Aims Left-ventricular non-compaction (LVNC) is characterized by excessive and prominent left-ventricular (LV) trabeculations and may be associated with systolic dysfunction in advanced disease. We ...sought to determine the proportion of patients fulfilling LVNC criteria in an adult population referred to a heart failure clinic using current diagnostic criteria. Methods and results One hundred and ninety-nine patients age 63.5 ± 15.9 years, 124 (62.3%) males with LV systolic impairment were studied. All underwent clinical examination, electrocardiography, and 2-D echocardiography. The number of patients fulfilling diagnostic criteria for LVNC was retrospectively determined using three published definitions. Results were compared with 60 prospectively evaluated normal controls (age 35.7 ± 13.5 years; 31 males, 30 blacks). Forty-seven patients (23.6%) fulfilled one or more echocardiographic definitions for LVNC. Patients fulfilling LVNC criteria were younger (P = 0.002), had larger LV end-diastolic dimension (P < 0.001), and smaller left atrial size (P = 0.01). LVNC was more common in black individuals (35.5 vs. 16.2%, P = 0.003). Five controls (four blacks) fulfilled one or more LVNC criteria. Conclusions This study demonstrates an unexpectedly high percentage of patients with heart failure fulfilling current echocardiographic criteria for LVNC. This might be explained by a hitherto underestimated cause of heart failure, but the comparison with controls suggests that current diagnostic criteria are too sensitive, particularly in black individuals.
A 52-year-old female presented with acute anterior ST-elevation myocardial infarction (STEMI) within one hour of symptom onset to the emergency department. She was referred for urgent primary ...angioplasty.
Physical examination, laboratory investigations, ECG, urgent percutaneous coronary intervention (PCI).
Single-vessel coronary artery disease (SVD).
Intended to stent culprit lesion. However, stent dislodged in left main coronary artery (LMCA) during attempted PCI to diffuse mid segment of left anterior descending (LAD). Initial attempt failed to retrieve the dislodged stent with snare. Dislodged stent removed with multiple wire technique, complicated by severe dissection in LAD and left circumflex artery back into the LMCA. The stent was trapped at tip of 6 Fr right femoral sheath, unable to be withdrawn. What next?
Rheumatic mitral valve disease in pregnancy Dubrey, Simon W; Kohli, Sanjay K; Grocott-Mason, Richard ...
British journal of hospital medicine (London, England : 2005),
05/2010, Volume:
71, Issue:
5
Journal Article
Management includes urgent CT or MRI scanning and prompt attention to potential life threatening corticosteroid deficiency and pituitary dysfunction. 1 Follow-up for tumour recurrence and full ...endocrine assessment is mandatory. 2 , 3
An unusual case of palpitations Dubrey, Simon W; Kohli, Sanjay K; Mehta, Paresh A ...
BMJ,
2009-Feb-11, Volume:
338, Issue:
feb11 2
Journal Article
Peer reviewed
First described in 1992, 1 the syndrome comprises ECG features of right bundle branch block and three recognised forms of ST segment elevation in the precordial chest leads. 2 Brugada syndrome is an ...ion channel disease, inherited in an autosomal dominant fashion.
To evaluate the prognosis of primary percutaneous coronary intervention (PPCI) and medical therapy (MT) in elderly patients presenting with ST-elevation myocardial infarction (STEMI).
A total of 238 ...STEMI patients aged above 80 and treated with PPCI (n=186) and MT (n=52) at Harefield Hospital, London were included in this study. Patients who did not have true STEMI based on non-diagnostic electrocardiogram (ECG) for STEMI and negative troponin, who presented with left bundle branch block (LBBB) and had normal coronaries were excluded from this study. Primary PCI was defined as any use of a guidewire for more than diagnostic purposes in patients with STEMI, whereas conventional MT was defined as treatment of patients with anti-platelets and anti-thrombotic medications without thrombolysis.
The survival rate of PPCI patients was 86% (n=160) at month 1 followed by 83.9% (n=156) at month 6, and 81.2% (n=151) at month 12. The survival rate of MT patients was 44.2% (n=23) at month 1 followed by 36.5% (n=19) at month 6, and 34.6% (n=18) at month 12. Compared to MT, significantly fewer comorbidities were found in the PPCI group. Ventricular fibrillation (VF) (4.8%) and consequent admission to intensive care unit (7%) were the major complications of the PPCI group.
PPCI has a higher survival rate and, compared to MT, fewer comorbidities were observed in the PPCI group of elderly patients presenting with STEMI.
The major objective of this project is to estimate the resource requirements of a real-time program
developed in the actor-based system ACT++. This report describes the design and implementation of
...instrumentation primitives. Using these primitives, a real-time system can be simulated and an estimate
of processor and memory requirements can be obtained.
Master of Science
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