxidation in the heart
tissue was similar to that in the blood, except
in the amlodipine-only group (group 3). In the
blood, the activity of total SOD (tSOD)
decreased in the group on the 2% cholesterol
diet (group 2) (p < 0.05) and markedly increased
in the amlodipine-only (group 3) and 2%
cholesterol-plus-amlodipine groups (group 4) (p
< 0.05).
Conclusion : Amlodipine decreased oxidative
stress in the heart and blood and improved the
lipid profile in cholesterol-fed rabbits.
Therefore, it may be considered a useful tool
for the reduction of oxidative stress and
improvement of lipid profiles in diseases
related to atherosclerosis.
Title: Interaction between
dyslipidaemia, oxidative stress and inflammatory
response in patients with angiographically
proven coronary artery disease : cardiovascular
topics
Authors: Tayal, D.; Goswami, B.; Tyagi, S.;
Chaudhary, M.; Mallika, V.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 23-27
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DOI Number: 10.5830/CVJA-2010-092
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-092
Abstract: Introduction : Coronary artery disease
(CAD) is emerging as the biggest killer of the
21st century. A number of theories have been
postulated to explain the aetiology of
atherosclerosis. The present study attempts to
elucidate the interaction, if any, between
inflammation, oxidative stress and dyslipidaemia
in CAD.
Methods : A total of 753 patients undergoing
angiography were evaluated and 476 were included
in the study. The parameters studied included
complete lipid profile, and apolipoprotein B,
ferritin and nitric oxide (NO) levels.
Statistical analysis was carried out to
determine the interrelationship between these
parameters and the best predictor of CAD risk.
Cut-off points were determined from the receiver
operating characteristics curves, and the
specificity, sensitivity, positive predictive
value, negative predictive value, odds ratio and
confidence intervals were calculated.
Results : The levels of the parameters studied
increased with the stenotic state and a positive
correlation was observed between ferritin, NO
and apolipoprotein B. NO emerged as the most
reliable predictor of CAD, with an area under
the curve of 0.992 and sensitivity and
specificity of 97 and 98%, respectively.
Conclusion : Environmental and genetic risk
factors for CAD interact in a highly complex
manner to initiate the atherosclerotic process.
These risk factors should be considered mutually
inclusive, not exclusive when devising
pharmacological interventions, as
multi-factorial risk management is the
cornerstone of CAD management.
Title: Cardiovascular, cortisol and
coping responses in urban Africans : the SAPBA
study : cardiovascular topics
Authors: Meyburgh, D.; Malan, L.; Van Rooyen,
J.M.; Potgieter, J.C.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 28-33
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DOI Number: 10.5830/CVJA-2010-101
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-101
Abstract: Objectives : To assess the
relationships between progression of
target-organ damage and cardiovascular, cortisol
and coping responses in black urban Africans.
Methods : Urban black African gender groups (n =
200) aged 21-62 years from the Sympathetic
Activity and Ambulatory Blood Pressure in
Africans study were stratified into normotensive
and hypertensive groups. Resting and reactivity
Finometer blood pressure, fasting sodium
fluoride glucose and salivary cortisol values
were obtained before and after applying the
Stroop and cold pressor tests. Coping strategies
were determined and high-resolution ultrasound
carotid intima-media scans were done to
determine progression of target-organ damage.
Results : A trend of high-normal resting
cortisol values during sampling time 1 was
demonstrated in all hypertensive men. Both
hypertensive gender groups showed increased
vascular responses during both mental stressors.
During the cold pressor test, vascular responses
predicted sub-clinical atherosclerosis in all
hypertensive men, independent of sampling time.
Conclusion : Early morning vascular responses in
all the hypertensive men could have occurred
secondarily to the permissive effect of cortisol
on norepinephrine secretion, with subsequent
α-adrenergic vasoconstriction. Their
α-adrenergic vascular responses during the cold
pressor test, however, predicted sub-clinical
atherosclerosis, independent of sampling time
and cortisol level.
Title: Prediction of early
postoperative atrial fibrillation after cardiac
surgery : is it possible?
The value of interatrial conduction time for the
prediction of early postoperative atrial
fibrillation using intra-operative
transoesophageal echocardiography :
cardiovascular topics
Authors: Karaca, M.; Demirbas, M.I.; Biceroglu,
S.; Cevik, A.; Cetin, Y.; Arpaz, M.; Yilmaz, H.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 34-36
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DOI Number: 10.5830/CVJA-2011-010
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-010
Abstract: Background : Postoperative atrial
fibrillation is common after cardiac surgery. In
this study, we aimed to investigate the value of
interatrial conduction time for the prediction
of early postoperative atrial fibrillation,
using intra-operative transoesophageal
echocardiography.
Methods : A total of 65 patients undergoing
cardiac surgery in our hospital between January
and March 2007 were prospectively evaluated, and
59 patients with sinus rhythm were included in
the study. We performed transoesophageal
echocardiography on all patients, and
intra-operatively measured the interatrial
conduction time, as recently described. The
patients with episodes of atrial fibrillation
during the post-surgery hospitalisation period
were defined as group 1 and those without
episodes were defined as group 2.
Results : Mean interatrial conduction time was
74 ± 15.9 ms in group 1 and 54 ± 7.9 ms in group
2. The difference in interatrial conduction time
between the two groups was statistically
significant (p < 0.05). In this study we found a
statistically significant interatrial conduction
delay between the groups. Postoperative atrial
fibrillation was more frequent in patients with
a longer interatrial conduction time.
Conclusion : Increased interatrial conduction
time may cause postoperative atrial fibrillation
and it can be measured intra-operatively by
transoesophageal echocardiography.
Title: An evaluation of
ankle-brachial blood pressure index in adult
Nigerians with sickle cell anaemia :
cardiovascular topics
Authors: Oguanobi, N.I.; Onwubere, B.J.C.;
Ibegbulam, O.G.; Ike, S.O.; Ejim, E.C.; Agwu, O.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 37-39
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DOI Number: 10.5830/CVJA-2011-013
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-013
Abstract: Aim : There are few studies to be
found in the literature on ankle-brachial index
in sickle cell disease. The aim of this study
was to compare ankle-brachial index of
steady-state adult sickle cell anaemia patients
with that of normal controls.
Methods : A descriptive cross-sectional study of
62 sickle cell anaemia patients and 62 age- and
gender-matched normal controls was carried out
in the adult outpatient sickle cell clinics and
the cardiac centre of the University of Nigeria
Teaching Hospital (UNTH), Enugu, Nigeria from
February to August 2007. The supine brachial and
ankle blood pressures were measured separately
with the cuff of the mercury sphygmomanometer
applied to the right arm and right calf,
respectively.
Results : The ankle systolic blood pressure was
lower in patients with sickle cell anaemia than
in the controls (p < 0.001). The mean indices
for ankle-brachial index were 0.88 ± 0.09 and
1.03 ± 0.06, respectively for patients and
controls. This difference was statistically
significant (p < 0.001). Seventy three per cent
of the patients had ankle-brachial index less
than 0.9 compared with controls (5%). This was
also significant (p < 0.001).
Title: The clinical value of the Tei
index among Nigerians with hypertensive heart
failure : correlation with other conventional
indices : cardiovascular topics
Authors: Akintunde, A.A.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 40-43
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DOI Number: 10.5830/CVJA-2011-032
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-032
Abstract: Background : Various conventional
methods are used for functional evaluation and
risk stratification in heart failure. A combined
index of global myocardial performance called
the Tei index has been described. The aim of
this study was to evaluate the correlation of
the Tei index with other conventional indices of
systolic and diastolic function among Nigerians
with hypertensive heart failure.
Methods : Fifty-five subjects with hypertensive
heart failure and 30 controls were examined, a
clinical history was taken, and echocardiography
was performed on them. The subjects were
categorised into four groups based on their
ejection fraction (normal ejection fraction,
mild, moderate and severe heart failure). The
Tei index was calculated as the sum of the
isovolumic relaxation and contraction time,
divided by the ejection time. Statistical
analysis was done using SPSS 16.0.
Results : The Tei index was significantly higher
among subjects with hypertensive heart failure
compared with the controls (0.91 ± 0.33 vs 0.28
± 0.16, p < 0.005). The Tei index also increased
with the severity of the heart failure and was
inversely correlated with ejection fraction (r =
-0.697, p < 0.001) and fractional shortening (r
= -0.580, p = 0.001). It was directly correlated
with mitral E/A ratio (r = 0.246, p = 0.030),
left ventricular internal diastolic dimension (r
= 0.414, p = 0.002), left ventricular internal
systolic dimension (r = 0.596, p < 0.001) and
deceleration time (r = 0.219, p = 0.032).
Conclusion : The Tei index correlated
significantly with other conventional indices of
systolic and diastolic function among Nigerians
with hypertensive heart failure. It can be used
as a risk-stratification index similar to other
traditional indices of systolic and diastolic
function.
Title: The prevalence and
heterogeneity of prehypertension : a
meta-analysis and meta-regression of published
literature worldwide : review article
Authors: Guo, X.; Zheng, L.; Zhang, X.; Zou, L.;
Li, J.; Sun, Z.; Hu, J.; Sun, Y.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 44-50
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DOI Number: 10.5830/CVJA-2011-058
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-058
Abstract: Objective : Prehypertension appears to
be a precursor of hypertension and has been
recognised as a major risk factor for
cardiovascular disease (CVD). Recognition of
prehypertension provides important opportunities
for preventing hypertension and CVD. We aimed to
investigate the worldwide prevalence and
heterogeneity of prehypertension.
Methods : We performed a meta-analysis of
cross-sectional studies worldwide that reported
the prevalence of prehypertension. We searched
for publications between January 1966 and
November 2010, using PubMed, Ovid and the
Cochrane Library, with the keyword
'prehypertension', supplemented by a manual
search of references from recent reviews and
relevant published original studies. Pooled
prevalence of prehypertension was calculated
using random-effects models. Heterogeneity was
investigated by subgroup analysis and
meta-regression. Twenty-two articles met our
inclusion criteria, with a total sample of 242
322 individuals.
Results : The overall pooled prevalence of
prehypertension was 38%. Significant
heterogeneity across estimates of prevalence was
observed (p = 0.000, I2 = 99.9%). The prevalence
rose as the sample size increased, and was
higher among men than women (41 vs 34%). The
non-Asian population was more likely to be
prehypertensive than Asian individuals (42 vs
36%). A high prevalence of 47% was observed
among the black African population in the
non-Asian subgroup. The inception year of the
surveys was the only source of heterogeneity we
found by meta-regressional analysis (p = 0.06).
Conclusion : These results indicate that the
prevalence of prehypertension was relatively
high, particularly among males. Although more
attention has been paid to this segment of the
population since 2003, additional practical and
reasonable steps should be taken to prevent and
treat prehypertension.
Title: Special report from the 2011
International Diabetes Federation - getting to
the heart of diabetic cardiovascular disease :
drug trends in cardiology
Authors: Kengne, Andrew P.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 51-53
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Abstract: This cardiovascular session,
co-chaired by Profs A Chait and R Eckel (both
from the USA) took place in the Sheikh Maktoum A
auditorium and included eight presentations,
dominated by studies conducted in Asia, with a
single African contribution.
Title: South African 2012 guidelines
for hypertension therapy
Therapeutic options in hypertension management :
2012 guidelines from the Southern African
Hypertension Society : drug trends in cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: 53-56
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Abstract: This guideline should perhaps be
called SAHS 5, in keeping with other
hypertension organisations' approach of
regarding guideline development as a continuum.
As new studies emerge, guidelines are updated as
a general reference for clinical practice.
Title: Pulse pressure monitoring in
hypertensive black Africans
(Intérêt du suivi de la pression pulsée chez
l'hypertendu noir Africain) : cardiovascular
topics : online article
Authors: Konin, C.; Adoh, M.; Adoubi, A.; Ekou,
A.; Koffi, J.; N'Djessan, J.J.; Ahoua, A.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e1-e6
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DOI Number: 10.5830/CVJA-2011-001
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-001
Abstract: Aim : A pulse pressure above 60 mmHg
in hypertensive subjects is an independent
cardiovascular risk factor. There are few data
on pulse pressure in sub-Saharan Africa. The aim
of this study was to describe the pulse pressure
in black Africans with arterial hypertension.
Methods : A 10-year study was carried out on 640
hypertensive sub-Saharan African subjects at the
outpatient department of the Abidjan Heart
Institute. The primary endpoint was to determine
the prevalence of a high pulse pressure, the
correlation between pulse pressure and
cardiovascular risk factors, the impact of pulse
pressure on target organs, and the variation in
pulse pressure while on treatment during follow
up. Evaluations were made at the start of the
study, and in the first, third, sixth and
twelfth months of follow up. The mean age was
56.2 years and 56% were female.
Results : The prevalence of a high pulse
pressure in our patients was 60% at the start of
the study. The factors contributing to a high
pulse pressure were age over 50 years (75.3 vs
24.7%, p < 0001), gender (60 vs 40%, p = 0.02),
and diabetes (76.7 vs 23.3%, p = 0.0006).
Smoking, obesity and dyslipidaemia were not
related to an elevation in pulse pressure. The
control of pulse pressure was poor during
monitoring. Only 17.8% of patients had their
pulse pressure lowered below 60 mmHg between the
first and fifth consultations. A high pulse
pressure was a predictor of future myocardial
complications but few target organs were
significantly affected. Dual therapy with a
diuretic was more effective in controlling the
pulse pressure, with a reduction rate of 22%
during follow up (19.2 mmHg), against a rate
reduction of 11% (8.4 mmHg) in patients without
a dual diuretic.
Conclusion : The prevalence of pulse pressure
above 60 mmHg was higher in hypertensive black
Africans. Their control was poor, but dual
therapy with a diuretic was more effective.
Myocardial consequences were significant.
Title: Macro CK in patients with
elevated troponin I levels : case report :
online article
Authors: Kohli-Kochhar, Ruchika; Mulwa, Evelyne;
Omuse, Geoffrey; Ojwang, Peter
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e7-e10
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DOI Number: 10.5830/CVJA-2010-082
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-082
Abstract: CK-MB activity levels can be falsely
elevated by the presence of macro CK, especially
if immuno-inhibition assays are used in the
measurement. In patients with macro CK and
cardiac pathology that could result in an
elevated CK-MB activity, the diagnostic
challenge lies in determining the true cause of
the elevated CK-MB activity. We present two case
reports of patients with elevated CK-MB activity
and troponin I levels, but who subsequently had
CK-MB activity higher than total CK activity,
raising the suspicion of the presence of macro
CK.
Title: A mysterious case of fatal
embolism after the repair of tetralogy of Fallot
: secondary to arrhythmia? : case report :
online article
Authors: Karabay, C.Y.; Guler, A.; Kilicgedik,
A.; Aung, S.M.; Kalayci, A.; Sahin, G.; Tanboga,
I.H.; Kirma, C.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e11-e12
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DOI Number: 10.5830/CVJA-2010-095
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-095
Abstract: Tetralogy of Fallot (TOF) is a common
cyanotic congenital heart disease. The most
important late complications observed after
repair of TOF are atrio-ventricular arrhythmias
and sudden cardiac death. We present a rare case
of fatal embolism and sudden cardiac death in a
36-year-old patient, 30 years after the
operation for TOF.
Title: Giant right atrial myxoma
leading to cardiac arrest in an infant : case
report : online article
Authors: Vuran, C.; Babaoglu, K.; Ozker, E.;
Ayabakan, C.; Saritas, B.; Kocyigit, O.I.;
Turkoz, R.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e13-e15
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DOI Number: 10.5830/CVJA-2010-099
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2010-099
Abstract: We present the case of a
three-month-old infant with a giant right atrial
myxoma obstructing the tricuspid valve, who
following haemodynamic deterioration and cardiac
arrest, was operated upon as an emergency. On
echocardiogram, there was a mass attached to the
tricuspid annulus, in close proximity to the
septal leaflet, with dimensions of 16.6 x 12.5
mm. The mass was prolapsing through the
tricuspid valve into the right ventricle and
obstructing the inflow. While preparing for
surgery, cardiac arrest occurred, so the patient
underwent an emergency operation under
cardiopulmonary resuscitation. The mass was
excised without damaging the tricuspid valve and
the conduction system. Histologically, the mass
consisted of a myxoid matrix with scatted
globoid and star-shaped myxoma cells. The
patient stayed 15 days in the intensive care
unit and was discharged home on the 20th day
postoperatively.
Although accepted as a benign tumour, a myxoma
can display an aggressive clinical course in
infants. In centres where cardiac operations
cannot be performed, these patients need to be
transferred to cardiac centres as soon as
possible. Whatever the clinical presentation, we
advocate immediate surgical extirpation of the
tumour in order to avoid any unpredictable
consequences in its clinical course.
Title: Coronary muscular bridge
mimicking acute stent thrombosis : case report :
online article
Authors: Karabay, C.Y.; Aykan, A.C.; Guler, A.;
Alizade, E.; Kalayci, A.; Zehir, R.; Dundar, C.
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e16-e17
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DOI Number: 10.5830/CVJA-2011-005
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-005
Abstract: A patient who develops hypotension or
angina pectoris after intravenous inotropic
agents should be assessed for dynamic left
ventricular outflow obstruction or the presence
of a muscular bridge. In this case report, we
present a patient with low ejection fraction who
developed hypotension and angina pectoris with
inotropic therapy after coronary intervention.
We performed a coronary angiogram to exclude
stent thrombosis but a muscular bridge was found
in the segment distal to the stent.
Title: Percutaneous closure of
patent foramen ovale and atrial septal aneurysm
using the Atriasept™ II PFO occluder : clinical
and technical implications : case report :
online article
Authors: Brown, Stephen; Buys, Daniel
From: Cardiovascular Journal of Africa, Vol 23,
Issue 1, Feb
Published: 2012
Pages: e18-e21
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DOI Number: 10.5830/CVJA-2011-043
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2011-043
Abstract: Two patients with a patent foramen
ovale associated with redundant and fenestrated
atrial septal aneurysms and a history of
multiple transient ischaemic episodes underwent
percutaneous device closure using the Atriasept™
II septal occluders. After release of the
devices, the aneurysms were stabilised and no
residual shunts were detected. Certain clinical
and technical considerations are outlined.