Primary percutaneous coronary intervention for ST elevation myocardial infarction complicated by cardiogenic shock.

Objective: To determine the outcomes of primary percutaneous coronary intervention for ST elevation myocardial infarction complicated by cardiogenic shock.

Methods: The retrospective study was conducted at the Tabba Heart Institute, a private-sector facility in Karachi. It reviewed the medical records of 56 consecutive patients between January 2009 and June 2011 with acute ST elevation myocardial infarction complicated by cardiogenic shock and subjected to primary percutaneous coronary intervention.

Transradial primary percutaneous coronary intervention - experience from a tertiary care cardiac centre.

Objective: To determine the outcomes of primary percutaneous coronary intervention via transradial approach in a tertiary care cardiac centre.

Methods: The study retrospectively reviewed the medical records of 160 consecutive patients who presented to Tabba Heart Institute, a private-sector facility in Karachi, between January 2009 and January 2011 with acute ST-elevation myocardial infarction and treated with primary percutaneous coronary intervention via transradial approach. The primary end-points were in-hospital mortality and procedural success.

Coronary aneurysm complicated by acute myocardial infarction.

The case of a 55 years old, hypertensive, obese female is presented, who came to the emergency department with inferoposterior ST segment elevation myocardial infarction (STEMI) with right ventricular infarction. After thrombolytic therapy, she reperfused but had anginal symptoms on minimal activity. The patient underwent coronary angiogram which showed aneurysmal right coronary artery (RCA) with 60% stenosis and thrombus in mid portion and distal bifurcation of RCA with TIMI III distal blood flow.

Correlation of Duke's treadmill score with gated myocardial perfusion imaging in patients referred for chest pain evaluation.

Objective: To determine the correlation of Duke treadmill score (DTS) with gated single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) in patients evaluated for chest pain.

Methods: A retrospective study was conducted at Tabba Heart institute. Two hundred consecutive patients, referred to the nuclear cardiology laboratory for evaluation of chest pain by using stress myocardial perfusion imaging (MPI) from January 2008 to August 2008 were included.

Supracristal ventricular septal defect with severe right coronary cusp prolapse.

The case of a 20 years old male, diagnosed as supracristal ventricular septal defect (VSD) for last 6 years is being presented. He came in emergency department with decompensated congestive cardiac failure. After initial stabilization, he underwent transthoracic echocardiogram which showed large supracristal VSD, severely prolapsing right coronary cusp, severe aortic regurgitation and severe pulmonary hypertension.

Coronary artery disease in patients undergoing valve replacement at a tertiary care cardiac centre.

Objective: To determine the prevalence of coronary artery disease in patients undergoing valve surgery at a tertiary care cardiac centre.

Methods: The medical records of 144 consecutive patients who underwent mitral, aortic or dual (mitral and aortic) valve replacement surgery at the Tabba Heart Institue between January 2006 to December 2008 were retrospectively reviewed. All patients underwent coronary angiogram.

Procedure indications and outcome of percutaneous coronary interventions in a tertiary care hospital.

Objective: To determine clinical indications and one month outcome of Percutaneous Coronary Interventions (PCI) in a tertiary care centre.

Methods: We prospectively conducted a descriptive study on 259 symptomatic coronary artery disease patients, who underwent primary, rescue or elective PCI with stent deployment at the Tabba Heart Institute, from May 2005 to September 2006. The primary objective of the study was to identify--stable angina, unstable angina, Non-ST elevation myocardial infarction (NSTEMI), ST elevation myocardial infarction (STEMI), congestive heart failure (CHF) and cardiogenic shock) and thirty days outcome of PCI in terms of mortality, peri-procedural myocardial infarction, re-infarction and stent thrombosis.

Cholesterol emboli syndrome--a rare complication of cardiac catheterization.

We are reporting the case of a 57 years old male, hypertensive, diabetic, dyslipidaemic who presented with exertional angina. He had a coronary artery bypass surgery, one year ago. He underwent left heart catheterization with graft study which showed critical native triple vessel disease with patent arterial graft to left anterior descending and occluded venous grafts to obtuse marginal and right coronary artery.

Doppler derived gradient of St. Jude mechanical prosthesis, early postoperative assessment.

Objective: To determine the doppler derived mean gradients of St Jude mechanical prosthesis in early postoperative period in patients undergoing valve replacement at a tertiary care cardiac centre.

Methods: Medical records of 190 consecutive patients who underwent 233 mitral, aortic or dual (mitral and aortic) valve replacement by St Jude bileaflet mechanical prosthesis at Tabba Heart Institute, between March 2006 to December 2008 were reviewed. Doppler derived mean gradients were assessed predischarge and recorded.

Association of ST segment depression >5 min after exercise testing with severity of coronary artery disease.

Objective: To determine the association of prolonged ST segment depression after an exercise test with severity of coronary artery disease.

Methods: A cross sectional study of 100 consecutive patients referred to the cardiology laboratory for stress myocardial perfusion imaging (MPI) conducted between April-August 2008. All selected patients were monitored until their ST segment depression was recovered to baseline.

Primary percutaneous coronary aspiration of thrombus from infarct related artery.

We are reporting the case of a 48-year-old man hypertensive, and smoker presenting with acute inferoposterior ST elevation myocardial infarction (STEMI) with right ventricular infarction. He underwent diagnostic angiogram which revealed total occlusion of mid right coronary artery (RCA) by thrombus. Multiple runs of aspiration were performed using Export Aspiration Catheter-6F and thrombus was aspirated from RCA.

Role of serum troponin-I in identifying left ventricular ejection fraction of

Objective: To determine the serum levels of troponin-I in identifying left ventricular ejection fraction (LVEF) of
Study Design: Case series.

Place And Duration Of Study: At the Tabba Heart Institute, Karachi, from May to November 2008.

Outcomes of primary percutaneous coronary intervention (PCI) in a tertiary care cardiac centre.

Objective: To determine the outcomes of primary percutaneous coronary intervention (PCI) in a tertiary care cardiac centre.

Methods: Medical records of 104 consecutive patients presented in our hospital between January 2006 to December 2007 with acute ST elevation myocardial infarction (STEMI) and treated with primary PCI as a mode of reperfusion were reviewed. The primary end point was in hospital mortality and secondary end points were 30 day mortality, myocardial infarction, recurrent angina and congestive cardiac failure, from discharge to one month follow up.

Chronic thromboembolic pulmonary hypertension.

The case of a 65 years old lady, diabetic, hypertensive, reduced functional class with history of episodic dyspnoea lasting for few weeks for the last two years. On presentation she was tachypnoiec with reduced oxygen saturation. Jugular venous distension was present with bibasal crackles.

Chronic total left main coronary artery occlusion.

A 65 year old man, smoker, presented with a history of exertional shortness of breath over the last 4 months. He denied any chest discomfort. On examination jugular venous distension was noted with bilateral basal crackles.

Biatrial myxoma.

A female, 32 years of age, presented with complaint of easy fatigability and exertional dyspnoea for the last one year. She had no previous history of cardiac disease. On clinical examination, there was a diastolic murmur at apex.