Displaying publications 101 - 120 of 188 in total

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  1. [Possibilities for predicting of cardiac arrhythmias and conductivity disorders in former athletes.]
    Krysiuk OB, Obrezan AG, Zadvorev SF, Yakovlev AA
    Adv Gerontol, 2020;33(1):131-136.
    PMID: 32362096
    In order to analyze the relationship between the athletic qualification and syndrome of cardiac rhythm and conductivity disturbances in former athletes, a retrospective analysis of medical records of 39 male former athletes with cardiovascular complaints (mean age 61,6±11,3 years, mean duration of career in sports 23,9±17,3 years, mean duration of post-athletic period 20,1±9,9 years) was carried out. The patients were screened for cardiac arrhythmias and underwent echocardiography. The overall prevalence of sustained paroxysms of atrial fibrillation was 42%, increasing with the athletic qualification. Ryan grade 4b-5 premature ventricular contractions were found in 14% of patients. 3 parameters were found to be the independent predictors of arrhythmias in former athletes, i. e. athletic qualification, multifocal atherosclerosis (as an anti-risk factor), and age. The coefficient of determinance for the created prognostic model reached 43%. Further prospective studies are needed to validate an algorithm.
    Matched MeSH terms: Echocardiography
  2. A case of surgically resected cardiac rhabdomyoma with progressive left ventricular outflow tract obstruction
    Mohammed F, Tan GC, Hor KN, Arnold M, Wong YP
    Cardiovasc. Pathol., 2020 05 12;49:107226.
    PMID: 32574866 DOI: 10.1016/j.carpath.2020.107226
    Cardiac rhabdomyoma is the most prevalent cardiac tumors in the pediatric population, in close association with tuberous sclerosis complex. It is usually detected antenatally or postnatally by echocardiography. Clinical presentations depend greatly on the size and position of the tumor mass. Interestingly, rhabdomyoma has a propensity to regress spontaneously and is not usually operated upon, unless the patient becomes hemodynamically compromised. Herein, we report an unusual case of surgically treated cardiac rhabdomyoma in a baby boy presented at birth with a progressive enlarging intraventricular mass, complicated with left ventricular outflow tract obstruction 7 weeks later. Histopathological examination of the intracardiac mass revealed sheets of tumor cells with spider-like morphology (known as "spider cells"), confirmed the diagnosis of rhabdomyoma. Close disease monitoring of patient's hemodynamic status in a newly diagnosed cardiac rhabdomyoma is inevitable as the tumor, although rare, may progress.
    Matched MeSH terms: Echocardiography
  3. Fulltext Ruling out PE: anovelapproach usingend-tidal CO2 with compression Ultrasonography and transthoracic Echocardiography in Pulmonary Embolism Diagnosis (CUEPED)
    Cheong, Chee Yen, Rashidi Ahmad, Nesarajah, Kiran, Aida Bustam, Muhaimin Noor Azhar
    Malaysian Journal of Emergency Medicine, 2017;2(1):1-8.
    MyJurnal
    Diagnosis of pulmonary embolism (PE) remains a challenge in clinical practice, especially in emergency setting despite availability of various diagnostic tools. It is desirable to have a rapid and accurate bedside test to rule out PE.The aim of this study is to evaluate the diagnostic accuracyof CUEPED, a novel method of ruling out pulmonary embolism using a combination of end-tidal CO2(ETCO2), Compression Ultrasonography (CUS) and Transthoracic Echocardiography (TTE).In this pilot study, patients who presented to the Emergency Department at Univers it y Malaya Medical Centre with suspected acute PE from December 2013 to October 2014,who fulfilled the inclusion and exclusion criteria, were assessed using CUEPED. CUEPED was considered positive if the measured ETCO2 was less than 35 mmHg, or if there was presence of venous incompressibility in lower limb ultrasonography orif tricuspid annular plane systolic excursion (TAPSE) in transthoracic echocardiography was less than 1.6. All patients received a computed tomography pulmonary angiography (CTPA) for confirmation of diagnosis. Data obtained was analyzed to determine if a negative CUEPED has the potential to accurately rule out a PE. 30 patients (mean age = 48 years [SD = 13.6]) were involved with an equal distribut io nbetween gender. The incidence of PE was 56.7%. CUEPED had a sensitivity of 100% for PE. Negative CUEPED ruled out PE with a negative predictive value of 100%. Positive CUEPED ruled in PE with a low specificity of 53.8% and moderate positive predictive value of 73.9%. This diagnostic study showedthat a negative CUEPED is potentially accurate in ruling out PE.
    Matched MeSH terms: Echocardiography
  4. Fulltext Hyperthyroidism presenting as ST Elevation Myocardial Infarction with Normal Coronaries - A Case Report
    Krishnan GD, Yahaya N, Yahya M
    J ASEAN Fed Endocr Soc, 2019;34(1):92-94.
    PMID: 33442142 DOI: 10.15605/jafes.034.01.14
    A 31-year-old male, apparently well, presented with typical chest pain. His ECG showed ST-elevation from V1-V4 and echocardiogram revealed anteroseptal wall hypokinesia with ejection fraction of 45%. Normal coronary arteries were seen on coronary angiogram. A thyroid function test showed elevated free T4 levels with suppressed thyroid stimulating hormone (TSH). Treatment with thionamides and beta-blockers improved symptoms. Upon review 4 months later he was well. Repeat echocardiogram showed good ejection fraction with no hypokinetic area.
    Matched MeSH terms: Echocardiography
  5. The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients
    Yap LB, Qadir F, Nguyen ST, Ma SK, Koh KW, Muhammad Z, et al.
    Int J Cardiol, 2015 Mar 15;183:178-9.
    PMID: 25666128 DOI: 10.1016/j.ijcard.2015.01.042
    Matched MeSH terms: Echocardiography/methods
  6. Persistent valve of systemic venous sinus: a cause of neonatal cyanosis
    Qureshi AU, Latiff HA, Sivalingam S
    Cardiol Young, 2014 Aug;24(4):756-9.
    PMID: 24016801 DOI: 10.1017/S1047951113001200
    Incomplete involution of valve of systemic venous sinus can present across a spectrum of anatomical lesions ranging from eustachian valve to division of right atrium (cor triatriatum dexter) with overlapping features. We present the case of a neonate presenting with cyanosis, having persistent valve of systemic venous sinus with anatomical details of the redundant tissue in right atrium suggesting an intermediate form between Chiari network and division of right atrium.
    Matched MeSH terms: Echocardiography, Doppler, Color; Echocardiography, Three-Dimensional
  7. Fulltext Cardiac imaging in valvular heart disease
    Choo WS, Steeds RP
    Br J Radiol, 2011 Dec;84 Spec No 3:S245-57.
    PMID: 22723532 DOI: 10.1259/bjr/54030257
    The aim of this article is to provide a perspective on the relative importance and contribution of different imaging modalities in patients with valvular heart disease. Valvular heart disease is increasing in prevalence across Europe, at a time when the clinical ability of physicians to diagnose and assess severity is declining. Increasing reliance is placed on echocardiography, which is the mainstay of cardiac imaging in valvular heart disease. This article outlines the techniques used in this context and their limitations, identifying areas in which dynamic imaging with cardiovascular magnetic resonance and multislice CT are expanding.
    Matched MeSH terms: Echocardiography/methods
  8. Enhanced optical flow field of left ventricular motion using quasi-Gaussian DCT filter
    Riyadi S, Mustafa MM, Hussain A, Maskon O, Nor IF
    Adv Exp Med Biol, 2011;696:461-9.
    PMID: 21431586 DOI: 10.1007/978-1-4419-7046-6_46
    Left ventricular motion estimation is very important for diagnosing cardiac abnormality. One of the popular techniques, optical flow technique, promises useful results for motion quantification. However, optical flow technique often failed to provide smooth vector field due to the complexity of cardiac motion and the presence of speckle noise. This chapter proposed a new filtering technique, called quasi-Gaussian discrete cosine transform (QGDCT)-based filter, to enhance the optical flow field for myocardial motion estimation. Even though Gaussian filter and DCT concept have been implemented in other previous researches, this filter introduces a different approach of Gaussian filter model based on high frequency properties of cosine function. The QGDCT is a customized quasi discrete Gaussian filter in which its coefficients are derived from a selected two-dimensional DCT. This filter was implemented before and after the computation of optical flow to reduce the speckle noise and to improve the flow field smoothness, respectively. The algorithm was first validated on synthetic echocardiography image that simulates a contracting myocardium motion. Subsequently, this method was also implemented on clinical echocardiography images. To evaluate the performance of the technique, several quantitative measurements such as magnitude error, angular error, and standard error of measurement are computed and analyzed. The final motion estimation results were in good agreement with the physician manual interpretation.
    Matched MeSH terms: Echocardiography/statistics & numerical data*
  9. Performance of emergency physicians in point-of-care echocardiography following limited training
    Bustam A, Noor Azhar M, Singh Veriah R, Arumugam K, Loch A
    Emerg Med J, 2014 May;31(5):369-73.
    PMID: 23428721 DOI: 10.1136/emermed-2012-201789
    OBJECTIVES: The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.
    METHODS: Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.
    RESULTS: 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was -9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.
    CONCLUSIONS: Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
    Study site: Trauma and emergency department, University of Malaya Medical Centre, Kuala Lumpur
    Matched MeSH terms: Echocardiography*
  10. Real-time signal processing for fetal heart rate monitoring
    Ibrahimy MI, Ahmed F, Mohd Ali MA, Zahedi E
    IEEE Trans Biomed Eng, 2003 Feb;50(2):258-62.
    PMID: 12665042
    An algorithm based on digital filtering, adaptive thresholding, statistical properties in the time domain, and differencing of local maxima and minima has been developed for the simultaneous measurement of the fetal and maternal heart rates from the maternal abdominal electrocardiogram during pregnancy and labor for ambulatory monitoring. A microcontroller-based system has been used to implement the algorithm in real-time. A Doppler ultrasound fetal monitor was used for statistical comparison on five volunteers with low risk pregnancies, between 35 and 40 weeks of gestation. Results showed an average percent root mean square difference of 5.32% and linear correlation coefficient from 0.84 to 0.93. The fetal heart rate curves remained inside a +/- 5-beats-per-minute limit relative to the reference ultrasound method for 84.1% of the time.
    Matched MeSH terms: Echocardiography/methods*
  11. Inverted left atrial appendage masquerading as a cardiac mass
    Leong MC, Latiff HA, Hew CC, Mazlan SL, Osman H
    Echocardiography, 2013 Feb;30(2):E33-5.
    PMID: 23134298 DOI: 10.1111/echo.12044
    An inverted left atrial appendage is a rare phenomenon post cardiac surgery. The lesion presents as an additional mass in the left atrium, which would trigger unnecessary concerns and frequently, a battery of tests. The lesion can be easily diagnosed using echocardiography. We report a case of inverted left atrial appendage in a patient post repair of common arterial trunk. Echocardiographic pictures and features which help to identify this lesion as well as to differentiate it from other possible left atrial mass are described. This article aimed to improve the awareness of sonographers toward this rare but possible post operative lesion.
    Matched MeSH terms: Echocardiography, Transesophageal/methods*
  12. Fulltext Persistent left superior vena cava and absence of innominate vein during coronary artery bypass surgery
    Tan JH, Ng ZQ, Vendargon S
    BMJ Case Rep, 2018 Apr 17;2018.
    PMID: 29666108 DOI: 10.1136/bcr-2018-225271
    Matched MeSH terms: Echocardiography, Transesophageal/methods
  13. Diastolic dysfunction grading, echocardiographic and electrocardiogram findings in 50 patients with apical hypertrophic cardiomyopathy
    Aslannif R, Suraya K, Koh HB, Tey YS, Tan KL, Tham CH, et al.
    Med J Malaysia, 2019 12;74(6):521-526.
    PMID: 31929479
    INTRODUCTION: Apical Hypertrophic Cardiomyopathy (Apical HCM) is an uncommon variant of hypertrophic cardiomyopathy, but it is relatively more common in Asian countries. This is a retrospective, non-randomised, single centre study of patients with Apical HCM focusing on their diastolic dysfunction grading, echocardiographic parameters and electrocardiograms (ECG).

    METHODS: All Apical HCM patients coming for clinic visits at the Institut Jantung Negara from September 2017 to September 2018 were included. We assessed their echocardiography images, grade their diastolic function and reviewed their ECG on presentation.

    RESULTS: Fifty patient were included, 82% (n=41) were males and 18% (n=9) females. The diastolic function grading of 37 (74%) patients were able to be determined using the updated 2016 American Society of Echocardiography (ASE) diastolic guidelines. Fifty percent (n=25) had the typical ace-ofspades shape left ventricle (LV) appearance in diastole and 12% (n=6) had apical pouch. All patients had T inversion in the anterior leads of their ECG, and only 52% (n=26) fulfilled the ECG left ventricular hypertrophy (LVH) criteria. Majority of our patients presented with symptoms of chest pain (52%, n=26) and dyspnoea (42%, n=21).

    CONCLUSION: The updated 2016 ASE guideline makes it easier to evaluate LV diastolic function in most patients with Apical HCM. It also helps in elucidating the aetiology of dyspnoea, based on left atrial pressure. Clinicians should have a high index of suspicion for Apical HCM when faced with deep T inversion on ECG, in addition to a thick LV apex with an aceof- spades appearance during diastole.

    Matched MeSH terms: Echocardiography/methods*
  14. Fulltext Favourable outcome after peripartum cardiomyopathy: a ten-year study on peripartum cardiomyopathy in a university hospital
    Chee KH
    Singapore Med J, 2013 Jan;54(1):28-31.
    PMID: 23338913
    INTRODUCTION: Peripartum cardiomyopathy (PPCM) is an uncommon form of congestive heart failure, affecting obstetric patients around the time of delivery. The epidemiology of PPCM is infrequently reported. This study was undertaken to define the prevalence, presentation and outcome of PPCM among women giving birth in a teaching hospital in Malaysia.

    METHODS: A retrospective case record analysis was conducted on all patients admitted and diagnosed with PPCM at the University Malaya Medical Centre, Kuala Lumpur, Malaysia, from 1 January 2000 to 31 December 2009. All deliveries were undertaken in the same hospital.

    RESULTS: A total of 12 patients were diagnosed with PPCM during the ten-year study period. The prevalence of PPCM was 2.48 in 100,000 (1 in 40,322) live births. Nine women were diagnosed with PPCM within five months of delivery. Three women had twin pregnancies. There was one death in the group (mortality rate 8.3%). The mean left ventricular ejection fraction at the time of diagnosis was 28.9% ± 8.5% (range 15%-40%). Following the index event, left ventricular function normalised in six of the nine patients (66.7%) who underwent subsequent echocardiography one year later. All patients were treated with standard heart failure therapy. Two patients with normalised left ventricular function had subsequent pregnancies - one pregnancy was terminated at seven weeks and the other patient delivered uneventfully at full term.

    CONCLUSION: PPCM is uncommon. The outcome in our series was favourable, with 66.7% of patients with PPCM recovering their left ventricular function. The mortality rate was 8.3%.
    Matched MeSH terms: Echocardiography/methods
  15. Fulltext Symptomatic anaemia 17 years after double valve replacement
    Wong MH, Chee KH, Azman W
    Singapore Med J, 2009 Oct;50(10):e362-4.
    PMID: 19907876
    A 40-year-old Malay woman presented with increasing lethargy, palpitation and shortness of breath, 17 years after a mitral and aortic valve replacement. A Starr-Edwards prosthetic valve replaced the mitral valve, and a Bjork-Shiley prosthetic valve replaced the aortic valve. Biochemical parameters demonstrated intravascular haemolysis, as evidenced by haemoglobin 7.8 g/dL, reticulocyte count 8.4%, lactate dehydrogenase 2,057 IU/L and low haptoglobulin levels (less than 6 mg/dL). Transoesophageal echocardiography revealed a paravalvular leakage over the mitral valve. The haemoglobin levels remained persistently low despite frequent blood transfusions. She successfully underwent a second mitral valve replacement. Her anaemia resolved subsequently.
    Matched MeSH terms: Echocardiography, Transesophageal/methods
  16. Ductal Stenting to Retrain the Involuted Left Ventricle in d-Transposition of the Great Arteries
    Leong MC, Ahmed Alhassan AA, Sivalingam S, Alwi M
    Ann Thorac Surg, 2019 09;108(3):813-819.
    PMID: 30998905 DOI: 10.1016/j.athoracsur.2019.03.045
    BACKGROUND: Ductal stenting is performed to retrain involuted left ventricles (LVs) in patients with d-transposition of the great arteries and intact ventricular septum (TGA-IVS). However, its efficacy is largely unknown. This study aimed to determine the safety and efficacy of ductal stenting in retraining of the involuted LV in patients with TGA-IVS.

    METHODS: This was a single-center, retrospective study. Echocardiographic assessment of the LV geometry, mass, and free wall thickness was performed before stenting and before the arterial switch operation. Patients then underwent the arterial switch operation, and the postoperative outcomes were reviewed.

    RESULTS: There were 11 consecutive patients (male, 81.8%; mean age at stenting, 43.11 ± 18.19 days) with TGA-IVS with involuted LV who underwent LV retraining by ductal stenting from July 2013 to December 2017. Retraining by ductus stenting failed in 4 patients (36.3%). Two patients required pulmonary artery banding, and another 2 had an LV mass index of less than 35 g/m2. Patients in the successful group had improved LV mass index from 45.14 ± 17.91 to 81.86 ± 33.11g/m2 (p = 0.023) compared with 34.50 ± 10.47 to 20.50 ± 9.88 g/m2 (p = 0.169) and improved LV geometry after ductal stenting. The failed group was associated with an increased need for extracorporeal support (14.5% vs 50%, p = 0.012). An atrial septal defect-to-interatrial septum length ratio of more than 0.38 was associated with failed LV retraining.

    CONCLUSIONS: Ductal stenting is an effective method to retrain the involuted LV in TGA-IVS. A large atrial septal defect (atrial septal defect-to-interatrial septum length ratio >0.38) was associated with poor response to LV retraining.

    Matched MeSH terms: Echocardiography/methods
  17. Fulltext Successful anticoagulation with fresh frozen plasma for cardiopulmonary bypass in a patient with heparin resistance: a cautionary tale
    Badrin O, Kushairi S, Zakaria Z, Sachithanandan A
    BMJ Case Rep, 2013;2013.
    PMID: 23632185 DOI: 10.1136/bcr-2013-009112
    Heparin resistance (HR) is an increasingly common occurrence due to a greater awareness of the benefits of antithrombosis prophylaxis in hospitalised patients with low molecular weight and unfractionated heparin. Furthermore as more high-risk patients with prior heparin exposure undergo cardiac surgery we can expect to encounter more such cases. Adequate anticoagulation is essential for the safe conduct of any operation requiring cardiopulmonary bypass and is usually achieved with systemic heparinisation. We report a case of successful anticoagulation with the intraoperative administration of fresh frozen plasma in a high-risk coronary patient with HR and highlight the perils of unwitting overheparinisation in such cases. This case highlights the importance of clinical awareness of this phenomenon and the available alternative anticoagulants.
    Matched MeSH terms: Echocardiography
  18. Fulltext A young patient with history of Kawasaki disease presenting with triple vessel disease
    Lim AL, Lam HY, Kareem BA, Kamarulzaman MH
    Med J Malaysia, 2012 Apr;67(2):219-21.
    PMID: 22822650 MyJurnal
    Kawasaki disease is primarily a condition that affects young children and it is associated with cardiac morbidity and mortality. This disease has been known to cause coronary artery aneurysms which occurs as a sequelae of vasculitis. The progression of triple vessel disease in adult which results from cardiac complications from Kawasaki disease is rare. We report a case of a young man with history of Kawasaki disease at infancy presenting with triple vessel disease requiring cardiac bypass surgery at the age of 20 years old.
    Matched MeSH terms: Echocardiography
  19. Fulltext Cardiac mass in a patient with sigmoid adenocarcinoma: a metastasis?
    Ngow HA, Khairina WM
    Cardiovasc J Afr, 2012 Aug;23(7):e10-2.
    PMID: 22915057 DOI: 10.5830/CVJA-2012-027
    Cardiac metastasis from a bowel malignancy seldom occurs and there is a limited number of case reports published on this subject. Although colorectal cancer is the third commonest malignancy in Malaysia, the incidence of cardiac metastasis has never been reported. We report a case of an elderly man with recently diagnosed adenocarcinoma of the sigmoid colon, who presented with congestive cardiac failure secondary to mechanical obstruction by a right atrial mass. The intractable shock led to his sudden death before any intervention could be planned. If an intra-cavity cardiac mass is detected in a patient with an underlying metastatic malignancy, cardiac metastasis should be suspected. However, primary cardiac tumour or thrombus could also be the differential diagnosis. In our case, the definitive cardiac pathology remained unsolved as an autopsy was refused.
    Matched MeSH terms: Echocardiography
  20. Fulltext Tako-Tsubo like syndrome triggered by meperidine
    Sacco A, Morici N, Belli O, Bossi I, Mafrici A, Klugmann S
    Med J Malaysia, 2011 Dec;66(5):520-1.
    PMID: 22390119
    We present a case of "inverted Tako-Tsubo" syndrome in a woman sedated with meperidine before undergoing a colonscopy. We discuss possible etiology of this ventricular dysfunction.
    Matched MeSH terms: Echocardiography
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