use of doppler - echocardiogiography for the assessment of cardiac functions in children with Iron deficiency anaemia

This study included 30 patients [17 males and 13 females, with an age range from 1 to 12 years with a mean of 5.75 +/- 3.43 years] of those attending pediatric clinic. Detailed retrospective clinical history, complete clinical examination, stool analysis, CBC, hemoglobin concentration, hematocrit value, mean corpuscular volume and mean corpuscular hemoglobin concentration together with the estimation of serum iron and total iron binding capacity [TIBC] were done. Echo-Doppler examination to estimate left ventricular dimensions, septal and posterior wall thickness, ejection fraction and fractional shortening, diastolic ventricular function estimation by mitral valve diastolic flow study were also carried out. It was concluded that iron deficiency anemia leads to a hyperdynamic circulating state with significant left ventricular diastolic dysfunction

Management of patients with equivocal chest pain presenting to emergency department of secondary care hospitals

Thirty patients were included in this study, all of them were presented with chest pain to the Emergency Department of a secondary care hospital, where myocardial perfusion scanning and cardiac catheterization facilities were not available. The primary evaluation showed normal resting ECG in 26 of them and an equivocal result in 4. In all cardiac enzymes, the estimation was negative, considered as low risk patients. All patients were admitted to the intermediate care unit. After follow up with cardiac enzymes and ECG for an average of 19.15 hours, symptom limited modified Bruce protocol stress test was followed. Patients with negative test were discharged soon after the test. The patients were followed up for six months after admission to the hospital

Qualitative and quantitative coronary angiography in patients with Q-wave myocardial infarction versus patients with non-Q wave myocardial infarction

The classification of myocardial infarction into transmural and subendocardial types has been based on the presence or absence of abnormal Q-waves in the ECG; it is more appropriate to describe myocardial infarction as Q-wave and non-Q wave infarction. Visual evaluation of CA lesions was associated with inter observer and intraobserver variability of about 30%. In the present study 40 patients [20 patients with Q-wave and 20 patients with non Q-wave myocardial infarction] have been assessed for the presence or absence of significant difference regarding all risk factors for CAD, echocardiographic findings, cardiac enzymes and various QCA [Quantitative Coronary Angiography] variables [percentage of stenosis, plaque area, length of lesion, type of lesion, number of vessels affected and site of lesion]. The distribution of risk factors [age. sex, smoking, hypertension, diabetes, hyperlipmdemia] between both groups revealed no statistically significant difference. The history of previous ischemic insult was significantly higher in group II [40% in group II and 5% in group I]. Echocardiographic findings: Regional wall motions abnormalities [RWMA]: in group 1, 95% of patients have hypokinesia and 5% have akinesia in one or more left ventricular wall segments. In goup 2, 20% of patients have normal wall motions, 65% have hypokinesia and 15% have akinesia in one or more of left ventricular wall segments [P<0.05]. However the ejection fraction, fractional shortening, end-systolic and end-diastolic volumes were not statistically different between the two groups. In evaluation of cardiac enzymes, CPK; ranged from 550 to 2001 IU, in group I. with a mean value of 997 +/- 425 IU, in group 2, it ranges from 220 to 900 IU with a mean value of 451 +/- 149 IU [P<0.001]- LDH; it ranges from 550 IU tol900 IU with a mean value of 1657 +/- 198 IU while in group 2 it ranges from 301 IU to 860 IU with a mean value of 618 +/- 168 IU [P<0.05]. CPK MB fraction; values were ranging from 28 IU to 60 IU with a mean value of 53 +/- 21.7 IU for group I. In group 2 it ranges from 22 to 30 IU with a mean value of 32.9 +/- 9.1 IU [P<0.001]. As regard the parameters of QCA, Percentage stenosis; in group I, it ranges from 61% to 99.6% with a mean value of 87.66 +/- 12.4. In group 2, it ranges from 59% to 99.9% with a mean value of 90 +/- 14.1%, [P>0.05]. Plaque area; in group 1, it range from 1.09 to 16.8 mm2 with a mean value of 5.15 +/- 2.4 mm2. In group 2 it ranges from 0.33 to 21.66 mm2 with a mean value of 7.12 +/- 6.6 mm2 [P>0.05]. Length of lesion; in group 1, it range from 4.42 to 25.75 mm with a mean value of 16.68 +/- 3.7 mm. In group 2. it ranges from 4.72 to 29.3 mm with a mean value of 17.65 +/- 4.6 mm [P>0.05]. Number of vessels affected; in group 1, 60% of patients have single vessel disease, 20% two-vessel disease and 20% multi-vessel disease. In group 2, 50% of patients have single vessel disease, 25% two-vessel disease and 25% multi-vessel disease [P>0.05]. So we concluded that there is no significant difference between Q-wave and non Q-wave myocardial infarction except in the following points: the history of previous myocardiat infarction and ischemia is commoner in non Q-wave myocardial infarction. Regional wall motions abnormalities occur more frequently in patients with Q-wave myocardial infarction. Cardiac enzymes are more elevated in Q-wave myocardial infarction than non Q-wave myocardial infarction. It is clear from the study that the magnitude of myocardial infarction should be judged on the anatomical and functional basis rather than the designation of Q-wave or non Q-wave type of myocardial infarction. It is also apparent that quantitative coronary angiography is an accurate and reproducible method for assessing the coronary artery lesion

Sensitivity and specificity of troponin T enzyme estimated for diagnosis of myocardial cell damage

This study included 36 patients, [2 females and 34 males] with age range of 37-65 years [average 5 +/- years] of whom 24 were the studied group. The control group composed of 12 patients. The determination of troponin T compared with conventionally applied analysis of cardiac enzymes offers several distinct advantages for the diagnosis of AMI. Troponin T is normally not detectable in serum; its release in serum lasts long after acute M.1. improving detection of minor myocardial cell damage [1]