Tachycardia induced cardiomyopathy, case report

Tachyarrhythmia is a one of the well-known causes of dilated cardiomyopathy. The cardiomyopathy is reversible once arrhythmia is controlled. Cardiologists need to be aware of this reversible cause of left ventricular impairment. We report an eight year old girl who presented with severe left ventricular impairment secondary to paroxysmal junctional reciprocating tachycardia. She failed drug therapy, so radiofrequency ablation was successfully done afterwards. Her left ventricular function returned to near normal within the following six months

Post major lung resection cardiac arrhythmias

To describe the possible postoperative cardiac arrhythmias after major lung resection surgery performed for lung malignancies. This descriptive study was conducted from January 2007 to October 2009 at the Thoracic Surgery Division of the Royal Medical Services in Amman-Jordan. Forty-eight patients were included in this study. Patients with pre existing cardiac diseases were excluded. All the patients underwent different types of major lung resection surgery for primary and secondary lung malignancies. Postoperative cardiac arrhythmias after different types of lung resection surgery were documented and described. Simple descriptive statistics were used. The sample included 35 males [72.9%] and 13 females [27.1%]. Age ranged between 21 to 82 years [mean 56.6 +/- 14.9]. Left sided surgery was performed in 21 patients [43.7%], while right sided resections were performed in 27 patients [56.3%]. Lobectomy was the most commonly performed operation which was carried out in 27 patients [56.3%], followed by pneumonectomy which was performed in 14 patients [29.2%]. Post operative cardiac arrhythmias occurred among 19 patients [39.6%]. Atrial fibrillation was the most common reported arrhythmia which occurred in 15 patients [31.2%], followed by supra ventricular tachycardia in 2 patients [4.2%], and 2 patients developed atrial flutter [4.2%]. Cardiac arrhythmias were observed to be more common after lobectomy or pneumonectomy, in old male patients, and during the first 48 hours post lung resection. Post major lung resection cardiac arrhythmias are common. Preoperative evaluation and postoperative cardiac monitoring are mandatory in these patients even among those without pre existing cardiac diseases

Frequency of renal artery stenosis among cohort of Jordanians undergoing drive-by renal angiography at time of conventional cardiac catheterization

To determine the frequency of renal artery stenosis [RAS] by performing routine renal angiography in a cohort of patients undergoing clinically indicated non-emergent coronary angiography. A secondary goal was to define potential variables which may predict RAS in this cohort. This was a prospective observational cross-sectional study whereby routine drive-by renal angiography was performed in 870 consecutive patients undergoing non-emergent coronary angiography at Queen Alia Heart Institute, Amman, Jordan during a 4-month period extending from January 2006 to April 2006. Patients were evaluated regarding the presence and severity of RAS. Renal artery stenosis has been defined as diameter stenosis >50% on conventional angiography. Univariate analysis and multivariate analysis were then performed to evaluate potential predictors for RAS. Renal artery stenosis was found in 21 patients leading to a very low frequency of 2.4%. In univariate analysis, significant association with RAS was found with age, female gender, coronary artery disease severity, systolic blood pressure and creatinine clearance. In multivariate analysis, the only significant predictors were female gender [odds ratio 6.61, confidence interval 1.73-25.31, and p=0.006] and creatinine clearance in males [odds ratio 1.97, confidence interval 1.21-3.67, p=0.004]. Low frequency of RAS was noticed in our study. Performing drive-by renal angiography may be not justified in Jordanians except in high risk subgroups for RAS

Cardiac complications in the first week post transhiatal esophagectomy for esophageal cancer

To determine cardiac complications and associated risk factors in the first week post transhiatal esophagectomy for esophageal cancer patients without detectable cardiac diseases. This descriptive study was conducted during the period from January 2000 through October 2007. Sixty-eight patients were included in this study. Patients with pre existing cardiac diseases were excluded. All the patients underwent transhiatal esophagectomy for a malignant lesion. All the cardiac complications were documented and analysed in the first week post operatively. There were 50 males [73.5%] and 18 females [26.5%], age ranged from 35 to 83 years [mean 62.7 +/- 10.3]. Post operative cardiac complications occurred in 25 patients [36.8%] during the first post operative week. Atrial fibrillation was the most commonly reported cardiac complication which occurred in 14 patients [20.6%], followed by supra ventricular tachycardia in six patients [8.8%], two patients developed atrial flutter [2.9%], fatal myocardial infarction in two patients [2.9%] and nonfatal myocardial infarction in one [1.5%]. Male gender, older age, longer procedure and first 48 hours post transhiatal esophagectomy were risk factors. Cardiac complications, mainly arrhythmias, are common after transhiatal esophagectomy. Preoperative evaluation, intraoperative and postoperative cardiac monitoring are mandatory in all patients even in those who have no cardiac illnesses