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Background: Percutaneous coronary intervention (PCI) has been an effective and widely used treatment for patients with coronary artery disease (CAD). The presence of anaemia in critically ill patients undergoing surgical procedures has been associated with worse clinical outcomes. Hence, the current study was conducted to assess short term outcome of percutaneous coronary interventions in anaemic patients presenting with coronary artery diseases. Methods: This prospective observational study enrolled 200 patients who underwent PCI. Patients were classified into 2 groups: anaemic patients and non-anaemic patients. The anaemic patients were furtherly be classified according to severity of anaemia into 3 grades mild anaemia, moderate anaemia, and severe anaemia. All cases were subjected to complete history taking, clinical examination and baseline laboratory tests: including CBC, serum urea and creatinine, cardiac enzymes include serum troponin, CK-MB and standard 12-lead ECG. Results: The mean Heart Rate was statistically significantly higher in the anaemic group as compared with the non-anaemic group. The mean Ejection Fraction was statistically significantly lower in the anaemic group as compared with the non-anaemic group. The percentage of LM affection in the anaemic group was statistically significantly higher as compared with the non-anaemic group. The incidence of arrythmia in the anaemic group was statistically significantly higher as compared with the non-anaemic group. Severe anaemic and low EF% patients were associated with higher incidence of stroke and MI. Conclusions: Patients with baseline anaemia before PCI have a higher incidence of PCI associated complications. Therefore, anaemia could be a predictor of PCI related complications.
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Background: The Symptomatic manifestation of pediatric arrhythmias varies according to the age. Patients with disturbances in cardiac rhythm have several complaints, but also could be totally asymptomatic. This study aimed to assess clinical characteristics of Tachy and Brady arrhythmia in neonates, infant, children and adolescents of various age groups. Methods: This cross-sectional study included 253 patients of pediatric age below 18 years old presented with different types of tachyarrhythmia or bradyarrhythmia. All patients were subjected to clinical general examination of patient, vital data collection, local cardiac examination, 12 leads electrocardiography, ambulatory ECG Holter monitoring, exercise ECG stress testing if indicated and transthoracic echocardiography. Results: There was a significant relation between age of presentation of the study patients and classification of arrhythmia (P < 0.001). Palpitations was the most common presentations of arrhythmia in our study patients (32%) followed by dyspnea in 17.8 % of the patients. 20.6 % of the study patients with arrhythmias were asymptomatic. Congenital heart anomalies were in 43 % of the patients. Conclusion: Pediatric arrhythmia can be totally asymptomatic and discovered accidentally. Congenital cardiac anomalies and cardiac arrhythmias are closely correlated. Holter monitoring and exercise ECG testing can help in diagnosing pediatric arrhythmia. Untreated or persistent arrhythmia causes LV myopathy and dilatation. Antiarrhythmic drugs can have their harmful effect on the growing child.
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Background: This study describes cardiac pacing activity during 2021: demographic data of patients underwent permanent pacemaker implantation (PPM), risk factors, clinical presentations, indications, mode of pacing, and complications post PPM implantation. Cardiac pacemakers have become the common treatment of symptomatic bradycardia or high-grade atrioventricular block. Methods: The study was carried out at the department of cardiology Tanta University Hospitals. 102 patients were included in this study. This study was done over a period of six months from October 2020 until April 2021 and follow up for 6 months. All the data about the patients underwent permanent pacemaker implantation were collected by the coordinator in the participating cardiac center. Results: The most frequent risk factors of PPM implantation was hypertension (69%), followed by diabetes mellitus (29%), coronary artery disease (21%), chronic kidney disease (18%), hypothyroidism (6%), cardiomyopathy (3%), valvular heart disease (2%) and congenital heart disease (1%). The most common indication is complete heart block (69%), followed by second degree heart block "mobeitz type 2" (13%), slow atrial fibrillation (7%), symptomatic heart failure patients with LVEF ? 35% , QRS ? 150 ms (6%), trifascicular block (3%), sick sinus syndrome (2%). The most frequent mode of pacing used in our study was DDD mode (63%), followed by VVI mode (32%) with (78%) sinus rhythm and (22%) atrial fibrillation rhythm, then CRT-D (4%). Overall complication rate (9%) within 6 months. In our study the most common complication is infection (5%), followed by haematoma (1%), lead fracture (1%), pneumothorax (1%), and lead displacement (1%). Conclusion: Approximately three-quarters of the patients related to atrioventricular block underwent permanent pacemaker implantaion. Approximately more than half of pacemakers related to patients underwent permanent pacemaker implantation were dual chamber pacemakers. Infection is the most common complication in our study and this is important for strict infection control measures.
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Background: Cardiovascular atherosclerosis, particularly coronary artery disease (CAD), represents the main reason for death prematurely over the world. Risk stratification and prevention by risk factor modification are crucial aspects of CAD therapy. The CHADS2 and CHA2DS2-VASc scores are effective in determining the risk of thrombosis in non-valvular atrial fibrillation (AF). The current research aimed to determine the CHA2 DS2-VASc-HSF score as a predictor for CAD severity in CAD patients after coronary angiography. Methods: This cross-sectional study was assessed on 100 patients who attended the coronary care unit and underwent coronary angiography. They were categorised into three groups: Group I: Low syntax scores (2-13), Group II: Intermediate syntax score (14-20), and Group III: High syntax score (21-40). Results: Our study showed that the SYNTAX score revealed a statistically significant relation with patient's age, gender, and presentation. Regarding the medical history of the studied participant in relation to SYNTAX score, most patients reported a history of HTN, DM, Dyslipidemia, CHF, and previous history of vascular disease showed intermediate and high SYNTAX score in comparison to those with normal blood pressure, glucose level, lipid profile, no CHF history and those no previous history. SYNTAX score showed significant relation with ejection fraction and CHA2 DS2-VASc-HSF score of the patient. Significant low ejection fraction in high SYNTAX score patients compared to low SYNTAX score patients. Significant high average of CHA2 DS2-VASc-HSF score among those with high and intermediate SYNTAX score compared to those with low SYNTAX score. Conclusions: CHA2DS2-VASc-HSF should be constituted as the ideal scoring scheme for predicting the severity of CAD. Risk scoring systems may be effective as predictors due to their simplicity and easy employment by physicians in ordinary practice without incurring additional costs