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To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (<40%), impaired LV functions or abnormal wall motions on transthoracic echocardiographies (TTEs), who underwent cardiac magnetic resonance (CMR) imaging viability studies were included. Patients with incomplete or limited studies (due to artifacts), previous coronary artery bypass graft (CABG), those who lost follow-ups, and those who were contraindicated or unfit for MRIs were excluded. An area of low signal intensity with no late gadolinium enhancement (LGE) was defined as thrombus on MR imaging, and two radiologists reached consensus report for the diagnoses. Patients with anterior or non-anterior wall MI were documented, and their ejection fractions were recorded. Percentage estimation of LV thrombi as detected on CMR studies was made. Any complications (like MI, stroke or death) that occurred within one year of diagnoses were documented. A Chi-square was used to determine association.

Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (<40%). Three out of 11 patients with LV thrombi developed complications versus 3 out of 114 without LV thrombi (P- value, .0005).

Left ventricular thrombi can be detected on cardiac viability studies in recently re-perfused STEMI patients and may possibly predict the risk of complications.

Left ventricular thrombi can be detected on cardiac viability studies in recently re-perfused STEMI patients and may possibly predict the risk of complications.Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a serious congenital malformation. Reports about asymptomatic, incidentally discovered ALCAPA in adults are scarce. We describe a patient with no known pre-existing cardiac condition admitted to our hospital with coronavirus disease 2019 (COVID-19) and was incidentally found to have ALCAPA. To the best of our knowledge, this is the first reported case of incidentally discovered ALCAPA in a COVID-19 patient and highlights the importance of appropriate investigation of the coronary status by Multidetector Cardiac Computed Tomographic Angiography (MDCCTA) in individuals with asymptomatic left ventricular dysfunction. The presentation of this case, discussion and literature review serves to iterate the necessity of appropriately investigating patients with asymptomatic LV dysfunction.

The purpose of this study is to measure the incidence of recurrence of discrete subaortic stenosis (DSS) after primary resection in two major cardiac centers in Saudi Arabia and to identify risk factors associated with recurrence.

Data on 234 patients who were diagnosed with DSS and underwent surgical resection between 1999 and 2018 were retrospectively reviewed. Patient demographics as well as echocardiographic, surgical, and pathological data were compared between patients with recurrence and non-recurrence.

The overall recurrence incidence after primary resection was 44.87% (N = 105). Most patients were male (59%). The median age at the 1

operation was 60 months (range 3 months to 133 months). The presence of aortic stenosis at the time of diagnosis was significantly associated with recurrence (p-value = 0.002). The overall median peak gradient in which the primary resection was indicated is 60 mmHg (range 11 to 152 mmHg). The median peak gradient pre-operation and post-operation were significantly higher for the recurrence group (p-value=0.018 and p<0.001, respectively). We used univariate and multivariate analysis and controlled for the follow-up time, but there were no significant independent predictors of recurrence.

The recurrence rate of DSS after the primary resection is relatively high in this study. Temsirolimus cost Further prospective studies are needed to draw a definite conclusion on risk factors for recurrence after primary resection.

The recurrence rate of DSS after the primary resection is relatively high in this study. Further prospective studies are needed to draw a definite conclusion on risk factors for recurrence after primary resection.During the COVID-19 pandemic, the effectiveness of the combination of hydroxychloroquine and azithromycin is widely discussed. This treatment can cause many severe cardiac side effects that makes us discuss its utility. The aim of this study is to describe the cardiovascular effect of hydroxychloroquine and azithromycin by analyzing surface ECG in patients with COVID-19. This observational cohort study included Moroccan patients with COVID-19 diagnosis and were hospitalized in Cheikh Khalifa International University Hospital, Casablanca, Morocco between March 26 and April 20, 2020. Patients were treated with a combination of hydroxychloroquine and azithromycin over a period of at least ten days. We were interested in the effects of this combination on the electrocardiogram. A total of 118 eligible patients were enrolled in the study. QT interval prolongation was observed in 19% of patients under the treatment. Only 5 patients required discontinuation of treatment. The factors associated with QT prolongation are male gender (P value 0,043), age over 68 years (P value 0,09), cardiovascular comorbidity (P value 0,013), tisdale score ≥11 (P value less then 0,001), and a severe form of COVID-19 (P value less then 0,001). First degree atrioventricular block was observed in 2 patients. No serious rhythm or conduction disorders were observed in this study. QT prolongation is a real risk with the combination of hydroxychloroquine and azithromycin. In the current context, it is necessary to select patients at high risk of severe rhythm disturbances that require closer ECG monitoring. Treatment should be discontinued if there are alarming signs such as QTc prolongation beyond 550 ms and the development of ventricular extrasystole or torsade de pointe.