International Journal of Cardiovascular Practice
Volume:4 Issue: 1, Mar 2019

Pregnancy represents a physiologic hypercoagulable state. The presence of inherited thrombophilias (factor V Leiden, prothrombin G20210A mutation, deficiencies of protein C, protein S and antithrombin) or acquired thrombophilias (antiphospholipid syndrome) increases the risk for venous thromboembolism, which represents one of the most common causes of direct maternal death. The clinical diagnosis of thrombosis can be difficult because of the overlap of symptoms with pregnancy-related manifestations. Antiphospholipid syndrome is correlated with early and late pregnancy complications whereas the association between the inherited thrombophilias and adverse pregnancy outcomes is still controversial. The psychological impact of thrombophilia in pregnancy should be also taken into consideration to prevent the negative effects of anxiety and stress on mother’s health and on birth outcomes. Thrombophilia testing in pregnancy is recommended only in cases in which the result is likely to influence the therapeutic decision. Low-molecular-weight heparins are the preferred anticoagulant for prophylaxis and therapy of thromboembolic events in pregnancy, presenting a low incidence of side effects. Future research is required to establish the optimal therapeutic strategy in pregnant women with thrombophilia, based upon a better stratification, in order to prevent thromboembolism and to improve pregnancy outcomes.

Determining the rate and regularity of peripheral arterial pulses has a major role in assessing the clinical status of patients with cardiovascular disorders. We compared two training methods on the ability of patients to take their radial pulse rate accurately. Three-hundred patients were randomly divided into two arms. One arm received individual face-to-face training and the other arm received group training via displaying an animation movie. Immediately after the training and then after 48 hours, the patients were tested by a nurse to find out whether they have learned the correct technique of taking radial pulse rate or not. Immediately after the intervention, 84.9% in face-to-face arm and 81.8% in group training arm were able to correctly count their radial pulse rate (P = 0.536). After 48 hours, 71.7% in face-to-face and 60.8% in group training arm were able to correctly count their radial pulse rate (P = 0.051). Both methods were effective to improve the ability of the patients to count their radial pulse rate correctly though face-to-face method was marginally superior to group training.

The ischemic time serves as the most important parameter for treatment choice in patients with ST–elevation myocardial infarction (STEMI). The current study aimed at comparing the short– and long–term follow–up of elderly patients with STEMI undergoing primary angioplasty (PCI) or thrombolytic therapy. The current cross sectional study was conducted on all patients aged >65 years, admitted to the emergency department of Imam Hossein Hospital, Tehran, Iran from January 2014 to July 2016, diagnosed with STEMI . The demographics, medical history, family history, and mediation history were recorded for all patients. Patients received PCI or thrombolytic therapy based on the ischemic time and the treatment outcome and the following events were recorded. Patients were contacted after six months and data of their death or used treatments were recorded. All data were compared between the groups. Of all patients, 38 subjects received thrombolytic therapy and 62 PCI. There was no significant difference between the groups in terms of mean age and gender (P=0.5 and 0.1, respectively). The frequency of positive medical history and smoking did not differ between the groups. There was no difference in the mean values of vital signs or serum parameters, mean ischemic time, left ventricular ejection fraction (LVEF), frequency of pulmonary emboli, cardiogenic shock, the involved vessel, and post-treatment complications between the groups (P>0.05). Of the 14 cases that died after six months, five were in the thrombolytic therapy group and nine in the PCI group (P=0.8). Mean hospital stay was not different between the groups (P=0.5). The results of the present study on two groups with similar demographics showed no significant difference between the groups in terms of the short– and long–term follow–up of PCI and thrombolytic therapy. The results indicated the appropriateness of treatment choice based on ischemic time and the available methods.

The current study described the electrocardiography case of a 22-year-old male, a few months after heart transplantation that demonstrated two sets of QRS leading to understand the technique of the transplantation.

Superselective bronchial embolization is recently performed with a high success rate. The current study aimed at discussing the procedure and reporting two cases underwent embolization in the Masih-Daneshvari Hospital, a large center for this procedure, in Iran.