[Seven years study of pregnant women with cardiovascular disease department of cardiology, Imam Reza Hospital, Mashhad, Iran [1996-2003]]

In this study we evaluated cardiovascular changes during pregnancy. Our main aim was, in cardiovascular disease pregnancy causing worse heart problems and increase functional classes during gestation. In which groups of patients, before pregnancy, is therapeutic management like intervention or surgery necessary to be performed, and fetal and newborn complications evaluated. In this prospective study we evaluated, 53 pregnant women with heart disease who were admitted to Dept of Cardiology, Imam Reza Hospital before or immediately after delivery. Maternal gestational age parity, the kind of heart disease history of cardiac surgery, and also Abortion, stillbirth, and functional classes based on New York Heart Association classification was done. After collection of information, percent of the data was assessed and presented. At the time of admission [47.1%] of patients were in functional class II, class I [33.9%] class III. [13.2%], class IV [5.6%]. In this study the most common cause of cardiovascular disease [Figure III] was rheumatic heart disease [69.8%] and the most common cause of patients admission to hospital [Figure I] was those, with the history of heart disease [81.1%], and most common clinical manifestation [Figure II] Was exertional dyspnea [35.8%] . Patients with MR, mild MS, AI and mild AS, VSD and functional class I and II can tolerate pregnancy and delivery well. But usually for pts in class III, IV, they will have serious problems during pregnancy and delivery. The decision of continuation or termination of pregnancy in high risk pts for example severe MS, AS and pulmonary hypertension, izenmenger's syndrome, high functional class are depending on the consultation between cardiologist, cardiac surgeon, obstetrician and pts family

Percutaneous balloon pericardiotomy in a patient with recurrent pericardial tamponade

Malignancy is the leading cause of chronic pericardial effusion. Although maybe not life-threatening as the acute tamponade, by compressing cardiac cavities and adjacent organs, causes significant morbidity and discomfort for the patient. Its early diagnosis and effective and safe treatment would have significant role in improving the patint's quality of life and his life expectancy

There are various treament modalities with different success rate including,pericardiocentesis alone [average success rate of 47%] or with indwelling catheter drainage [78%], sclerotherapy [83%], external radiotherapy [69%], and surgery [success rete of 48-92% for different techniques], and Percutaneous balloon pericardiotomy [96%]

Percutaneous balloon pericardiotomy is a promising nonsurgical therapy, especially in malignant recurrent tamponade, in which after drainage of pericardial fluid through subxiphoid pericardiotomy, using a balloon catheter, a window is created in parietal pericardium

Generally it has the same early and late results as surgical Pericardiotomy, especially in malignancies, with less morbidity. But its role in the management of nonmalignant pericardial effusion is not clear. Here, in addition to introducing this method, we report successful treatment of a case of recurrent temponade with past history of treated gastric cancer

[Comparison of the prevalence and risk factors of coronary artery disease between 100 menopausal women with ischemic heart disease and 100 men, in cardiology center of Imam Reza Hospital-Mashhad Iran [2003-2004]]

Objective: to determine the total and gender - specific prevalence of coronary artery disease [CAD] - related risk factors in Cardiology Center of Emam Reza Hospital- Mashhad

Materials and Methods: a cross -sectional, descriptive study was conducted on 200 patients [100 menoposal women and 100 men] with ischemic heart disease. We consider four CAD - related risk factors [Hypertension, Diabetes mellitus, hyperlipidemia and Smoking] in assessment of these patients. Data sheets were filled e basis of the presence or absence of these risk factors. The results were analyzed using SPSS software

Results: in general, among the factors mentioned above, hypertension is the most common one [40% or 80/200] and after that, hyperlipidemia, smoking and diabetes come in sequence [31, 30, 21%]. Compared to men, HTN is more common in menoposal women [P<0.05] On the other hand, smoking is more common in men. [P<0.001]

Conclusion: according to our study, HTN is the most common risk factor in general. We also consider the role of smoking as the most common risk factor in men and also an important one with the same prevalence to diabetes in women.] So we really need to reinforce smoking cessation