فهرست مطالب barun kumar

Pericardial effusion is usually caused by infection, fluid overload states, connective tissue disorders, heart surgery, aortic dissection, and malignancy. When a patient presents with recurrent isolated pericardial effusion accompanied by a nonspecific history and negative laboratory tests, it can pose a diagnostic dilemma to the clinician. Primary malignant tumors of the pericardium are sporadic, and most primary malignant pericardial tumors are mesotheliomas. We report the case of a young adult male with recurrent pericardial effusion and no specific clinical clues enabling an early diagnosis, which later turned out to be caused by a primary angiosarcoma of the pericardium.

Cardiac haemangiomas (CH) are rare benign primary tumours of the heart and constitute nearly 2.8% of primary cardiac tumours. In a-48-year-old female, a cardiac tumour mass over right ventricular out flow area and main pulmonary artery was detected during diagnostic workup for aetiology of recurrent pericardial effusion. Echocardiograhy and pericardial fluid findings were non conclusive. Contrast enhanced Computed tomography (CECT) and Positron emission tomography (PET) scan imaging found the exophytic, moderately hypermetabolic, heterogeneous mass lesion posterolateral to main pulmonary trunk. We did partial resection of lesion without cardiac reconstruction and open incisional biopsy through midline sternotomy incision. Histopathological analysis confirmed this as a case of Capillary type of haemangioma of heart.

There is lack consensus on superiority of transparent vs. pressure dressing for prevention of post-cardiac catheterization pain, discomfort and hematoma. Therefore, we conducted this systematic review and meta-analysis of available RCTs on this subject.

We performed a systematic search of RCTs published between in 2000-2019 in English language using databases including PubMed Medline, EMBASE, CINAHL, Cochrane Library, ERMED Journals, Clinical trials database, DELNET, Google Scholar and Discovery Search. Studies conducted on adult patients with femoral dressing after cardiac catheterization measuring pain, discomfort, hematoma as intended outcomes have been included. Data extraction, critical appraisal, assessment of risk bias was done and decisions on quality were made on mutual consensus. Mantel-Haenszel (MH) and odds ratio for dichotomous variables was calculated by Review Manager 5.3 software.

Out of all identified studies, only 5 studies comprising 664 patients fulfilled the inclusion criteria and met the quality assessment. Incidence of discomfort (25, 333) were significantly less in transparent dressing group as compared to pressure dressing group (149, 331); odds ratio 0.10, 95% confidence interval [CI] 0.06-0.15; I2 = 0%, P= 0.00. Four studies reported significantly lower number of pain cases in transparent dressing (17, 203) as compared to pressure dressing (57, 201); odds ratio 0.13, 95% confidence interval [CI] 0.03-0.59; I2 = 47%, P= 0.01). However, incidence of hematoma did not reveal any significant difference between two groups.

Transparent dressing is a better option in patients with femoral/groin dressing after cardiac catheterization as it is more effective in prevention of pain and discomfort.

One of the rare abnormalities of coronary artery anatomy is the common origin of all three coronary arteries from the right sinus of Valsalva, which, may associated with myocardial ischemia. Percutaneous coronary intervention of such patients with anomalous coronary arteries is particularly challenging. In such patients femoral route is usually chosen for coronary angioplasty, various studies have proved that the radial access provides better engagement and robust support to the guide catheter. We report a rare case diagnosed with ST-segment elevated myocardial infarction. The patient underwent successful trans-radial primary angioplasty with a buddy wire, parked in the non-culprit artery