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Recurrent Prosthetic Paravalvular Leakage in Culture-negative Endocarditis Caused by mycoplasma hominis: A Case Report
Weiteng Wang,
Oudi Chen,
Lixi Gan,
Xin Li,
Hongkun Qing,
Fanyu Chen,
Zuoren Xiao,
Xuhua Jian
Issue:
Volume 6, Issue 4, December 2022
Pages:
92-96
Received:
19 June 2022
Accepted:
8 October 2022
Published:
21 October 2022
DOI:
10.11648/j.ccr.20220604.11
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Abstract: Background: Culture-negative endocarditis in patients with previous prosthetic valve replacement is a challenging disease with high mortality and poor outcomes. Recurrent paravalvular leakage is a common complication in patients with prosthetic valve but is rarely realized to endocarditis. Objectives: To report a diagnostic strategy for culture-negative endocarditis caused by atypical pathogen in patients with previous prosthetic valve replacement. Patients and Methods: We present a case report about recurrent prosthetic valvular leakage with preoperatively unknown cause. Traditional clinical laboratory for pathogen detection and echocardiography were routinely performed. The patient received aortic and mitral valve replacement and tricuspid annuloplasty. Metagenomic next-generation sequence tests on removal tissue and blood are performed. Results: Preoperative imaging finding of vegetation and blood culture was negative. Metagenomic next-generation sequence tests on resected valve tissue and blood specimens revealed 236 and 154 unique read-pairs aligning to mycoplasma hominis, respectively. Retrospective serological immunofluorescence assay revealed cross-reaction to mycoplasma pneumonia. Haematoxylin-eosin-stained histological section of the mobile vegetation attached to the mitral mechanism prosthesis demonstrated hyalinization in intercellular substance and infiltration of neutrophils, lymphocytes, and plasmocytes, which indicated chronic infective endocarditis. Culture-negative endocarditis were diagnosed by multidisciplinary team. Azithromycin was selected for anti-mycoplasma hominis. The patient made an excellent recovery and repeat transthoracic echocardiography performed at discharge demonstrated a good prosthetic valve function. Conclusion: Culture-negative endocarditis may be a criminal in cryptogenic paravalvular leakage. A multiple-image-technique strategy combined with metagenomic next-generation sequence to patients with recurrent paravalvular leakage are recommended for early diagnosis ant timely antibiotic administration for potential endocarditis.
Abstract: Background: Culture-negative endocarditis in patients with previous prosthetic valve replacement is a challenging disease with high mortality and poor outcomes. Recurrent paravalvular leakage is a common complication in patients with prosthetic valve but is rarely realized to endocarditis. Objectives: To report a diagnostic strategy for culture-neg...
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The Risk Factor Profile in Egyptian Patients with Acute Coronary Syndrome: An Observational Study
Ahmed El Kersh,
Ashraf Reda,
Ahmed Samir
Issue:
Volume 6, Issue 4, December 2022
Pages:
97-102
Received:
12 February 2022
Accepted:
3 March 2022
Published:
10 November 2022
DOI:
10.11648/j.ccr.20220604.12
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Abstract: Little is known about risk factors and treatment modalities in Egyptian patients with acute coronary syndrome (ACS). This cross-sectional study was conducted on 200 adult subjects presenting with ACS including ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), or unstable angina to evaluate the pattern of risk factors profile among Egyptian patients with ACS. All patients were subjected to history taking, clinical examination, 12-lead ECG, and plasma troponin I to confirm myocardial necrosis and to identify STEMI, NSTEMI, and unstable angina. The percent of current smokers was significantly higher than non-smokers (63.5% versus 36.5%, p=0.001). History of hypertension was significantly more frequent among the studied patients (57.5% versus 42.5%, p=0.034), and the same was observed for diabetes mellitus (60.5% versus 39.5%, p=0.003). The number of patients having dyslipidemia was significantly higher than those having no dyslipidemia (57% versus 43%, p=0.048). Regarding the body mass index (BMI), high percentages of the studied patients were overweight or obese (40.5% and 37.5%, respectively), with significant differences (p=0.000). The mean LDL was significantly higher in females than males (125.67±34.3 versus 114.68±25.6, p=0.043). Further, the mean BMI was significantly greater in females than males 32.44±5.5 versus 30.38±3.9, p=0.018). Conclusions: The findings of the present study indicated the pattern of modifiable risk factors for ACS Egyptian patients. These included smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. Lifestyle interventions and awareness of the public are highly recommended for preventing ACS, with especial consideration for women.
Abstract: Little is known about risk factors and treatment modalities in Egyptian patients with acute coronary syndrome (ACS). This cross-sectional study was conducted on 200 adult subjects presenting with ACS including ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), or unstable angina to evaluate the pattern of r...
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High Serum Uric Acid, Anemia, Microalbuminuria, and Reduced Estimate Glomerular Filtration Rate in Africans with High Blood Pressure at Brazzaville (Congo)
Christian Michel Kouala Landa,
Fatime Arousse Mampouya,
Solange Flore Mongo Ngamami,
Jospin Karel Makani Bassakouahou,
Rog Paterne Bakekolo,
Kivie Ngolo Letomo,
Arthur Bolongue Awasandeke,
Yannis Franck Kouikani,
Bertrand Fikahem Ellenga Mbolla
Issue:
Volume 6, Issue 4, December 2022
Pages:
103-108
Received:
20 October 2022
Accepted:
10 November 2022
Published:
23 November 2022
DOI:
10.11648/j.ccr.20220604.13
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Abstract: Background: High blood pressure (HBP) is a public health problem. Its management requires a biological and morphological evaluation, looking for associated abnormalities. The aim of this study was to determine the biological abnormalities in patients with HBP and their relationship with the level of blood pressure (BP). Methods: This cross-sectional study was conducted from May to October 2018 (6 months), in outpatient consulting at the University Hospital of Brazzaville. Were included, patients followed for essential hypertension. Results: One hundred and four patients were included, 57 women (54.8%). The mean age was 54.6±12.7 years. HBP was known in 74 cases (71.2%). The associated risk factors were abdominal obesity (n=52, 50%), family history of cardiovascular disease (n=52, 50%), sedentariness (n=50, 48.1%), dyslipidemia (n= 38, 36.5%), diabetes (n=16, 15.4%), and tobacco use (n=8, 7.7%). Biological abnormalities were hyperuricemia (n=50, 52.6%), anemia (n=43, 40.4%), microalbuminuria (n= 39, 37.5%), hypernatremia (n=34, 32.7%), reduced estimate filtration glomerular rate (eGFR) in 29 cases (27.9%) and hypercholesterolemia (n=21, 20.2%) The metabolic syndrome was found in 25 cases (24%). HBP was severe in 59 cases (56.7%). The relationship between severe HBP listed: altered eGFR (n=13, 22%, OR 0.51, 95%CI 0.21-1.21), albiminuria (n=37, 62.7%, OR 1.75, 95%CI 0.8-3.86), anemia (n=23, 39%, OR 0.79, 95%CI 0.36-1.75). Conclusion: Biological abnormalities are numerous in patients with HBP monitored in Central Africa. Thus, patients are poorly controlled on treatment. Early detection of these abnormalities is necessary to improve patient care.
Abstract: Background: High blood pressure (HBP) is a public health problem. Its management requires a biological and morphological evaluation, looking for associated abnormalities. The aim of this study was to determine the biological abnormalities in patients with HBP and their relationship with the level of blood pressure (BP). Methods: This cross-sectiona...
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Myocardial Strain Abnormalities in Patients with Long COVID After Mild to Moderate Acute COVID-19 Disease
Atul Kapoor,
Aprajita Kapur
Issue:
Volume 6, Issue 4, December 2022
Pages:
109-117
Received:
10 November 2022
Accepted:
28 November 2022
Published:
8 December 2022
DOI:
10.11648/j.ccr.20220604.14
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Abstract: Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recently recovered patients of COVID 19 disease with mild to moderate severity of disease using cardiac magnetic resonance imaging along with strain imaging for both left and right ventricles. Methods: A prospective observational study of 52 symptomatic patients post recovery from recent mild to moderately severe COVID 19 disease was taken. Exclusion criteria included any prior cardiovascular risk, diabetes and smoking. CMR was done and ventricular functions were calculated and recorded along with T1 MOLLI mapping with T2 parametric maps in short axis followed by strain imaging using feature tracking for global circumferential shortening (GCS) and global circumeferential early strain rate (GCSe’r) for left and right ventricle. Results: All 52 patients evaluated had normal ejection fraction of both ventricles. T2 maps showed diffuse pattern of involvement of free right ventricle wall while mixed pattern of edema involving mid and basal septum, inferolateral or mid lateral walls was seen along with subendocardial involvement. Right ventricle showed a diffuse pattern of involvement by edema. Strain abnormalities were seen in all patients with a median reduction of GCS and GCSe’r of 9.9%, 61.8% and 6.2% and 46.5% for left and right ventricle respectively. Conclusion: The study highlights the presence of myocarditis in post recovered patients of COVID-19 disease with mild to moderate severity and its detection with the use of CMR and also shows the predominant involvement of right ventricle. Marked reduction of GCS and GCSe’r of both the ventricles were seen with preserved ejection fraction and absent wall motion abnormalities and high lights the need for long term follow up of these patients.
Abstract: Background: Global pandemic of COVID-19 disease has left many recovered patients with variety of sequelae out of which involvement of heart in the form of myocarditis has been an important and a challenging problem from not only diagnosis but also treatment point of view. Aim: The aim of this study was to evaluate the changes in the heart of recent...
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Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective
Okechukwu Iheji,
Boma Oyan,
Nkemegbunam Okoli,
Rosemary Stanley,
Ngozi Pauline Onwueme
Issue:
Volume 6, Issue 4, December 2022
Pages:
118-123
Received:
22 November 2022
Accepted:
15 December 2022
Published:
27 December 2022
DOI:
10.11648/j.ccr.20220604.15
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Abstract: Introduction. The impact of heart failure in Africa is worthy of attention owing to its economic and social impact on life expectancy in individuals who are young and economically active, and thus, identification of the aetiology of heart failure is important as some of the causes are potentially treatable. Methods. A total of one hundred and sixty heart failure patients in the Cardiology clinic and medical wards were recruited. Basic demographic information was obtained, and a clinical examination was performed. All patients underwent a resting Electrocardiography and Echocardiography. Results. The mean age of the respondents was 52.49±13.89 years and 52.5% were female. The commonest cause of HF was hypertension which was the causative factor in 51.3% of the cases, while dilated cardiomyopathy and Rheumatic heart disease, which had 16.3% each, distantly followed this. Ischaemic heart disease was present in 5.0%. There was a significant difference in age group representation with hypertension, dilated cardiomyopathy and ischaemic heart disease being more predominant in the middle-aged group while rheumatic heart disease and pericardial disease occurred in the young (p<0.001). There was also a difference in the sex representation with hypertension and ischaemic heart disease affecting more males than females (p=0.018). Conclusion. Hypertension, dilated cardiomyopathy and rheumatic heart disease are the major aetiologies of heart failure while ischemic heart disease is assuming a greater prominence as a cause of HF in our environment.
Abstract: Introduction. The impact of heart failure in Africa is worthy of attention owing to its economic and social impact on life expectancy in individuals who are young and economically active, and thus, identification of the aetiology of heart failure is important as some of the causes are potentially treatable. Methods. A total of one hundred and sixty...
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New Approaches in Coronary Atherosclerotic Disease: A Brief Overview
Issue:
Volume 6, Issue 4, December 2022
Pages:
124-129
Received:
14 October 2022
Accepted:
31 October 2022
Published:
29 December 2022
DOI:
10.11648/j.ccr.20220604.16
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Abstract: Coronary atherosclerotic disease is a pathology of great prevalence in the Western population and that accompanies the human being from intrauterine stage until the end of life. In young people necropsies from Korea and Vietnam wars it was found a 12 to 20% of coronary arteries narrowing in people under 26 years old otherwise healthy. Many traditional treatments in this illness have been considered but in the last years new approaches have appeared and promise a very interesting point of view in coronary disease such as omega 3 oils or antioxidant compounds that could work resetting ischemic tissue disorders. For instance Diabetes Mellitus is a disease very relationed to coronary disease through the formation of AGES. These are proteins modified and altered by glucose. In a hyperglicemic state there are many glucose particles fusioned to proteins; In the beginning this occurs in a reversible way but later the glucose becomes an integral part of proteins. AGES will be- accompanied by Oxygen free radicals- the originators of diabetic complications such as coronary artery disease. Evidently we need to learn more about this illness in order to get a better comprehension of physiopathologic mechanisms involucrated and try to stop or slow its progress. In this briefly monography we try to go through some of these statements.
Abstract: Coronary atherosclerotic disease is a pathology of great prevalence in the Western population and that accompanies the human being from intrauterine stage until the end of life. In young people necropsies from Korea and Vietnam wars it was found a 12 to 20% of coronary arteries narrowing in people under 26 years old otherwise healthy. Many traditio...
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