Peripartum cardiomyopathy, what if your patient plans to reconceive?

Patients with peripartum cardiomyopathy (PPCM) often express a desire to conceive again, and the risk of relapse in future pregnancies should be disclosed. No consensus is available that can determine that risk. Adequate contractile reserve, evidenced by a stress echocardiogram (exercise or dobutamine), can identify those with lower relapse risk.

Thrombomodulin gene proximal promoter polymorphisms in premature acute coronary syndrome patients in Bahrain.

Thrombomodulin is expressed on endothelial cells and monocytes (mTM) where it has an anticoagulant function. Enzymatic cleavage from the cell surface produces soluble thrombomodulin (sTM) in plasma. Abnormal levels of sTM and mutations in the thrombomodulin gene (THBD) are linked to cardiovascular disease.

Heart rate differentiates urgency and emergency in hypertensive crisis.

Objective: To study the clinical significance of presenting blood pressure parameters and heart rate in patients with hypertensive crisis.

Methods: In patients admitted with hypertensive crisis between January 2011 and May 2011, demography, mode of presentation, co-morbidities, blood pressure readings, and heart rate at presentation were documented. Further clustering of hypertensive crisis into emergency or urgency was based on the presence or absence of target organ involvement.

Complete heart block in thyrotoxicosis, is it a manifestation of thyroid storm? A case report and review of the literature.

Thyrotoxicosis complicated by advance degree atrioventricular block, a rare complication of a common disease. The term apathetic thyrotoxicosis, where palpitations and cardiac involvement are the sole manifestations of disease, is well known. Thyroxin's ability to sensitize the catecholamine receptors causing tachyarrhythmias is well addressed.

Role of tissue Doppler imaging in assessing left ventricular diastolic dysfunction severity. Does it hold the same ability?

Objective: To validate the diagnostic capability of tissue Doppler imaging in assorting the extent of diastolic dysfunction.

Methods: In this primary clinical research diagnostic study, we enrolled 70 patients with systemic hypertension presenting with shortness of breath between May 2010 to July 2010 to Salmaniya Medical Complex, Manama, Bahrain. Forty-eight patients satisfied the inclusion criteria.

Hypertensive crisis. Clinical presentation, comorbidities, and target organ involvement.

Objective: To evaluate the clinical presentation and comorbidities of hypertensive crisis in our own population.

Methods: In this cohort based study, we investigate the clinical presentation and comorbidities of hypertensive crisis by evaluating the data collected between January and April 2009. We included 154 patients admitted with systolic and diastolic blood pressure of >179 mm Hg and >119 mm Hg (based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria) in the Department of Internal Medicine, Salmaniya Medical Complex, Kingdom of Bahrain.