Abstract We report an elderly woman with renal stones, in whom a calcified dissecting aortic aneurysm was discovered. We discuss the implications for subsequent management.
Abstract Physiological changes of pregnancy exert stress on the heart that could lead to cardiac decompensation, especially in the presence of background diseases such as cardiomyopathy, hypertension, valvular, or congenital heart diseases. Heart disease in pregnancy is an important contributor to maternal and fetal adverse outcomes. Although data on heart disease in pregnancy are generally scarce, a few available studies have shown higher prevalence in northern than southern regions of Nigeria. In addition, clinical outcomes among pregnant women diagnosed with heart disease are worse than among those without and apparently healthy women. The aim of this review was to describe the pattern and outcomes of heart disease in pregnancy in Northern Nigeria and to identify the existing gaps in knowledge, which can be explored in a subsequent multicenter national study.
Abstract Introduction: Patients with human immunodeficiency virus (HIV) infection are at increased risk of cardiovascular disease compared with the general population, and right ventricular (RV) systolic dysfunction is said to be associated with worse outcomes. HIV infection is an established risk factor for pulmonary hypertension. On the other hand, pulmonary hypertension directly affects RV function through an increase in pulmonary vascular resistance, causing right ventricle hypertrophy, chamber dilatation, and ultimately RV systolic dysfunction. We, therefore, sought to assess RV systolic function (RVSF) using RV fractional area change (RVFAC) among HIV patients on highly active antiretroviral therapy (HAART) and its relationship with viral load and CD4 cell count. Methods: The study was a cross-sectional conducted among HIV patients receiving HAART at the Federal Medical Center, Nguru, Yobe State, North Eastern Nigeria, using RVFAC among HIV patients on HAART and its relationship with viral load and CD4 cell count. Results: One hundred and seven subjects were recruited into the study, comprising 37 (34.6%) males and 70 (65.4%) females. Ninety-six (89.71%) had preserved RVSF, while 11 (10.3%) had reduced RVSF. The mean CD4 cell count of patients with preserved RVSF was significantly higher compared to those with reduced RVSF (838.4 ± 27.5 cells/μL and 301.7 ± 12.4 cells/μL), respectively P ≤ 0.001. The mean viral load of patients with preserved was significantly lower compared to those with reduced RVSF (547.9 ± 10.8 1 copies/mL and 10,293.00 ± 74.8 1 copies/mL), respectively P ≤ 0.001. Conclusion: The prevalence of RV systolic dysfunction among HIV patients on HAART was found to be 10.3% and there was a significant positive correlation between RVFAC with CD4 cell count and a significant negative correlation between RVFAC with HIV viral load.
Abstract Interest in cardiac electrophysiology is increasing in sub Saharan Africa, but the interpretation of results is poorly understood. Cardiac electrophysiology is the study of the electrical activity of the heart by virtue of catheters that are positioned in the heart in addition to leads placed on the chest surface. It is useful in identifying sites of origin of various cardiac arrhythmias, diagnosing conduction abnormalities, and treating various arrhythmias. This is the second in a series reviewing cardiac electrophysiology methods. The first introduced cardiac electrophysiology and assessment of the sinus and atrioventricular nodes. This paper reviews the assessment of supraventricular tachycardias.
Abstract Endomyocardial fibrosis (EMF) is characterized by the abnormal scarring of the endocardium with deposition of fibrous tissues in the apices and inflow tracts of the right ventricle, left ventricle, or both, leading to symptoms such as heart failure, arrhythmias, and intracardiac thrombosis. EMF is a rare cause of cardiac morbidity and mortality in children of the tropics including Nigeria, hence the presentation of this case report. A 12-year-old male presented to Children emergency ward with abdominal swelling from infancy, which worsened 3 months before presentation, leg swelling and weight loss of 3 months, cough of 1 month, and fast breathing of 1 week. Physical examination revealed dyspnea, pedal and leg edema, absent breath sounds in the right middle and lower lung zone, tachycardia, irregular pulse, elevated jugular venous pressure, and a grossly distended abdomen. Echocardiography demonstrated dilated atria, thickened AV valves, small, thickened ventricular cavities, intra-atrial thrombus, fibrous tissue in the apices and inlets of left and right ventricles, and pericardial effusion. Electrocardiography revealed first-degree AV block, left anterior fascicular block, and left atrial enlargement. Chest radiograph revealed right lobar pneumonia, pleural effusion, and cardiomegaly. The abdominopelvic scan revealed congestive hepatomegaly and ascites. He received diuretics, beta-blockers, aspirin, and antibiotics. Repeated abdominal paracentesis, thoracocentesis, and pericardiocentesis drained 14.2 L, 1.5 L, and 2.1 L of serosanguineous fluid, respectively. EMF is an enigmatic disease which requires further research to unravel its underlying mechanisms and develop more targeted therapeutic strategies.
