ABSTRACT
ST-segment elevation myocardial infarction (STEMI) is a known medical exigency that has seen considerable advances in medical treatment, dramatically boosting survival rates. Post myocardial infarction ventricular rupture is a major serious mechanical complication following myocardial infarction. We present a case of a 68-year-old male admitted to the emergency department with heaviness in the chest, for which electrocardiography was done and it was suggestive of anterior and lateral wall myocardial infarction. After six hours he experienced breathlessness, jugular venous pressure (JVP) was raised, and auscultation revealed early systolic murmur at apex suggestive of ventricular septal rupture. An urgent echocardiogram was done and it confirmed the diagnosis of ventricular septal rupture (VSR). To enhance the prognosis, early identification and appropriate care are required, which necessitate a thorough clinical evaluation that raises the possibility of mechanical problem, as late presentation is one of the major risk factors for developing VSR. VSR can manifest itself in numerous ways, based on the patient's condition. Right clinical judgement and ECG are required to establish a quick diagnosis, as a result, to determine the most appropriate treatment at the appropriate time.
ABSTRACT
An electrocardiographic pattern consisting of elevated ST segment in lead aVR with global ST-segment depression in multi-leads indicates circumferential subendocardial ischaemia due to mismatch of oxygen supply and demand. This finding of an echocardiogram is strongly suggestive of occlusion of proximal part of left anterior descending part of coronary artery. We describe a patient who presented to us with complaint of chest pain and had ST-segment elevation in lead aVR and global ST-segment depression in multi-leads and was suspected to have occlusion in left anterior descending artery. Patient was taken for early coronary angiography and angioplasty then. It was found that patient had occlusion in proximal part of of left anterior descending part only. Hence, early recognition of the condition and its prognosis can help preventing complications.
ABSTRACT
Yamaguchi syndrome, also known as apical (Ap) hypertrophic cardiomyopathy (HCM), is a variant of cardiomyopathy that affects the apical region of the left ventricle. ApHCM is frequently misdiagnosed or missed because its symptoms are extremely similar to those of acute coronary syndrome. As clinicians are unfamiliar with this disease, diagnosis can be missed or delayed; as a result, this condition is frequently discovered by chance. ApHCM has a favorable long-term prognosis once properly diagnosed. We report a case of a 50-year-old male who was diagnosed with Yamaguchi syndrome incidentally.
ABSTRACT
Dengue is a mosquito-borne viral fever seen commonly in the urban areas of tropical and sub-tropical countries. The spectrum of this disease varies from a simple fever which can be managed with anti-pyretics to dengue shock syndrome, which requires urgent intensive care admission. Dengue shock syndrome can be a life-threatening condition. Dengue fever can progress to dengue shock and later to dengue shock syndrome if not managed with promptness. Apart from the spectrum of progression known to us, dengue fever can have a varied set of atypical presentations. These atypical presentations can be neurological, cardiac, or even gastro-intestinal. Cardiac complications, although rare, have been reported, such as various atrioventricular arrhythmias, myocarditis, pericarditis, and even myopericarditis. Here, we report a case of a 65-year-old male who presented to us with severe dyspnea and fever. Examination and investigations revealed dengue fever with myopericarditis.
ABSTRACT
Pulmonary embolism is linked with a remarkable rate of mortality, particularly when it is associated with hemodynamic instability, right atrial thrombus and related right ventricular dysfunction. In patients affected with pulmonary embolism, thrombolysis has been documented to be life-saving. The administration of thrombolytic agents ensures early resolution of the thrombus and prevents arrhythmia and cardiogenic shock. Streptokinase, urokinase and alteplase are among the three thrombolytic agents approved for the treatment of pulmonary embolism. In emergency situations, thrombectomy plays a crucial role.
ABSTRACT
Numerous recommendations and guidelines aim to improve the quality, timeliness and transparency of medical publications. However, these guidelines use ambiguous language that can be challenging to interpret, particularly for speakers of English as a second language. Cultural expectations within the Asia-Pacific region raise additional challenges and several studies have suggested that awareness and application of ethical publication practices in the Asia-Pacific region is relatively low compared with other regions. However, guidance on applying ethical publication practice guidelines in the Asia-Pacific region is lacking. This commentary aims to improve publication practices in the Asia-Pacific region by providing guidance on applying the 10 principles of the Good Publication Practice 3 (GPP3) guidelines and the International Committee of Medical Journal Editors (ICMJE) criteria for authorship. Recommendations are provided for encore presentations, applying the ICMJE authorship criteria in the context of regional cultural expectations, and the role of study sponsors and professional medical writers. Ongoing barriers to compliance with guidelines are also highlighted, and additional guidance is provided to support authors submitting manuscripts for publication. The roles of regional journals, regulatory authorities and professional bodies in improving practices are also discussed.