Myocardial bridges: Their clinical implications and prognostic signs.

Among 980 consecutive selective coronary angiograms performed, nine patients had myocardial bridges of the left anterior descending (LAD) coronary artery. The overall prevalence of myocardial bridges was 0.92%. Among these patients, three patients had coronary artery disease, while six cases were isolated myocardial muscle bridges. With respect to functional abnormality, three had grade III milking effect, three had grade II and three had grade I milking effect. The indications for coronary angiograms were typical chest pain in seven cases and atypical pain in two cases. Their clinical and laboratory investigations are presented with literature review.

Cardiac amyloidosis: Diagnostic features and clinical implications.

Seven patients with cardiac amyloidosis were referred to King Khaled University Hospital. All patients in this study developed congestive heart failure. They had a long duration of illness and thickened ventricular wall with marked abnormalities in the left ventricular filling, and normal systolic function. Diastolic function is suggested as a possible mechanism of congestive cardiac failure in the patients presented.

Prevalence of bicuspid aortic valve and mitral valve prolapse in a healthy Saudi population and the clinical implications of their association.

In this study, 103 Saudi males and 172 Saudi females were referred for medical check-up for employment purposes and/or as undergraduate students. Clinical evaluation of all participants included full cardiovascular examination, with the following investigations being performed: ECG, chest x-ray, and cross-sectional echocardiography. Bicuspid aortic valve was detected in three males and in four females, for a total percentage of 2.5%. Isolated mitral valve prolapse was detected in seven males (6.7%) and six females (3.5%). Association with mitral valve prolapse was reported in five males and seven females, with a total percentage of 4.3%. This association seems to have important etiological, medical and surgical implications.

Clinical spectrum of skeletal abnormalities and mitral valve prolapse and their clinical implications.

Fifty-six patients were diagnosed to have mitral valve prolapse (MVP) syndrome by auscultatory criteria, confirmed by cross-sectional echocardiography. Complete physical examination and x-ray of the bony thorax revealed bony deformities which were subdivided into four main groups according to the predominant deformity. Shallow chest with pectus excavatum, straight back, kyphoscoliosis and elliptical chest in marfanoid patients were reported in the cases studied. It is concluded that musculoskeletal abnormalities have to be considered as nonauscultatory features of MVP. Therefore, any patient with musculoskeletal deformity has to be screened for MVP by cross-sectional echocardiography to prevent life-threatening complications.

Electrocardiographic abnormalities in patients with heat stroke.

Serial electrocardiograms were taken in 46 Hajj Pilgrims suffering from heat stroke immediately after cooling 12 and 24 h later. The collected data were analyzed and revealed that a statistically significant number of patients with heat stroke had sinus tachycardia (43 percent, p < 0.05), conduction defect (22 percent, p < 0.046), prolonged Q-T interval (61 percent, p < 0.007), diffuse nonspecific ST-T changes (26 percent, p < 0.036), and ST-T changes (localized to the ECG leads confirming to a territory of coronary artery) consistent with myocardial ischemia (21 percent, p < 0.02). Although adverse effects of heat stroke on the heart are multifactorial, the above data indicate that heat stroke predisposes to certain risk of myocardial ischemia and conduction disturbances. This may reflect the true cardiovascular status of these heat stroke victims.

Non-invasive evaluation of cardiac abnormalities in heat stroke pilgrims.

Serial electrocardiograms as well as echocardiographic studies of 51 pilgrims suffering from acute heat stroke (mean rectal temperature 41.6 degrees C) were performed. All patients were examined immediately after cooling and 24 h later whenever possible. Regional wall motion abnormalities were detected in 9 cases (17.6%) while pericardial effusion was observed in 13 cases (25%) and asymmetrical septal hypertrophy was detected in 8 cases (15.6%). Other cardiac abnormalities included right ventricular dilatation and increased in left ventricular internal dimensions in 4 cases (7.8%), respectively. Thirteen cases (25.5%) had normal echocardiographic findings. Forty (78%) patients had sinus tachycardia while 8 cases (15.7%) showed atrial fibrillation with uncontrolled ventricular rate, and 3 (5.8%) had sinus bradycardia. Heat stroke electrocardiograms showed tracings demonstrating ST segment depression, compatible with ischaemia in 9 cases, while in 6 cases there were nonspecific T wave changes, whereas in another 4 cases the tracings demonstrated different conduction abnormalities. The collected data were analysed and compared to those of 43 control patients. The adverse effects of heat stroke on the heart are multifactorial requiring the utmost attention and understanding, as they reflect the patient's cardiovascular status.

The spectrum of echocardiographic abnormalities in hypothyroidism and the effect of hormonal treatment.

Cross-sectional echocardiography was used to identify and quantify different cardiac abnormalities in 85 patients with hypothyroidism. Pericardial effusion was the most common and was found in 32 patients (37.6%), while abnormal increase in left ventricular dimensions with impairment of function followed next in frequency (16.4%). Asymmetrical septal hypertrophy as well as segmental wall motion abnormality were each detected in 11.76%. Holosystolic prolapse of the mitral valve was present in only 4.7% of the cases. Different combinations of abnormalities were observed in a total of 22 patients (25.76%), and pericardial effusion was a constant finding. Some of the abnormalities were reversed with physiological thyroxin replacement, but abnormal wall motion remained unimproved.

Aneurysmal dilatation of the coronary arteries: diagnostic patterns and clinical significance.

In order to define the clinical features, clinical patterns and significance of aneurysmal dilatation of the coronary arteries, five cases are presented which were diagnosed by coronary angiography. Three cases presented with left ventricular dysfunction secondary to coronary arterial occlusive disease and the fourth patient presented with thromboembolic cerebrovascular disease. The fifth case presented with manifestations of acute myocardial infarction.

Pulmonary alveolar microlithiasis: a report on four cases.

The accidental discovery of a diffuse but sharply defined micro-nodular pattern on routine chest x-ray of an asymptomatic patient makes the diagnosis of pulmonary alveolar microlithiasis more likely whereas the finding of different sized microliths that are located in alveolar spaces, in a lung biopsy specimen, confirm the diagnosis. Four cases are reported in this context.

Hydatidosis: clinical significance and morbidity patterns in Saudi Arabia.

Hydatid disease is an endemic zoonosis in Saudi Arabia causing a significant morbidity among Saudi nationals. The complications can be severe and life threatening. Seventy seven cases are presented with their salient clinical manifestations, organs affected, complications and methods of diagnosis. It was noticed that females are more commonly affected than males, and the younger age groups are commonly affected.

Hepatitis B virus vs schistosomiasis and hepatocellular carcinoma in Saudi Arabia.

Fifty patients with histopathological diagnosis of hepatocellular carcinoma were studied with special reference to infection with hepatitis B virus and schistosomal infestation. The possible correlation of these two risk factors and liver malignancy is discussed.

Is the desert lung syndrome (nonoccupational dust pneumoconiosis) a variant of pulmonary alveolar microlithiasis? Report of 4 cases with review of the literature.

Four cases of pulmonary alveolar microlithiasis are presented. These patients had heavy exposure to sand particles for long periods. This is to hypothesize that those sand particles are responsible for triggering a hyperimmune response resulting in the formation of microlithiasis. Previously expressed theories had linked microlithiasis to external irritants and the condition has similarities with desert lung syndrome, a disease definitely caused by the deposition of sand silica in the lungs.

Ventilatory function in normal Saudi Arabian adults. Observations and comparison with some Western and Eastern reference values.

Ventilatory function was studied in healthy non-smoking Saudi Arabian adult males from Riyadh area, and findings compared with those of some Western and Eastern populations. It was found that while the FVC and FEV1 in our subjects were lower than in American, Canadian, Jordanian, and Hongkong Chinese, these were higher than in Indian and Singapore Chinese. Most parameters of expiratory flowrate (e.g. PEF, MEF75, MEF50), however, were equal to or higher in our subjects than in American, Canadian, and Jordanian, as well as Indian and Chinese subjects. Compared to the findings in normal subjects from Jeddah, Saudi Arabia, FVC was equal to, but FEV1 and FEF 25-75 were higher in our subjects.