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Case Report: Intracardiac Mass, the Importance of Early Diagnosis and Surgical Intervention

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Case Reports in Clinical Medicine 2021年第9期10卷 240-245页

作者： Samir rafla Tarek Bishay Emeritus Professor of Cardiology Department Alexandria University Alexandria Egypt Cardiology Department National Heart Institute Cairo Egypt

Background: Cardiac masses are not rare findings;they can be primary or secondary. The differential diagnosis may need surgical intervention in most cases. Case summary: A 42-year female presented with complaints of dyspnea, palpitations, ventricular premature beats, attacks of non-sustained ventricular tachycardia. Echocardiography revealed a myocardial septal mass on both sides in the right and left ventricles. The decision to operate was taken and the masses were removed. It was proved by histopathologic examination to be metastatic from her skin melanoma. Clinically, arrhythmias subsided. Conclusion: The decision of surgery proved unavoidable. Early diagnosis by surgical intervention is important for effective treatment.

关键词： Melanoma Case Report Cardiac Masses Echocardiography Surgical Intervention

Evaluation of D-Dimer as a Diagnostic Tool in Patients with Acute Aortic Dissection

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World Journal of Cardiovascular Diseases 2021年第2期11卷 135-144页

作者： Samir rafla Tarek Bishay Cardiology Department Alexandria University Alexandria Egypt National Heart Institute Cairo Egypt

Acute (Ac.) Aortic Dissection (AD) is a life threatening cardiovascular emergency. The diagnostic methods (e.g., TEE, MRI, Multislice CT) are limited by availability. A fast, cost effective and technically simple method for diagnosis of AAD is needed. D-Dimer is a measure of clot formation and lysis. The aim of this study was to determine whether assessing D-Dimer level can be used for the diagnosis of AAD. Methods: 45 patients with clinical suspicion of AAD who presented within the first 24 hours from symptom onset were studied prospectively. 20 patients were proved to have AAD by TEE (group I). The other 25 patients had other final diagnosis (group II). All the 20 patients in group I (100%) with confirmed AAD had positive and elevated D-Dimer levels while only 9 patients in group II (36%) had positive D-Dimer levels (p Conclusion: D-Dimer levels are positive and elevated in all the patients with AAD presenting within the first 24 hours from symptom onset.

关键词： Aortic Dissection D-Dimer

Study of Bradyarrhythmias in Acute Myocardial Infarction

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World Journal of Cardiovascular Diseases 2022年第1期12卷 38-49页

作者： Samir rafla Sherif Wagdy Ayad Mohamed Sanhoury Department of Cardiology Faculty of Medicine Alexandria University Alexandria Egypt

Background: Arrhythmias after acute myocardial infarction are common. Bradyarrhythmias need specific insight into when and how to treat them. Objectives: To delineate the incidence, course, and management of different types of bradyarrhythmias after acute myocardial infarction, the study period was five years. Methods: 453 patients with Acute Myocardial Infarction (AMI) were admitted to intensive care in five years. ECGs were analyzed for the presence of bradyarrhythmias and details of management. Results: 65 patients with bradycardia were found. Sinus bradycardia in 40, sick sinus syndrome in 10, junctional rhythm

关键词： Acute Myocardial Infarction Complete Heart Block Temporary Pacemakers Bradyarrhythmias Atropine

The Hidden Value of Assessing Right Ventricular Performance with Exercise in Hypertensive Patients with Left Ventricular Diastolic Dysfunction

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World Journal of Cardiovascular Diseases 2021年第6期11卷 261-276页

作者： Mohamed Sanhoury Samir rafla Tarek El Badawy Radwa Momtaz Khalil Cardiology Department Faculty of Medicine Alexandria University Alexandria Egypt

Background: Right ventricular (RV) dysfunction could develop during exercise in patients with both hypertension and left ventricular diastolic dysfunction and may contribute to the patient symptoms. The objective is to assess RV function, both at rest and during exercise in patients with hypertension and left ventricular diastolic dysfunction. Methods: We included 30 patients with hypertension and resting LV diastolic dysfunction. The systolic function of the right ventricle was assessed by TAPSE (Tricuspid Annular Plane Systolic Excursion) and S, while E/A ratio, annular lateral E’, E/E’ and E’/A’ were used to measure diastolic function. The global function of the right ventricle was assessed by measuring the right indexed myocardial performance. The dimensions and pulmonary pressures were also measured. Results: The following parameters of RV systolic function were increased significantly with exercise: TAPSE (P = 0.0054), S’ (P = 0.0045). Moreover, the following diastolic parameters of the RV increased significantly with exercise: E/E’ (P = 0.05), A’ (P = 0.04). The global RV function showed also a significant increase (P = 0.0011). The th

关键词： Right Ventricular Dysfunction Left Ventricular Dysfunction Exercise Echocardiography Tricuspid Annular Plane Systolic Excursion (TAPSE)