Basma Hammad

A Rare Case of Fatal Left Ventricular Free Wall Rupture: Case Report and Short Review

Left ventricular free wall rupture (LVFWR) is a rare, yet lethal, complication of acute myocardial infarction (AMI), occurring in approximately 2% of cases. In the era of percutaneous coronary intervention, however, it is less frequently encountered. We were confronted with a case of AMI complicated with LVFWR after receiving thrombolytic therapy. The diagnosis was established using transthoracic echocardiography (TTE). Unfortunately, the patient passed away before surgical intervention. This case demonstrates the importance of prompt diagnosis and management of such a lethal complication.

An inferior vena cava filter causing perforation with all six legs

A 52-year-old male patient with past medical history most significant for recurrent unprovoked bilateral lower limb deep vein thrombosis in 2010 as well as diabetes, hypertension, and smoking. Although the patient was appropriately anti-coagulated, on warfarin, he presented with sub-massive pulmonary embolism in 2011, hence a …

A left ventricular true aneurysm

True ventricular aneurysm is a scarred wall that most commonly results after an unrevascularized ST elevation myocardial infarction. Patients usually present with heart failure, angina, ventricular arrhythmia, systemic embolization, or ventricular rupture. Diagnosis can be achieved via echocardiography, left ventricle angiogram, cardiac computed tomography, or cardiac magnetic resonance.

Long-term prognostic implication of coronary plaque characterization as detected by 64-multidetector computed tomography in Egyptian population

Objectives We aimed to determine the role of multi-detector computed tomography (MDCT) in prognosis of patients with known or suspected coronary artery disease (CAD) by applying plaque characterization and whether obstructive versus non-obstructive plaque volume is a predictor of future cardiac events. Background Vulnerable plaques may occur across the full spectrum of severity of stenosis, underlining that also non-obstructive lesions may contribute to coronary events. Methods We included 1000 consecutive patients with intermediate pretest likelihood of CAD who were evaluated by 64-MDCT. Coronary artery calcium scoring, assessment of degree of coronary stenosis and quantitative assessment of plaque composition and volume were performed. The end point was cardiac death, acute coronary syndrome, or symptom-driven revascularization. Results After a median follow-up of 16 months, 190 patients had suffered cardiac events. In a multivariate regression analysis for events, the total amount of non-calcified plaque (NCP) in non-obstructive lesions was independently associated with an increased hazard ratio for non-fatal MI (1.01–1.9/100-mm3 plaque volume increase, p = 0.039), total amount of obstructive plaque was independently associated with symptoms driven revascularization (p = 0.04) and coronary artery calcium scoring (CACS) was independently associated with cardiac deaths (p = 0.001). Conclusion MDCT is a non-invasive imaging modality with a prognostic utility in patients with known or suspected coronary artery disease by applying plaque characterization and it could identify vulnerable plaques by measuring the total amount of NCP in non-obstructive lesions which could be useful for detecting patients at risk of acute coronary syndrome (ACS) and guide further preventive therapeutic strategies. CACS was shown to be an independent predictor of mortality, while total amount of obstructive volume was shown to be an independent predictor of symptoms driven revascularization.

AN UNUSUAL CAUSE OF CHEST PAIN AFTER CORONARY ARTERY BYPASS GRAFTING

Iatrogenic aortocoronary arteriovenous fistula (ACAVF) resulting from grafting of an arterial graft to a cardiac vein is an unusual complication of coronary artery bypass grafting (CABG), it has been only reported in 37 cases. A 35-year-old female patient with history of diabetes mellitus and