Acute myocardial infarction after a negative Dobutamine stress echocardiogram in a patient with end-stage liver disease.

Dobutamine stress echocardiogram (DSE) is generally a safe and reliable test for detection of myocardial ischaemia. We report the case of a 43-year-old male with end-stage liver disease (ESLD), who underwent DSE as part of workup for liver transplantation. Although the patient had an uneventful negative DSE, within 45 minutes he developed inferior ST-segment elevation myocardial infarction (STEMI).

Prescription of statins after acute coronary syndrome; a single-centre observational study.

There is limited information about the current use of high-intensity statins (HIS) after acute coronary syndrome (ACS) in Pakistani patients. We studied the prescription of HIS in patients admitted with ACS to Ittefaq Hospital, Lahore, Pakistan, from February 2019 to December 2019. Among the 411 patients, 221 (53.

Frequency of high bleeding risk in patients undergoing percutaneous coronary intervention.

Objective: To assess the prevalence of risk factors for bleeding and high bleeding risk in patients undergoing percutaneous coronary intervention.

Methods: The single-centre retrospective observational study was conducted at Ittefaq Hospital Lahore and comprised data of patients who underwent percutaneous coronary intervention from February 2018 to December 2019. Minor and major bleeding risk factors were identified on the basis of the consensus definition of the Academic Research Consortium.

Knowledge, attitudes and practices of patients with chronic illnesses during the COVID-19 pandemic: A cross-sectional survey from Pakistan.

Objectives: We studied the impact of the Covid-19 pandemic on the physical and mental health of patients with chronic illnesses and their behavioural responses.

Methods: We conducted a cross-sectional knowledge, attitudes and practices (KAP) survey among outpatients with chronic illnesses in Lahore, Pakistan.

Results: Four hundred and one participants were surveyed (84% above 50 years of age).

IVUS and OCT guided primary percutaneous coronary intervention for spontaneous coronary artery dissection with bioresorbable vascular scaffolds.

Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate.

Thrombus aspiration during primary percutaneous coronary intervention for acute myocardial infarction: A review of clinical evidence and guidelines.

Acute ST segment elevation myocardial infarction (STEMI) is characterized by complete thrombotic occlusion of a major coronary artery. Early recanalization of the infarct-related artery is most efficiently delivered by primary percutaneous coronary intervention (PPCI), however this does not always restore normal myocardial perfusion, mainly due to distal embolization of the thrombus and microvascular obstruction. Early evidence for manual thrombus aspiration during PPCI was promising and this was once considered an important aspect of the procedure, especially in patients with a high thrombus burden.

The 7-year teesside experience of primary prevention ICD indications following primary PCI (PPCI) and the potential impact of a change in NICE guidance.

Introduction: The recovery of LV function in patients with severe LV impairment in the acute phase following primary percutaneous coronary intervention (PPCI) is not well established. The indication for a primary prevention ICD post-STEMI is dependent on which screening guidance, NICE or ESC, is followed. The potential impact of the new NICE guidance is estimated.

A left atrial mass in a patient with atrial fibrillation and previous renal cancer.

A 73-year-old man underwent a surveillance CT following a laparoscopic radical nephrectomy for left-sided renal cell carcinoma 3 years earlier. He had atrial fibrillation. CT identified a large left atrial mass.

Hypokalaemia: common but not always benign. Severe, persistent hypokalaemia secondary to ectopic ACTH from a carcinoid tumour.

Hypokalaemia is a common and often benign observation. There is usually an obvious underlying cause for the anomaly. However, hypokalaemia can very rarely be the sole presentation of a more sinister disease.

Haematological emergencies on the acute medical take.

As haematological emergencies are uncommon in daily clinical practice, enhanced awareness and high index of suspicion is required to ensure that the potentially lifesaving measures are offered. This article discusses some of the haematological conditions which may present on the acute medical take.