Juniper Publishers Journal of Cardiology and Cardiovascular Therapy

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JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Chest pain is one of the most common complaints for patients presenting to the hospital. It can be a manifestation of coronary artery disease, acid peptic disease, pleuritis, or musculoskeletal problems. Patients with obstructive sleep apnea may present with chest pain and heart block but lack typical features such as day-time sleepiness, poor concentration, fatigue, and restlessness. Obstructive sleep apnea can cause these problems due to episodes of transient nocturnal hypoxia. Patient report A 44 year-old gentleman with hypertension and obesity, presented with episodic chest pain, lasting from a few minutes to hours, mostly at night time for the last 3-4 weeks. His body mass index (BMI) was more than 50. His EKG showed third degree heart block. He was admitted to telemetry for further management. During his hospital stay, he had intermittent chest pain while his ca

Juniper Publishers - Journal of Cardiology Abstract Kawasaki disease is a rare vasculitis of unknown aetiology that occurs in childhood. It can have a fatal outcome when there is involvement of the heart. Only few cases have been reported in Nigeria with none reported from Lagos despite the high turnout of children presenting in the various private, general and teaching hospitals in Lagos. We therefore report the current case in a 23 month old boy who presented with persistent fever, non exudative bilateral conjunctivitis, erythema and fissuring of the lips, perinanal excoriation and swelling of the hands and feet. At the referral hospital, he was being managed as a case of sepsis. Echocardiography done in LASUTH was essentially normal and he had IVIG and oral aspirin. A remarkable recovery was made and he is currently stable. Conclusion: Kawasaki disease exists among children in Lagos. Diagnosis however requires a high index of suspicion. Early identification, ev

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Juniper Publishers - Journal of Cardiology Abstract Massive rise of the pacing threshold during lead maturation period (up to 6 months post-implant) has declined after the introduction of steroid eluting electrodes but not totally disappeared [1], many trials discussed the management of this problem including systemic steroid therapy during the early stage but repositioning of the lead implantation of new lead remains the solution of the exit block. We describe a case of loss of capture of coronary sinus (CS) lead 3 months post-implant due to exit block which is thought to be due to lead maturation process resulted in extensive fibrosis inside the CS which was successfully managed by balloon angioplasty, followed by successful placement of new CS lead. Case Report 50 year old male patient with DCM (EF 28%) with past history of CRT-P implantation 3 months ago with no difficulty during implantation (Figures 1 & 2) with marked improvement of the functional

Juniper Publishers - Journal of Cardiology Abstract Introduction: Appropriate Use Criteria Scores for percutaneous intervention (AUC-PCI) are being used to evaluate appropriateness of procedures performed by hospitals and interventional cardiologists. Effective strategies for improving AUC-PCI scores are needed. Methods: We reviewed all inappropriate for one year. Multiple interventions targeting the root causes were implemented. We then evaluated the subsequent percentage change for AUC scores, prior stress imaging, non-obstructive disease and PCI volume. Results: From 2012 Quarter 2- 2013 Quarter 1 (2012Q2-2013Q1) the inappropriate PCI rate was 1.7%; Following the intervention, there were 0.0% inappropriate PCI for one year. PCI volume increased by 5.35%; stress testing increased by 5.1% and the rate of non-obstructive disease increased by 1.5%. Conclusion: Our experience demonstrates that 0.0% inappropriate PCI rates are not only achievable, but can be sus

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Juniper Publishers - Journal of Cardiology Abstract Introduction: In previous echocardiographic studies less importance is given to the right heart chambers due to the dominant opinion that the right heart plays a minor role in the global cardiac function. Recent studies emphasized the undoubted importance of the right heart and indicated the study of right heart cavities as priority. Aim: The aim of this study was to performe echocardiographic measurements of morphological and functional parameters of the right atrium and right ventricle in healthy children and present the results as a possible reference values. Materials and Methods: The study included a group of 93 healthy children (48 boys and 45 girls), aged 1 month to 18 years. Dimensions and function of the right atrium and ventricle were examined by standard and new echocardiographic techniques. Results: The values of the parameters were as follows : VCI / BSA: 11.25 ± 2.67 mm/m2 , RAVI: 23 ± 6.2 ml/m