M. Tameem Akhtar

Rutgers, The State University of New Jersey

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Kevin Joseph Jerome Borges

Ziauddin University

Umair Ahmad

University of Lahore

Edo Kaluski

Commonwealth Medical College

Rubina Hussain

Guttmacher Institute

Eyad Alhaj

Franciscan University of Steubenville

Marc Klapholz

Rutgers New Jersey Medical School

Ralph G. Oriscello

East Orange VA Medical Center

Andrew Zabolotsky

Jefferson College

Daniel R. Zakhary

Winthrop-University Hospital

Apostolos Voudouris

Christ Hospital

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Rutgers New Jersey Medical School

Rutgers, The State University of New Jersey

Ziauddin University

Ziauddin Hospital

Emory University

Columbia University

Hackensack University Medical Center

University of Lahore

Government of Khyber Pakhtunkhwa

The Ohio State University Wexner Medical Center

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Atypical stress-induced cardiomyopathy: a case series

Acta Cardiologica (2013)

Eyad Alhaj Umair Ahmad Oussama T. Niazi Daniel R. Zakhary M. Tameem Akhtar

Stress-induced cardiomyopathy (SIC) is characterized by reversible left ventricular (LV) systolic dysfunction, which appears to be triggered by an intense, stressful event in the absence of significant coronary artery disease. It manifests typically with transient left ventricular wall motion abnormalities (WMA) involving the apical and/or mid-ventricular myocardial segments, associated with minimal troponin rise (<5 ng/ml), and typical EGG changes. Described are 3 cases of stress-induced cardiomyopathy with atypical distribution of wall motion abnormalities. Possible contributing mechanisms to the pathogenesis and the variability in WMA are discussed.

10.1080/ac.68.2.2967286

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EFFECTS OF VARIATION IN UMBILICAL ARTERY FLOW ON FOETAL MIDDLE CEREBRAL ARTERY FLOW IN HYPERTENSIVE PREGNANCIES

Kevin Joseph Jerome Borges Nuzhat Hassan Rubina Hussain M. Tameem Akhtar

Introduction: Cerebral vasodilation occurs in conditions of hypovolemia and cerebral hypoxia in adults. This effect is also found in foetuses. In gestational hypertension, blood flow to the foetus is compromised creating a situation somewhat similar to hypovolemia and cerebral hypoxia. Doppler ultrasound indices namely Resistive Index (RI) Pulsatility Index (PI) and Systolic-Diastolic Ratio (S/D)are useful tools in picking these changes in blood flow. The aim of this study was to see the effects of alterations in umbilical artery flow on foetal middle cerebral arterial flow with Doppler ultrasound parameter. Material and Methods: Ninety pregnant women with pregnancy-induced hypertension were selected with gestational age >35 weeks. Doppler ultrasound examination were carried out to record Pulsatility Index (PI), Resistive Index (RI), and Systolic-Diastolic Ratio (S/D) of Umbilical artery (UA) and Foetal Middle Cerebral Artery (MCA). Pearson’s correlation was determined between UA and MCA PI, RI and SD. Results: A non-significant (p=0.067) negligible negative correlation (r= -0.194) was seen between UA PI and MCA PI. A significant (p=0.000) very strong negative correlation (r= -0.754) was present between the UA RI and MCA RI. A significant (p=0.002) moderate negative correlation (r= -0.328) was observed between UA SD and MCA SD. Conclusion: A significant negative correlation was observed between the resistive indices and SD ratios of umbilical and middle cerebral arteries. No significant correlation was found between the pulsatility indices of the two arteries.

Umbilical artery

Anterior cerebral artery

Hypovolemia

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