Woodsmcintosh4853
Summary- Symptomatic aortic aneurysms can manifest in different clinical settings, such as acute coronary syndrome (ACS), acute heart failure, a shock that is mostly due to the complications related to dissection or rupture of the aneurysm. In these clinical settings, the diagnosis can be established with the help of medical history, physical examination, and promptly performed imaging tests. However, the diagnosis of an asymptomatic aortic aneurysm is usually incidental. Thus, it is very rare to find a case of ACS with intact aortic aneurysm and without obstructive coronary artery disease. In this paper, we report a successfully treated male patient aged 41 years with intact ascending aortic aneurysm who presented with ACS and was diagnosed with the help of bedside echocardiographic assessment.Summary- Ventricular septal rupture (VSR) is an ominous mechanical complication of acute myocardial infarction (MI) accompanied with a poor prognosis. Transcatheter closure (TCC) of VSR has been proposed as an alternative approach for surgery. This study presents a 79-year-old man with diabetes mellitus, hypertension, dyslipidemia, and chronic stable angina with 3-vessel coronary artery disease, who had refused a coronary artery bypass graft. He complained of orthopnea and dyspnea of New York Heart Association (NYHA) function class III after the recent neglected inferior MI. Transthoracic echocardiography revealed moderate left ventricular (LV) systolic dysfunction, true aneurysm formation at the base of the inferoseptal wall, as well as a large-sized (12 mm) VSR at the posterior aspect of basal inferoseptal segment with significant left to right shunt and a peak systolic gradient of 50 mm Hg at the VSR site. Given the high risk profile for surgery and patient refusal, he was a candidate for TCC of VSR and staged multi-vessel percutaneous coronary intervention (PCI). A 30 mm Figulla atrial septal defect (ASD) occluder device was chosen and successfully deployed at the VSR site with minimal residual shunt. A month later, successful multi-vessel PCI was performed with good procedural and clinical outcomes on the 6-month follow-up.
The objective of this study is to determine the impact of applying lifestyle intervention in the form of a continuous care model (CCM) on reducing dietary sodium intake and blood pressure (BP) in patients with hypertension.
This randomized controlled trial was conducted in a 2-group design on a total of 50 patients who were hypertensive (experimental and control) as a pre‒post test study. A healthy lifestyle (emphasizing physical activity and heart-healthy diet) in the form of CCM, which considers the patient as an active agent in the health process, was conducted in the experimental group over a period of 4 months. The mean BP value and dietary sodium intake in both groups were measured at the beginning and the end of the study.
The mean sodium intake, the mean systolic BP, and the mean diastolic BP decreased to 2.42±0.73 mm Hg (from 3.12±0.79), 128.4±13.04 mm Hg (from 144.20±13.12), and 79.4±8.93 mm Hg (from 89±9.12), respectively, after the intervention in the experimental group (p=0.021, p<0.001, and p=0.011, respectively).
Applying lifestyle intervention in the form of CCM may be recommended to reduce dietary sodium intake and mean systolic and diastolic BP in patients who are hypertensive. Considering the fact that lifestyle modifications are quite important regardless of the use of antihypertensive drugs, lifestyle intervention in the form of CCM is recommended to improve patient's adherence to dietary restrictions and consequently, treatment outcomes in patients who are hypertensive.
Applying lifestyle intervention in the form of CCM may be recommended to reduce dietary sodium intake and mean systolic and diastolic BP in patients who are hypertensive. Considering the fact that lifestyle modifications are quite important regardless of the use of antihypertensive drugs, lifestyle intervention in the form of CCM is recommended to improve patient's adherence to dietary restrictions and consequently, treatment outcomes in patients who are hypertensive.
Sudden cardiac death (SCD) is one of the causes of death among patients infected with human immunodeficiency virus (HIV). The T peak to T end interval (Tp-e interval) is a parameter that is used in the prediction of SCD. The aim of this study was to investigate the difference in Tp-e interval and Tp QT and Tp corrected QT interval (QTc) ratios between patients infected with HIV and healthy individuals as well as in other factors affecting patients infected with HIV.
A total of 83 patients infected with HIV with negative HIV ribonucleic acid (RNA) levels who were receiving antiretroviral therapy (ART) and 83 healthy individuals were included in this study. All the participants underwent electrocardiography, their Tp-e and QT intervals were measured, and QTc intervals and Tp-e QT and Tp-e QTc ratios were calculated. In addition, in the patients infected with HIV, CD4 and CD8 T-cell count and HIV RNA levels were measured.
The Tp-e interval was found to be longer and the Tp-e QT and Tp-e QTc ratios were found to be higher in patients infected with HIV. Nadir CD4 was observed to be an independent predictor of Tp-e interval (p=0.014, β=‒0.28). learn more Furthermore, correlation analysis revealed a negative correlation of the nadir CD4 level and CD4 CD8 ratio with Tp-e interval and Tp-e QT ratio.
Low nadir CD4 and a reversed CD4 CD8 ratio in patients infected with HIV receiving ART were found to be associated with a prolonged Tp-e interval and increased Tp-e QT and Tp-e QTc ratios. Thus, more attention should be taken in terms of SCD in patients infected with HIV, especially in those with low nadir CD4 and reversed CD4 CD8 ratio.
Low nadir CD4 and a reversed CD4 CD8 ratio in patients infected with HIV receiving ART were found to be associated with a prolonged Tp-e interval and increased Tp-e QT and Tp-e QTc ratios. Thus, more attention should be taken in terms of SCD in patients infected with HIV, especially in those with low nadir CD4 and reversed CD4 CD8 ratio.
