Outcomes of Cardiac Screening in Adolescent Soccer Players.

Background: Reports on the incidence and causes of sudden cardiac death among young athletes have relied largely on estimated rates of participation and varied methods of reporting. We sought to investigate the incidence and causes of sudden cardiac death among adolescent soccer players in the United Kingdom.

Methods: From 1996 through 2016, we screened 11,168 adolescent athletes with a mean (±SD) age of 16.

Unfractionated heparin versus bivalirudin in primary percutaneous coronary intervention (HEAT-PPCI): an open-label, single centre, randomised controlled trial.

Background: Bivalirudin, with selective use of glycoprotein (GP) IIb/IIIa inhibitor agents, is an accepted standard of care in primary percutaneous coronary intervention (PPCI). We aimed to compare antithrombotic therapy with bivalirudin or unfractionated heparin during this procedure.

Methods: In our open-label, randomised controlled trial, we enrolled consecutive adults scheduled for angiography in the context of a PPCI presentation at Liverpool Heart and Chest Hospital (Liverpool, UK) with a strategy of delayed consent.

How should I treat a spontaneously reperfused acute STEMI that involves the left main stem and proximal LAD?

Background: A 41-year-old female with 90 minutes of severe chest pain and ST-elevation in leads V1-V2 underwent emergency coronary angiography with a view to primary angioplasty.

Investigations: Physical examination, electrocardiography, coronary angiography.

Diagnosis: ST-segment elevation anterior myocardial infarction.

Role of antiischemic agents in the management of non-ST elevation acute coronary syndrome (NSTE-ACS).

Non-ST elevation acute coronary syndrome (NSTE-ACS) is the commonest acute presentation of coronary artery disease (CAD). Mortality and morbidity of the condition has improved substantially over the last few decades as a result of the cumulative effect of multiple interventions acting via different mechanisms. Despite a significant increase in the rate of coronary intervention, medical therapy continues to retain a central role in the treatment of NSTE-ACS particularly in frail patients where revascularization is inappropriate or when it is incomplete.

Giant asymptomatic pericardial cyst.

Pericardial cysts are rare. We provide high-quality imagery demonstrating a giant cyst using plain radiography, ultrasound and magnetic resonance imaging (MRI).

Tako-tsubo, hypertrophic obstructive cardiomyopathy & muscle bridging--separate disease entities or a single condition?

We report a case of an apical ballooning syndrome using classical and high quality imagery. Co-existing features of asymmetrical septal hypertrophy, outflow tract obstruction, systolic anterior mitral valve motion and LAD myocardial bridging make the underlying patho-physiology difficult to ascertain. In conclusion we believe that this single case will promote discussion and add to an expanding literature base of the tako-tsubo cardiomyopathy syndrome.

Cardiac device therapy 2: indications, techniques and complications.

With advancing technology and ever-expanding indications for implantable cardiac pacing and defibrillation devices, this article reviews modern day practice in this field. This article focuses on topics pertinent not only to cardiologists but also to general physicians, medical trainees and allied medical specialties.

Clinical outcomes after percutaneous coronary intervention involving very long segments of drug-eluting stent implantation: single-center experience.

Background: Data on effectiveness and safety following the implantation of very long segments of drug-eluting stents (DES) are lacking.

Aim: To describe our experience of consecutive patients undergoing implantation of very long segments of DES (> 50 mm) in de novo coronary lesions.

Methods: We evaluated major in-hospital complications, target lesion revascularization (TLR) rates and long-term outcomes in 88 consecutive patients (91 procedures) who underwent a single-vessel intervention with implantation of > 50 mm of overlapping DES to de novo lesions between October 2002 and October 2007.

Cardiac device therapy 1: theory, technology and terminology.

With advancing technology and ever-expanding indications for implantable cardiac pacing and defibrillation devices, this article reviews modern day practice in this field. This article focuses on topics pertinent not only to cardiologists but also to general physicians, medical trainees and allied medical specialties.

The whole nine yards: multiple cardiac surgical and percutaneous interventions in a patient during 30 years of care.

A 38-year-old man underwent coronary artery bypass graft surgery for angina pectoris following myocardial infarction. During the following 28 years, he required two repeat coronary artery bypass graft surgical procedures, nine percutaneous coronary interventions and 17 coronary angiograms. His treatment included saphenous vein, left internal mammary artery and gastroepiploic artery grafting, percutaneous transluminal coronary angioplasty and intragraft thrombolytic therapy, directional coronary atherectomy, cutting balloon angioplasty, intracoronary stenting with bare-metal and drug-eluting stents, treatment for in-stent restenosis, stenting of the left main and circumflex coronary arteries and saphenous vein graft as well as intracoronary pressure wire diagnostics.

Late outcomes after drug-eluting stent implantation in "real-world" clinical practice.

Background: We report the late outcomes in 411 consecutive patients undergoing drug-eluting stent (DES) implantation by a single operator between 2003-2006.

Methods: Prospective registry with continuous follow up. Patients with stable angina (SA) or acute coronary syndrome (ACS) received DES for long lesions, small vessels, chronic total occlusion, bifurcation, aorto-ostial, left main, post atherectomy or saphenous vein graft lesions, multivessel/multilesion single-vessel (V) disease, in-stent restenosis (ISR) or diabetes.

Clinical implications of QRS duration and QT peak prolongation in patients with suspected coronary disease referred for elective cardiac catheterization.

Background: The electrocardiogram (ECG) remains a simple, universally available, and prognostically powerful investigation in heart failure, and acute coronary syndromes. We sought to assess the prognostic utility of clinical, angiographic, and simple ECG parameters in a large cohort of patients undergoing elective cardiac catheterization (CC) for known or suspected coronary artery disease.

Methods: Consecutive consenting patients undergoing CC for coronary disease were enrolled at a single tertiary center.

QT peak prolongation is not associated with left ventricular hypertrophy in teenage professional football players.

Objective: QT peak prolongation is associated with left ventricular hypertrophy (LVH) in patients with hypertension. This study tests the hypothesis that QT peak prolongation correlates with LV mass index in apparently healthy young football players.

Methods: QT peak and other ECG criteria for LVH were assessed in 117 male professional footballers (mean age 16.

Percutaneous coronary intervention for chronic total occlusions: improved survival for patients with successful revascularization compared to a failed procedure.

Background: There are limited data on the impact of successful chronic total occlusion (CTO) revascularization by percutaneous coronary intervention (PCI) on survival. We performed a retrospective study comparing the survival between patients with a successful and a failed CTO revascularization by PCI.

Methods: Between January 1, 2000 and June 30, 2004, 543 of 5803 (9.

Ambulatory cardiac rhythm monitoring.

Cardiac arrhythmias may cause palpitations, dyspnoea, angina pectoris, dizziness or even syncope and sudden death. This article will review the indications for investigation, the novel devices that are available for investigating patients with suspected cardiac dysrhythmias and the new technology available for analysis and reporting.

Spectral analysis, death and coronary anatomy following cardiac catheterisation.

Objective: To establish the associations and prognostic utility of angiographic, clinical and HRV parameters in a large cohort of patients undergoing diagnostic cardiac catheterisation (CC).

Methods: Patients undergoing CC as elective day cases were enrolled at a single tertiary center from September 2001 to January 2003. Patient data, serum biochemistry, current drug therapy, catheter reports and five minute high resolution electrocardiograph (ECG) recordings were prospectively recorded and validated in an electronic archive.