The Correlation between QRS Dispersion and Coronary Artery Disease Severity in Patients with Non ST Elevation Myocardial Infraction

Non ST elevation myocardial infarction (NSTEMI) has been the subject of numerous studies. Risk stratification is a fundamental element for the management of NSTEMI; therefore, several scores have been established in this direction, particularly prognostic markers derived from the ECG. Aims: The aim of our study is to correlate the dispersion of the QRS with the severity of coronary lesions assessed by the GENSINI score in patients admitted for NSTEMI at the University Hospital of Marrakech. Methods: A retrospective study was conducted in the cardiology department of Mohammed VI university hospital of Marrakech from January 01, 2022 to March 31, 2022. Data was derived from the hospitalization register, including 30 patients (16 women and 14 men). Age ranged from 56 to 74 years with an average of 64.6 ± 9.3. Data was analyzed by SPSS, the level of significance set at p <0.05. Results: We found, in our study, a highly significant positive correlation between QRS dispersion (considered important if >20 ms) and admission heart rate (p=0.003) as well as the level of ultrasensitive troponins (p=0.003). There is also a very significant correlation between QRS dispersion and corrected QT interval (p=0.005), Moreover, we concluded that in patients admitted for NSTEMI, the greater the dispersion of the QRS, the higher the score of GENSINI (p<0.0001). Conclusion: The dispersion of the QRS is a simple marker on the ECG that can have a predictive value in different clinical contexts, particularly in acute ischemic heart disease. Further studies are needed, however, to validate its usefulness in routine practice.

Aorto-right Ventricular Fistula: A Rare and Severe Complication in a Young Patient with Double Localization of Infective Endocarditis

Aorto-right ventricular fistulas are defects of the aortic wall in the area above the right coronary cusp, where it separates aorta and right ventricular outflow tract. This entity is rare and exceptional. Often, these defects are due to trauma or infective endocarditis. We report an occasional finding of such a fistula with dramatic issue, in young patient without past medical history which admitted for rupture of cerebral mycotic aneurysm secondary to infective endocarditis with double localization (aortic and pulmonary valve).