Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation [AF] in a tertiary hospital in Riyadh, Saudi Arabia. We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Documented acute and chronic AF was present in 157 [21.8%] and 563 [78.1%] patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems [chest infection, bronchial asthma, and pulmonary embolism] were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus [DM] in 68.8%, hypertension [HTN] in 59.3%, chronic lung diseases [bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease] in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease [IHD] in 23.1%. In 9 [1.3%] patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF [P<0.01]. Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

Acute myeloblastic leukemia in a patient with primary antiphospholipid syndrome

Antiphospholipid syndrome is characterized by venous and arterial thrombosis, recurrent pregnancy loss and the presence of the lupus anticoagulant, anticardiolipin antibodies or both. Antiphospholipid syndrome may occur as a primary disease or in patients with systemic lupus erythematosus or other autoimmune, infectious or neoplastic disorders. In this paper we report a 29-year-old Saudi female, a known case of antiphospholipid syndrome, presented with complaints of fever, breathlessness and generalized fatigue. Further investigations confirmed her as a case of myeloblastic leukemia [M1, French-American-British classification]. Acute myeloblastic leukemia is not described to be associated with primary antiphospholipid syndrome in the literature to date. This is the first case report of such association