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This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1083028" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Rupture of Sinus of Valsalva aneurysm (SVA) may be either congenital or acquired. This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial infarction. The sinus of Valsalva aneurysm and the intracardiac shunt track into the right atrium was not defined by the twodimensional echocardiography could be seen by 64-slice multi detector computed tomography (MDCT).</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1083028" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="1018c4beebfd4be619ebdec9005260da" rel="nofollow" data-download="{"attachment_id":51111207,"asset_id":1083028,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/51111207/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="934832" href="https://hamad.academia.edu/JassimAlSuwaidi">Jassim Al Suwaidi</a><script data-card-contents-for-user="934832" type="text/json">{"id":934832,"first_name":"Jassim","last_name":"Al Suwaidi","domain_name":"hamad","page_name":"JassimAlSuwaidi","display_name":"Jassim Al Suwaidi","profile_url":"https://hamad.academia.edu/JassimAlSuwaidi","photo":"https://0.academia-photos.com/934832/374999/1775788/s65_jassim.al_suwaidi.jpg"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-1083028">+1</span><div class="hidden js-additional-users-1083028"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-1083028'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-1083028').html(); 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class="clearfix u-pv7x u-mb0x js-work-card work_1635733 coauthored" data-work_id="1635733" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635733/Comparison_of_Men_and_Women_With_Acute_Coronary_Syndrome_in_Six_Middle_Eastern_Countries">Comparison of Men and Women With Acute Coronary Syndrome in Six Middle Eastern Countries</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The aim of this study was to evaluate the gender differences in baseline characteristics, therapy, and outcomes in patients with acute coronary syndromes in 6 Middle Eastern countries. Over a 6-month period in 2007, 8,169 consecutive... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635733" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The aim of this study was to evaluate the gender differences in baseline characteristics, therapy, and outcomes in patients with acute coronary syndromes in 6 Middle Eastern countries. Over a 6-month period in 2007, 8,169 consecutive patients (74% men, 24% women) presenting with acute coronary syndromes were enrolled in a prospective, multicenter study from 6 adjacent Middle Eastern countries. Women were 9 years older than men and more likely to have diabetes, hypertension, and dyslipidemia. Women were more likely to present with unstable angina and more often had atypical presentations of ST elevation myocardial infarction. Compared to men, women were significantly less treated with ␤ blockers and antiplatelet therapy, whereas reperfusion therapy was nonsignificantly less used in women. In all patients with acute coronary syndromes, women not only ranked higher on Global Registry of Acute Coronary Events risk score but also had increased in-hospital mortality, 1.75 times that of men. This mortality difference persisted after adjusting for all confounders (odds ratios 1.76, 95% confidence interval 1.1 to 2.8, p <0.01).</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635733" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="14cad2dbc67386d01133ad0e103f0769" rel="nofollow" data-download="{"attachment_id":50891004,"asset_id":1635733,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50891004/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-1635733">+1</span><div class="hidden js-additional-users-1635733"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/RajvirSingh6">Rajvir Singh</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-1635733'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-1635733').html(); 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Over a 6-month period in 2007, 8,169 consecutive patients (74% men, 24% women) presenting with acute coronary syndromes were enrolled in a prospective, multicenter study from 6 adjacent Middle Eastern countries. Women were 9 years older than men and more likely to have diabetes, hypertension, and dyslipidemia. Women were more likely to present with unstable angina and more often had atypical presentations of ST elevation myocardial infarction. Compared to men, women were significantly less treated with ␤ blockers and antiplatelet therapy, whereas reperfusion therapy was nonsignificantly less used in women. In all patients with acute coronary syndromes, women not only ranked higher on Global Registry of Acute Coronary Events risk score but also had increased in-hospital mortality, 1.75 times that of men. This mortality difference persisted after adjusting for all confounders (odds ratios 1.76, 95% confidence interval 1.1 to 2.8, p \u003c0.01).","publication":"The American journal of …","publication_with_fallback":"The American journal of 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Mortality","url":"https://www.academia.edu/Documents/in/Hospital_Mortality"},{"id":1863718,"name":"The American","url":"https://www.academia.edu/Documents/in/The_American"}],"publication_year":2009,"publication_year_with_fallback":2009,"paper_rank":null,"all_time_views":9,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635734" data-work_id="1635734" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635734/Left_main_coronary_artery_stenosis_state_of_the_art">Left main coronary artery stenosis: state-of-the-art</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Patients with stenosis of the left main coronary artery present difficult challenges. The risks associated with this lesion have been known since the early days of angiography when patients were found to have increased mortality during... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635734" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Patients with stenosis of the left main coronary artery present difficult challenges. The risks associated with this lesion have been known since the early days of angiography when patients were found to have increased mortality during follow-up. This information led to the general guidelines that surgical revascularization should be considered the treatment of choice in patients with significant left main coronary artery stenosis. Current advances in invasive cardiology have brought important information to the field. Intravascular ultrasound is now used routinely to evaluate angiographically indeterminate lesions with criteria now set forward as to what constitutes an indication for revascularization. Stents have even further dramatically changed the landscape. There are substantial issues, however, that need to addressed. These include the following: (1) the effect of specific lesion location on outcome-it is known that patients with distal bifurcation left main disease have worse outcome; (2) the potential for subacute thrombosis of the left main coronary artery; (3) the impact of left ventricular function and patient comorbidities irrespective of the degree and location of left main coronary artery stenosis; and (4) the risk-benefit ratio of stenting versus coronary artery bypass graft surgery. These issues are currently being addressed in two seminally important trials including the SYNTAX trial, which randomizes patients with left main and/or three-The authors have no conflict of interest to disclose.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635734" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="f40f22a022fc6e5c2984f97581389382" rel="nofollow" data-download="{"attachment_id":50891008,"asset_id":1635734,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50891008/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635734 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635734"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635734, container: ".js-paper-rank-work_1635734", }); 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The risks associated with this lesion have been known since the early days of angiography when patients were found to have increased mortality during follow-up. This information led to the general guidelines that surgical revascularization should be considered the treatment of choice in patients with significant left main coronary artery stenosis. Current advances in invasive cardiology have brought important information to the field. Intravascular ultrasound is now used routinely to evaluate angiographically indeterminate lesions with criteria now set forward as to what constitutes an indication for revascularization. Stents have even further dramatically changed the landscape. There are substantial issues, however, that need to addressed. These include the following: (1) the effect of specific lesion location on outcome-it is known that patients with distal bifurcation left main disease have worse outcome; (2) the potential for subacute thrombosis of the left main coronary artery; (3) the impact of left ventricular function and patient comorbidities irrespective of the degree and location of left main coronary artery stenosis; and (4) the risk-benefit ratio of stenting versus coronary artery bypass graft surgery. These issues are currently being addressed in two seminally important trials including the SYNTAX trial, which randomizes patients with left main and/or three-The authors have no conflict of interest to disclose.","publication":"Current Problems in Cardiology","publication_with_fallback":"Current Problems in 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Agents","url":"https://www.academia.edu/Documents/in/Immunosuppressive_Agents"}],"publication_year":2007,"publication_year_with_fallback":2007,"paper_rank":null,"all_time_views":30,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635735" data-work_id="1635735" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635735/Anomalous_origin_of_the_three_coronary_arteries_from_the_right_aortic_sinus_Valsalva_Role_of_MDCT_coronary_angiography">Anomalous origin of the three coronary arteries from the right aortic sinus Valsalva: Role of MDCT coronary angiography</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background Monocuspal origin of all three coronary arteries through separate ostia from the right aortic sinus (RCS) is a rare occurrence. To date, the use of multidetector computed tomography (MDCT) for imaging of congenitally abnormal... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635735" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background Monocuspal origin of all three coronary arteries through separate ostia from the right aortic sinus (RCS) is a rare occurrence. To date, the use of multidetector computed tomography (MDCT) for imaging of congenitally abnormal coronary arteries has been discussed only in few individual case reports. Objective To describe the role of MDCT coronary angiography in the evaluation of two rare cases of monocuspal origin of all three coronary from RCS. Patients and methods We had a retrospective review of clinical information and imaging studies for two patients presented with chest pain. Both patients underwent conventional coronary angiography followed by noninvasive imaging with MDCT. Results Both patients had anomalous origin of the all three coronary arteries from the RCS. In one case the LAD took an intramural course in between the aorta and the right ventricular outflow tract (RVOT) while it passed anterior to the RVOT in the other patient. In the first patient, there was also associated coronary fistula to the right ventricle along with right coronary artery (RCA) and left anterior descending coronary artery (LAD) narrowing. Both the stenosed segments were successfully stented and were demonstrated to be patent in the subsequent MDCT. Conclusion Monocuspal origin of all three coronary artery from the RCS is a rare anomaly, can be reliably diagnosed by MDCT. CT angiogram is a convenient complementary tool for the coronary arteriography</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635735" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="2dd0bd4f688ac9a01a6a7aeb0b564c4c" rel="nofollow" data-download="{"attachment_id":17010378,"asset_id":1635735,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010378/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635735 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635735"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635735, container: ".js-paper-rank-work_1635735", }); 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To date, the use of multidetector computed tomography (MDCT) for imaging of congenitally abnormal coronary arteries has been discussed only in few individual case reports. Objective To describe the role of MDCT coronary angiography in the evaluation of two rare cases of monocuspal origin of all three coronary from RCS. Patients and methods We had a retrospective review of clinical information and imaging studies for two patients presented with chest pain. Both patients underwent conventional coronary angiography followed by noninvasive imaging with MDCT. Results Both patients had anomalous origin of the all three coronary arteries from the RCS. In one case the LAD took an intramural course in between the aorta and the right ventricular outflow tract (RVOT) while it passed anterior to the RVOT in the other patient. In the first patient, there was also associated coronary fistula to the right ventricle along with right coronary artery (RCA) and left anterior descending coronary artery (LAD) narrowing. Both the stenosed segments were successfully stented and were demonstrated to be patent in the subsequent MDCT. Conclusion Monocuspal origin of all three coronary artery from the RCS is a rare anomaly, can be reliably diagnosed by MDCT. CT angiogram is a convenient complementary tool for the coronary arteriography","publication":"The International Journal of …","publication_with_fallback":"The International Journal of 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href="https://www.academia.edu/Documents/in/Treatment_Outcome">Treatment Outcome</a>, <script data-card-contents-for-ri="12426" type="text/json">{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="28973" rel="nofollow" href="https://www.academia.edu/Documents/in/Comorbidity">Comorbidity</a>, <script data-card-contents-for-ri="28973" type="text/json">{"id":28973,"name":"Comorbidity","url":"https://www.academia.edu/Documents/in/Comorbidity","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="43520" rel="nofollow" href="https://www.academia.edu/Documents/in/Middle_East">Middle East</a><script data-card-contents-for-ri="43520" type="text/json">{"id":43520,"name":"Middle East","url":"https://www.academia.edu/Documents/in/Middle_East","nofollow":true}</script></span></li><script>(function(){ if (true) { new 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El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":10610,"name":"Survival Analysis","url":"https://www.academia.edu/Documents/in/Survival_Analysis","nofollow":true},{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome","nofollow":true},{"id":28973,"name":"Comorbidity","url":"https://www.academia.edu/Documents/in/Comorbidity","nofollow":true},{"id":43520,"name":"Middle East","url":"https://www.academia.edu/Documents/in/Middle_East","nofollow":true},{"id":71399,"name":"Hypertension","url":"https://www.academia.edu/Documents/in/Hypertension"},{"id":71511,"name":"Diabetes mellitus","url":"https://www.academia.edu/Documents/in/Diabetes_mellitus"},{"id":129457,"name":"Mayo Clinic","url":"https://www.academia.edu/Documents/in/Mayo_Clinic"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":194640,"name":"Patient 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Proceedings","url":"https://www.academia.edu/Documents/in/Mayo_Clinic_Proceedings"},{"id":1227768,"name":"Angiotensin Converting Enzyme Inhibitors","url":"https://www.academia.edu/Documents/in/Angiotensin_Converting_Enzyme_Inhibitors"},{"id":2366663,"name":"Glomerular Filtration Rate","url":"https://www.academia.edu/Documents/in/Glomerular_Filtration_Rate"},{"id":2463800,"name":"Severity of Illness Index","url":"https://www.academia.edu/Documents/in/Severity_of_Illness_Index"}],"publication_year":2010,"publication_year_with_fallback":2010,"paper_rank":null,"all_time_views":6,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635738" data-work_id="1635738" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635738/Persistent_Atrial_Standstill_in_Noncompaction_Cardiomyopathy">Persistent Atrial Standstill in Noncompaction Cardiomyopathy</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Atrial standstill is a rare form of bradyarrhythmia and consists of a transitory or permanent loss of the electrical and mechanical activity of the atria. It has been described in a few cases of long-standing valvular disease,... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635738" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Atrial standstill is a rare form of bradyarrhythmia and consists of a transitory or permanent loss of the electrical and mechanical activity of the atria. It has been described in a few cases of long-standing valvular disease, amyloidosis, myocarditis, and muscular dystrophy. We report on a young female with noncompaction cardiomyopathy that progressed to congestive heart failure. Electrocardiogram showed persistence atrial standstill that was confirmed clinically and by electrocardiomyopathy, Doppler two-dimensional echocardiogram, and tissue Doppler imaging. We assume that worsening of asymptomatic noncompaction and progression to the congestive form of cardiomyopathy could be presaged by the presence of persistent atrial standstill. Thus, persistence of atrail standstill in asymptomatic cardiomyopathy is a sign of poor prognosis.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635738" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="6a8529120ff42bdad2ddc608b3048e3c" rel="nofollow" data-download="{"attachment_id":17010404,"asset_id":1635738,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010404/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635738 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635738"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635738, container: ".js-paper-rank-work_1635738", }); });</script></li><li class="js-percentile-work_1635738 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 1635738; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_1635738"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_1635738 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="1635738"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 1635738; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=1635738]").text(description); $(".js-view-count-work_1635738").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_1635738").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="1635738"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">15</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="22506" rel="nofollow" href="https://www.academia.edu/Documents/in/Adolescent">Adolescent</a>, <script data-card-contents-for-ri="22506" type="text/json">{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="37788" rel="nofollow" href="https://www.academia.edu/Documents/in/Pediatric_Cardiology">Pediatric Cardiology</a>, <script data-card-contents-for-ri="37788" type="text/json">{"id":37788,"name":"Pediatric Cardiology","url":"https://www.academia.edu/Documents/in/Pediatric_Cardiology","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="39000" rel="nofollow" href="https://www.academia.edu/Documents/in/Electrocardiography">Electrocardiography</a>, <script data-card-contents-for-ri="39000" type="text/json">{"id":39000,"name":"Electrocardiography","url":"https://www.academia.edu/Documents/in/Electrocardiography","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="46824" rel="nofollow" href="https://www.academia.edu/Documents/in/Echocardiography">Echocardiography</a><script data-card-contents-for-ri="46824" type="text/json">{"id":46824,"name":"Echocardiography","url":"https://www.academia.edu/Documents/in/Echocardiography","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=1635738]'), work: {"id":1635738,"title":"Persistent Atrial Standstill in Noncompaction Cardiomyopathy","created_at":"2012-06-08T21:58:12.425-07:00","owner_id":1679792,"url":"https://www.academia.edu/1635738/Persistent_Atrial_Standstill_in_Noncompaction_Cardiomyopathy","slug":"Persistent_Atrial_Standstill_in_Noncompaction_Cardiomyopathy","dom_id":"work_1635738","summary":"Atrial standstill is a rare form of bradyarrhythmia and consists of a transitory or permanent loss of the electrical and mechanical activity of the atria. It has been described in a few cases of long-standing valvular disease, amyloidosis, myocarditis, and muscular dystrophy. We report on a young female with noncompaction cardiomyopathy that progressed to congestive heart failure. Electrocardiogram showed persistence atrial standstill that was confirmed clinically and by electrocardiomyopathy, Doppler two-dimensional echocardiogram, and tissue Doppler imaging. We assume that worsening of asymptomatic noncompaction and progression to the congestive form of cardiomyopathy could be presaged by the presence of persistent atrial standstill. Thus, persistence of atrail standstill in asymptomatic cardiomyopathy is a sign of poor prognosis.","publication":"Pediatric Cardiology","publication_with_fallback":"Pediatric Cardiology","downloadable_attachments":[{"id":17010404,"asset_id":1635738,"asset_type":"Work","always_allow_download":false,"scribd_thumbnail_url":"https://attachments.academia-assets.com/17010404/thumbnails/1.jpg","download_url":"https://d1wqtxts1xzle7.cloudfront.net/17010404/h11u71452m453313-libre.pdf?1390865173=\u0026response-content-disposition=attachment%3B+filename%3DPersistent_Atrial_Standstill_in_Noncompa.pdf\u0026Expires=1739917414\u0026Signature=FGCGhEdpPuzBDULMN1Z8g3JUZP2s8yDfZvI5bLluto5EW4-xXHmm4Mw2Bd-cUDu1zrflhHMCw3sJ~98J5cU6ouAfB5u8ycJhm9TKZUYLt8XIlcpyC~3EYY~PA1g1J7vhnJXfPrEuB~RLPmpi9ji20HispBK56G2C8VvbiZDi0~APVZUmCi7~XUQ~Yx4y~S~w0BOlZ~CsK8C5KslhYJZLVxyaTd6naFbtHGjgO8h3FRKPuOmJ4~IXAZCVsGvDxXGN-pacdgjyL6vQ8-EMLZGl0I15lWVtiMaPg~bV1VAwze0TIexmKxe2JTZOxg5cKk1eqF0eDYxl~R20MWsaM-hD~Q__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA","download_file_url":"https://www.academia.edu/attachments/17010404/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&","full_thumbnail_url":null}],"downloadable_attachments_with_full_thumbnails":[],"has_pdf":true,"has_fulltext":true,"page_count":null,"ordered_authors":[{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent","nofollow":true},{"id":37788,"name":"Pediatric Cardiology","url":"https://www.academia.edu/Documents/in/Pediatric_Cardiology","nofollow":true},{"id":39000,"name":"Electrocardiography","url":"https://www.academia.edu/Documents/in/Electrocardiography","nofollow":true},{"id":46824,"name":"Echocardiography","url":"https://www.academia.edu/Documents/in/Echocardiography","nofollow":true},{"id":49633,"name":"Heart Failure","url":"https://www.academia.edu/Documents/in/Heart_Failure"},{"id":88114,"name":"Congestive Heart Failure","url":"https://www.academia.edu/Documents/in/Congestive_Heart_Failure"},{"id":89118,"name":"Muscular Dystrophy","url":"https://www.academia.edu/Documents/in/Muscular_Dystrophy"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":323090,"name":"Cardiac Arrhythmias","url":"https://www.academia.edu/Documents/in/Cardiac_Arrhythmias"},{"id":347511,"name":"Electrocardiogram","url":"https://www.academia.edu/Documents/in/Electrocardiogram"},{"id":411268,"name":"Tissue Doppler Imaging","url":"https://www.academia.edu/Documents/in/Tissue_Doppler_Imaging"},{"id":489727,"name":"Prognosis","url":"https://www.academia.edu/Documents/in/Prognosis"},{"id":571738,"name":"Internal medicine Doppler ultrasonography","url":"https://www.academia.edu/Documents/in/Internal_medicine_Doppler_ultrasonography"},{"id":747845,"name":"Cardiomyopathies","url":"https://www.academia.edu/Documents/in/Cardiomyopathies"},{"id":2003391,"name":"Bradycardia","url":"https://www.academia.edu/Documents/in/Bradycardia"}],"publication_year":2006,"publication_year_with_fallback":2006,"paper_rank":null,"all_time_views":10,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635744" data-work_id="1635744" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635744/Clinical_and_histologic_studies_of_a_Qatari_family_with_myofibrillar_myopathy">Clinical and histologic studies of a Qatari family with myofibrillar myopathy</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The current study reports the first family with confirmed myofibrillar myopathy (MFM) in the Middle East and the third family worldwide. This study highlights the importance of considering MFM in young patients presenting with idiopathic... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635744" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The current study reports the first family with confirmed myofibrillar myopathy (MFM) in the Middle East and the third family worldwide. This study highlights the importance of considering MFM in young patients presenting with idiopathic cardiomyopathy, arrhythmia or atrioventricular block in the Gulf states. This is the first report that presented 2 different types of cardiomyopathy and 2 different indications of permanent pacemaker placement in the same generation of a family with MFM. This report studies a Qatari family consisting of one brother and 3 sisters. The brother had restrictive cardiomyopathy at the age of 16 years. One sister underwent heart transplantation for severe hypertrophic cardiomyopathy at the age of 15 years, the other sister had permanent pacemaker for complete heart block at the age of 21 years. This report is focused mainly on the clinical presentation and investigations carried out for the brother including echocardiogram, cardiac catheterization, cardiac and skeletal muscle biopsy, and electromyography and electrophysiology studies. The study findings support the diagnosis of MFM.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635744" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="51f14535b35647620a07d8d08e701ae6" rel="nofollow" data-download="{"attachment_id":17010446,"asset_id":1635744,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010446/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635744 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635744"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635744, container: ".js-paper-rank-work_1635744", }); 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This study highlights the importance of considering MFM in young patients presenting with idiopathic cardiomyopathy, arrhythmia or atrioventricular block in the Gulf states. This is the first report that presented 2 different types of cardiomyopathy and 2 different indications of permanent pacemaker placement in the same generation of a family with MFM. This report studies a Qatari family consisting of one brother and 3 sisters. The brother had restrictive cardiomyopathy at the age of 16 years. One sister underwent heart transplantation for severe hypertrophic cardiomyopathy at the age of 15 years, the other sister had permanent pacemaker for complete heart block at the age of 21 years. This report is focused mainly on the clinical presentation and investigations carried out for the brother including echocardiogram, cardiac catheterization, cardiac and skeletal muscle biopsy, and electromyography and electrophysiology studies. The study findings support the diagnosis of MFM.","publication":"Saudi Med J","publication_with_fallback":"Saudi Med J","downloadable_attachments":[{"id":17010446,"asset_id":1635744,"asset_type":"Work","always_allow_download":false,"scribd_thumbnail_url":"https://attachments.academia-assets.com/17010446/thumbnails/1.jpg","download_url":"https://d1wqtxts1xzle7.cloudfront.net/17010446/09clinical20040247-libre.pdf?1390865171=\u0026response-content-disposition=attachment%3B+filename%3DClinical_and_histologic_studies_of_a_Qat.pdf\u0026Expires=1739917414\u0026Signature=FxT1ljZjpTSE8wMdwiPfaMNOjl9YiDxw7Fxn3gTRVgclFGM~~wG0f9DEY8HAOBjwnPV-FlsFKdRTQDncqLeD-W6LlDScez-UD8M3MoSWjeYoEFxplRiqs~sHDfuStL53T4iBY81KfDK2wQBJWfS2c03mUHtx6BizHFuLbx5Hdvg2nvNyn0yWueU2HeKA9wiZ01rSCbLuusRNq5uk8UND-CHdxRoRBoAokJ9OMkpxY9NpLM85q81b~hHPGRNumn5ABKAGgojqMYG5I5nJeSzM~5dCepvenXHvkQE~BFkIA0AmjJrt0wnKSSgdOtUkMQEEIErN4KGp30IHzlTJ-w36JA__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA","download_file_url":"https://www.academia.edu/attachments/17010446/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&","full_thumbnail_url":"https://0.academia-photos.com/attachment_thumbnails/17010446/mini_magick20190427-26222-zti1z.png?1556352534"}],"downloadable_attachments_with_full_thumbnails":[{"id":17010446,"asset_id":1635744,"asset_type":"Work","always_allow_download":false,"scribd_thumbnail_url":"https://attachments.academia-assets.com/17010446/thumbnails/1.jpg","download_url":"https://d1wqtxts1xzle7.cloudfront.net/17010446/09clinical20040247-libre.pdf?1390865171=\u0026response-content-disposition=attachment%3B+filename%3DClinical_and_histologic_studies_of_a_Qat.pdf\u0026Expires=1739917414\u0026Signature=FxT1ljZjpTSE8wMdwiPfaMNOjl9YiDxw7Fxn3gTRVgclFGM~~wG0f9DEY8HAOBjwnPV-FlsFKdRTQDncqLeD-W6LlDScez-UD8M3MoSWjeYoEFxplRiqs~sHDfuStL53T4iBY81KfDK2wQBJWfS2c03mUHtx6BizHFuLbx5Hdvg2nvNyn0yWueU2HeKA9wiZ01rSCbLuusRNq5uk8UND-CHdxRoRBoAokJ9OMkpxY9NpLM85q81b~hHPGRNumn5ABKAGgojqMYG5I5nJeSzM~5dCepvenXHvkQE~BFkIA0AmjJrt0wnKSSgdOtUkMQEEIErN4KGp30IHzlTJ-w36JA__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA","download_file_url":"https://www.academia.edu/attachments/17010446/download_file?st=MTczOTkxMzgxNCw4LjIyMi4yMDguMTQ2&","full_thumbnail_url":"https://0.academia-photos.com/attachment_thumbnails/17010446/mini_magick20190427-26222-zti1z.png?1556352534"}],"has_pdf":true,"has_fulltext":true,"page_count":4,"ordered_authors":[{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":4228,"name":"Skeletal muscle biology","url":"https://www.academia.edu/Documents/in/Skeletal_muscle_biology","nofollow":true},{"id":8241,"name":"Tropical Medicine","url":"https://www.academia.edu/Documents/in/Tropical_Medicine","nofollow":true},{"id":9815,"name":"Developing Countries","url":"https://www.academia.edu/Documents/in/Developing_Countries","nofollow":true},{"id":12069,"name":"Histology","url":"https://www.academia.edu/Documents/in/Histology","nofollow":true},{"id":37826,"name":"Biopsy","url":"https://www.academia.edu/Documents/in/Biopsy"},{"id":46824,"name":"Echocardiography","url":"https://www.academia.edu/Documents/in/Echocardiography"},{"id":188349,"name":"Pedigree","url":"https://www.academia.edu/Documents/in/Pedigree"},{"id":916228,"name":"Hypertrophic Cardiomyopathy","url":"https://www.academia.edu/Documents/in/Hypertrophic_Cardiomyopathy"},{"id":1209864,"name":"Myofibrils","url":"https://www.academia.edu/Documents/in/Myofibrils"}],"publication_year":2004,"publication_year_with_fallback":2004,"paper_rank":null,"all_time_views":25,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635745" data-work_id="1635745" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635745/Prevalence_and_Prognosis_of_Chronic_Obstructive_Pulmonary_Disease_Among_8167_Middle_Eastern_Patients_With_Acute_Coronary_Syndrome">Prevalence and Prognosis of Chronic Obstructive Pulmonary Disease Among 8167 Middle Eastern Patients With Acute Coronary Syndrome</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">BackgroundThe purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS).The purpose of this study was to report the... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635745" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">BackgroundThe purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS).The purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS).HypothesisCOPD in patients with ACS is associated with worse outcome.COPD in patients with ACS is associated with worse outcome.MethodsData were derived from a prospective, multicenter, multinational study of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared.Data were derived from a prospective, multicenter, multinational study of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared.ResultsThe prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality.The prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality.ConclusionsIn this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality. Copyright © 2010 Wiley Periodicals, Inc.In this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality. Copyright © 2010 Wiley Periodicals, Inc.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635745" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="12d036757df66e90a3e59d23701907c5" rel="nofollow" data-download="{"attachment_id":50891002,"asset_id":1635745,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50891002/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635745 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635745"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635745, container: ".js-paper-rank-work_1635745", }); 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Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared.Data were derived from a prospective, multicenter, multinational study of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared.ResultsThe prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality.The prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality.ConclusionsIn this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality. Copyright © 2010 Wiley Periodicals, Inc.In this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality. Copyright © 2010 Wiley Periodicals, Inc.","publication":"Clinical …","publication_with_fallback":"Clinical 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itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635747/Obesity_A_Risk_Factor_for_Acute_Myocardial_Infarction_with_Angiographically_Patent_Epicardial_Coronary_Vessels_in_an_Adolescent">Obesity: A Risk Factor for Acute Myocardial Infarction with Angiographically Patent Epicardial Coronary Vessels in an Adolescent</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">A 17-year-old Syrian male patient living in Qatar since birth, who is a nonsmoker, nondiabetic and normotensive with no family history of coronary artery disease and no acknowledged drug abuse, presented to the emergency department with... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635747" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">A 17-year-old Syrian male patient living in Qatar since birth, who is a nonsmoker, nondiabetic and normotensive with no family history of coronary artery disease and no acknowledged drug abuse, presented to the emergency department with central chest pain during the previous night. The pain was crushing in nature,</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635747" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="f1bd020bc99e5f47e7bc82cdbd9f17b9" rel="nofollow" data-download="{"attachment_id":17010463,"asset_id":1635747,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010463/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635747 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635747"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635747, container: ".js-paper-rank-work_1635747", }); 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href="https://www.academia.edu/1635749/Intracardiac_shunting_of_ruptured_Sinus_of_Valsalva_aneurysm_in_a_patient_presented_with_acute_myocardial_infarction_role_of_64_slice_MDCT">Intracardiac shunting of ruptured Sinus of Valsalva aneurysm in a patient presented with acute myocardial infarction: role of 64-slice MDCT</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Rupture of Sinus of Valsalva aneurysm (SVA) may be either congenital or acquired. This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635749" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Rupture of Sinus of Valsalva aneurysm (SVA) may be either congenital or acquired. This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial infarction. The sinus of Valsalva aneurysm and the intracardiac shunt track into the right atrium was not defined by the two-dimensional echocardiography could be seen by 64-slice multi detector computed tomography (MDCT).</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635749" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="c7523f18cab0468cd7618f92577f51ab" rel="nofollow" data-download="{"attachment_id":17010472,"asset_id":1635749,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010472/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635749 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635749"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635749, container: ".js-paper-rank-work_1635749", }); 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This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial infarction. The sinus of Valsalva aneurysm and the intracardiac shunt track into the right atrium was not defined by the two-dimensional echocardiography could be seen by 64-slice multi detector computed tomography (MDCT).","publication":"The International Journal …","publication_with_fallback":"The International Journal …","downloadable_attachments":[{"id":17010472,"asset_id":1635749,"asset_type":"Work","always_allow_download":false,"scribd_thumbnail_url":"https://attachments.academia-assets.com/17010472/thumbnails/1.jpg","download_url":"https://d1wqtxts1xzle7.cloudfront.net/17010472/g554j7wk7r023230-libre.pdf?1390865178=\u0026response-content-disposition=attachment%3B+filename%3DIntracardiac_shunting_of_ruptured_Sinus.pdf\u0026Expires=1739917415\u0026Signature=TmALAoMpK~dZIef53XIhHWLQp~uP6Op7fUb9eTqxFPmJn-xkaiMiySRnhFT0JnEklyYz8Jmyrrob94FFyMijT4TYnqtUEjWxjfIillfL3OrHzIHqBF1SB9Ls1oa3yA00E5S6SD8ki1BoJJmF1DCfT8u9WnDWsLVB4-xGIrmBWpFV1ieVoFmKDswOhoyjjdmoiOkeIyLGhkvYd9pPH0Wv3oyLKe6hsyXBusYmSbaVOGyOc~81wTH1sZS5t4ZA5uy96LxiIlaFoZTZsCKdBc~1DL-JMqHP3mqApzfv0bV~Dot87X8p5mna6G3uCaY8pE3U~NnXnNWHYfrih8fv4tmsug__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA","download_file_url":"https://www.academia.edu/attachments/17010472/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&","full_thumbnail_url":null}],"downloadable_attachments_with_full_thumbnails":[],"has_pdf":true,"has_fulltext":true,"page_count":null,"ordered_authors":[{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":1648,"name":"Computed Tomography","url":"https://www.academia.edu/Documents/in/Computed_Tomography","nofollow":true},{"id":46824,"name":"Echocardiography","url":"https://www.academia.edu/Documents/in/Echocardiography","nofollow":true},{"id":161176,"name":"The","url":"https://www.academia.edu/Documents/in/The","nofollow":true},{"id":172151,"name":"Acute Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Acute_Myocardial_Infarction","nofollow":true},{"id":198747,"name":"Left Ventricular Dysfunction","url":"https://www.academia.edu/Documents/in/Left_Ventricular_Dysfunction"},{"id":374984,"name":"Coronary Angiography","url":"https://www.academia.edu/Documents/in/Coronary_Angiography"},{"id":378016,"name":"Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Myocardial_Infarction"},{"id":396445,"name":"Cardiovascular Imaging","url":"https://www.academia.edu/Documents/in/Cardiovascular_Imaging"},{"id":805590,"name":"Aortic Aneurysm","url":"https://www.academia.edu/Documents/in/Aortic_Aneurysm"},{"id":1254076,"name":"Right Atrium","url":"https://www.academia.edu/Documents/in/Right_Atrium"}],"publication_year":2006,"publication_year_with_fallback":2006,"paper_rank":null,"all_time_views":4,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635751" data-work_id="1635751" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635751/Initial_hospital_pulse_pressure_and_cardiovascular_outcomes_in_acute_coronary_syndrome">Initial hospital pulse pressure and cardiovascular outcomes in acute coronary syndrome</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The association between admission pulse pressure (PP) and cardiovascular outcomes in acute coronary syndrome (ACS) is not well defined.To explore the prognostic value of initial PP in ST-segment elevation myocardial infarction (STEMI) and... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635751" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The association between admission pulse pressure (PP) and cardiovascular outcomes in acute coronary syndrome (ACS) is not well defined.To explore the prognostic value of initial PP in ST-segment elevation myocardial infarction (STEMI) and non-ST elevation ACS (NSTE-ACS).Over a 5-month period in 2007, 6704 consecutive patients with ACS were categorized into five groups according to initial PP: P1, PP ≤ 0; P2, PP 31–40; P3, PP 41–50; P4, PP 51–60; P5, PP > 60 mmHg. Patient characteristics and in-hospital outcomes were analysed.Mean PP was lower in men versus women (55 ± 19 vs. 61 ± 22), young versus old (53 ± 17 vs. 59 ± 21), STEMI vs. NSTE-ACS (51 ± 18 vs. 60 ± 18) and patients who died versus survived (46 ± 22 vs. 57 ± 19 mmHg) (P < 0.001 for all). Most patients with low PP had a high Global Registry of Acute Coronary Events risk score. Compared with P5, crude odds ratios (ORs) (95% confidence intervals) for death were: P1, 9 (5.78–13.35); P2, 3 (1.71–4.06); P3, 1.5 (1.01–2.49); P4, 0.90 (0.51–1.58). After adjustment, low PP was associated with high mortality and stroke rates in ACS (adjusted ORs 7.5 [3.77–14.72] and 4.5 [1.20–18.88], respectively), high rates of recurrent ischaemia in NSTE-ACS (adjusted OR 2.8 [1.52–5.22]) and a high heart failure rate in STEMI (adjusted OR 2.1 [1.18–3.76]). Women with low PP had a higher mortality rate than men.In ACS, all blood pressure variables were significantly correlated. Low PP was an independent predictor for stroke and mortality in overall ACS. Although PP was not superior to systolic blood pressure, only low PP was an independent predictor for recurrent ischaemia in NSTE-ACS.L’association entre la pression pulsée à l’admission et les évènements cardiovasculaires au décours d’un syndrome coronaire aigu n’est pas bien connue.Évaluer l’impact pronostique de la pression pulsée à l’admission chez des patients ayant un syndrome coronaire aigu avec (STEMI) ou sans sus décalage du segment ST (NSTE-ACS).Pendant une durée de cinq mois, 6704 patients consécutifs ayant un syndrome coronaire aigu ont été répartis en groupes en fonction de la pression pulsée à l’admission : P1 pression pulsée ≤ 30, P2 PP 31–40, P3 PP 51–60, P5 PP > 60 mmHg. Les caractéristiques de base de ces patients et les évènements cardiovasculaires en phase hospitalière ont été analysés.La pression pulsée moyenne était significativement moindre chez les hommes comparativement aux femmes (59 ± 19 vs. 61 ± 22 mmHg), chez les patients jeunes comparativement aux sujets âgés (53 ± 17 vs. 59 ± 21 mmHg), en cas de STEMI versus NSTE-ACS (51 ± 18 versus 60 ± 18 mmHg) et chez les patients décédés comparativement aux survivants (46 ± 22 vs. 57 ± 19 mmHg) (p < 0,001 pour l’ensemble de ces variables). La majorité des patients ayant une pression pulsée basse avaient un score GRACE élevé. Comparativement au groupe P5, l’odd ratio non ajusté (ORs) (IC 95 %) était le suivant pour les décès P1, 9 (IC 95 %, 5,78–13,35) ; P2, 3 (IC 95 %, 1,71–4,06) ; P3, 1,5 (IC 95 %, 1,01–2,49) ; P4 0,90 IC 95 %, (0,51–1,58). Après ajustement, la pression pulsée est associée à une surmortalité de risque accru (ORs 7,5, IC 95 % 3,77–14,72) et à un taux accru d’AVC 4,5 (1,20–18,88), avec un taux plus élevé de récidive d’ischémie dans le syndrome coronaire aigu sans sus décalage du ST, NSTE-ACS (OR ajusté 2,8 [IC 95 %, 1,52–5,22]) et un taux accru d’insuffisance cardiaque chez les patients ayant un STEMI (odd ratio 2,1 [IC 95 %, 1,18–3,76]). Les femmes ayant une pression pulsée moindre avaient un taux de mortalité augmenté comparativement aux autres.Dans le syndrome coronaire aigu, toutes les variables dérivées de la pression artérielles sont significativement corrélées. Une pression pulsée basse est un prédicteur indépendant du risque d’AVC et de surmortalité quel que soit leur type de syndrome coronaire aigu. Bien que la pression pulsée ne soit pas supérieure à la pression artérielle systolique, seule une pression pulsée basse est un prédicteur indépendant de la récidive ischémique dans les syndromes coronaires aigus sans sus décalage de ST.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635751" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="82db3c41a45716acc2226e7bbd60d7d8" rel="nofollow" data-download="{"attachment_id":50890999,"asset_id":1635751,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50890999/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635751 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635751"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635751, container: ".js-paper-rank-work_1635751", }); 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P2, PP 31–40; P3, PP 41–50; P4, PP 51–60; P5, PP \u003e 60 mmHg. Patient characteristics and in-hospital outcomes were analysed.Mean PP was lower in men versus women (55 ± 19 vs. 61 ± 22), young versus old (53 ± 17 vs. 59 ± 21), STEMI vs. NSTE-ACS (51 ± 18 vs. 60 ± 18) and patients who died versus survived (46 ± 22 vs. 57 ± 19 mmHg) (P \u003c 0.001 for all). Most patients with low PP had a high Global Registry of Acute Coronary Events risk score. Compared with P5, crude odds ratios (ORs) (95% confidence intervals) for death were: P1, 9 (5.78–13.35); P2, 3 (1.71–4.06); P3, 1.5 (1.01–2.49); P4, 0.90 (0.51–1.58). After adjustment, low PP was associated with high mortality and stroke rates in ACS (adjusted ORs 7.5 [3.77–14.72] and 4.5 [1.20–18.88], respectively), high rates of recurrent ischaemia in NSTE-ACS (adjusted OR 2.8 [1.52–5.22]) and a high heart failure rate in STEMI (adjusted OR 2.1 [1.18–3.76]). Women with low PP had a higher mortality rate than men.In ACS, all blood pressure variables were significantly correlated. Low PP was an independent predictor for stroke and mortality in overall ACS. Although PP was not superior to systolic blood pressure, only low PP was an independent predictor for recurrent ischaemia in NSTE-ACS.L’association entre la pression pulsée à l’admission et les évènements cardiovasculaires au décours d’un syndrome coronaire aigu n’est pas bien connue.Évaluer l’impact pronostique de la pression pulsée à l’admission chez des patients ayant un syndrome coronaire aigu avec (STEMI) ou sans sus décalage du segment ST (NSTE-ACS).Pendant une durée de cinq mois, 6704 patients consécutifs ayant un syndrome coronaire aigu ont été répartis en groupes en fonction de la pression pulsée à l’admission : P1 pression pulsée ≤ 30, P2 PP 31–40, P3 PP 51–60, P5 PP \u003e 60 mmHg. Les caractéristiques de base de ces patients et les évènements cardiovasculaires en phase hospitalière ont été analysés.La pression pulsée moyenne était significativement moindre chez les hommes comparativement aux femmes (59 ± 19 vs. 61 ± 22 mmHg), chez les patients jeunes comparativement aux sujets âgés (53 ± 17 vs. 59 ± 21 mmHg), en cas de STEMI versus NSTE-ACS (51 ± 18 versus 60 ± 18 mmHg) et chez les patients décédés comparativement aux survivants (46 ± 22 vs. 57 ± 19 mmHg) (p \u003c 0,001 pour l’ensemble de ces variables). La majorité des patients ayant une pression pulsée basse avaient un score GRACE élevé. Comparativement au groupe P5, l’odd ratio non ajusté (ORs) (IC 95 %) était le suivant pour les décès P1, 9 (IC 95 %, 5,78–13,35) ; P2, 3 (IC 95 %, 1,71–4,06) ; P3, 1,5 (IC 95 %, 1,01–2,49) ; P4 0,90 IC 95 %, (0,51–1,58). Après ajustement, la pression pulsée est associée à une surmortalité de risque accru (ORs 7,5, IC 95 % 3,77–14,72) et à un taux accru d’AVC 4,5 (1,20–18,88), avec un taux plus élevé de récidive d’ischémie dans le syndrome coronaire aigu sans sus décalage du ST, NSTE-ACS (OR ajusté 2,8 [IC 95 %, 1,52–5,22]) et un taux accru d’insuffisance cardiaque chez les patients ayant un STEMI (odd ratio 2,1 [IC 95 %, 1,18–3,76]). Les femmes ayant une pression pulsée moindre avaient un taux de mortalité augmenté comparativement aux autres.Dans le syndrome coronaire aigu, toutes les variables dérivées de la pression artérielles sont significativement corrélées. Une pression pulsée basse est un prédicteur indépendant du risque d’AVC et de surmortalité quel que soit leur type de syndrome coronaire aigu. Bien que la pression pulsée ne soit pas supérieure à la pression artérielle systolique, seule une pression pulsée basse est un prédicteur indépendant de la récidive ischémique dans les syndromes coronaires aigus sans sus décalage de ST.","publication":"Archives of …","publication_with_fallback":"Archives of 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Assessment","url":"https://www.academia.edu/Documents/in/Risk_Assessment-2"},{"id":901284,"name":"Hospital Mortality","url":"https://www.academia.edu/Documents/in/Hospital_Mortality"},{"id":1294607,"name":"Logistic Models","url":"https://www.academia.edu/Documents/in/Logistic_Models"}],"publication_year":2011,"publication_year_with_fallback":2011,"paper_rank":null,"all_time_views":19,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_1635753" data-work_id="1635753" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635753/The_Prevalence_and_Outcome_of_Excess_Body_Weight_Among_Middle_Eastern_Patients_Presenting_With_Acute_Coronary_Syndrome">The Prevalence and Outcome of Excess Body Weight Among Middle Eastern Patients Presenting With Acute Coronary Syndrome</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">We evaluated the effect of body weight on the outcome of Middle Eastern patients presenting with acute coronary syndrome (ACS). Analysis of the Gulf Registry of Acute Coronary Events (Gulf RACE) survey that included 7843 consecutive... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635753" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">We evaluated the effect of body weight on the outcome of Middle Eastern patients presenting with acute coronary syndrome (ACS). Analysis of the Gulf Registry of Acute Coronary Events (Gulf RACE) survey that included 7843 consecutive patients hospitalized with ACS was made. Patients were categorized as normal weight, overweight, or obese based on their body mass index (BMI). Overall, 67% of patients were overweight or obese; obese and overweight patients were more likely to be female and have diabetes mellitus, hypertension, dyslipidemia, and less likely to be smokers. In-hospital mortality, congestive heart failure, cardiogenic shock, and strokes were comparable between the groups, although patients with obesity were more likely to have recurrent ischemia and major bleeding complication in the ST-elevation myocardial infarction group. Excess body weight with ACS is associated with higher risk profile characteristics without an increase in hospital mortality or cardiovascular events.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635753" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="4f6c4ee153dcb39d2bf2c47e7440a47c" rel="nofollow" data-download="{"attachment_id":50890997,"asset_id":1635753,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50890997/download_file?st=MTczOTkxMzgxNSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635753 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635753"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635753, container: ".js-paper-rank-work_1635753", }); 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data-work_id="1635754" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635754/Prevalence_of_the_metabolic_syndrome_in_patients_with_acute_coronary_syndrome_in_six_middle_eastern_countries">Prevalence of the metabolic syndrome in patients with acute coronary syndrome in six middle eastern countries</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">J Clin Hypertens (Greenwich).The objective of this study was to evaluate the prevalence and effect of the metabolic syndrome (MetS) on patients with acute coronary syndrome (ACS) in six Middle Eastern countries using the new definition of... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635754" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">J Clin Hypertens (Greenwich).The objective of this study was to evaluate the prevalence and effect of the metabolic syndrome (MetS) on patients with acute coronary syndrome (ACS) in six Middle Eastern countries using the new definition of MetS. Analysis of the Gulf Registry of Acute Coronary Events (Gulf RACE), which included 8716 consecutive patients hospitalized with ACS, was conducted and patients were divided into two groups: patients with and patients without the MetS. Overall, 46% of patients had MetS. Patients with MetS were more likely to be female and less likely to be smokers. In-hospital mortality and cardiogenic shock were comparable between the two groups, although MetS patients were more likely to have congestive heart failure and recurrent ischemia. In ST-elevation myocardial infarction, MetS was also associated with increased risk of recurrent myocardial infarction and stroke. Using the recent MetS definition, MetS is highly prevalent among Middle Eastern patients presenting with ACS. MetS is associated with higher-risk profile characteristics and increased risk for development of heart failure and recurrent myocardial ischemia without an increase in hospital mortality. 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itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/1635756/The_effect_of_high_plasma_levels_of_angiotensin_converting_enzyme_ACE_and_plasminogen_activator_inhibitor_PAI_1_on_the_reperfusion_after_thrombolytic_therapy_in_patients_presented_with_acute_myocardial_infarction">The effect of high plasma levels of angiotensin-converting enzyme (ACE) and plasminogen activator inhibitor (PAI-1) on the reperfusion after thrombolytic therapy in patients presented with acute myocardial infarction</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The resistance to thrombolytic agents and delays in reperfusion occur in more than 30% after acute myocardial infarction. This may play an important role in the unsuccessful recanalization after thrombolytic therapy. The aim of this study... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_1635756" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The resistance to thrombolytic agents and delays in reperfusion occur in more than 30% after acute myocardial infarction. This may play an important role in the unsuccessful recanalization after thrombolytic therapy. The aim of this study is to assess the clinical and biochemical markers of reperfusion after different types of thrombolytic therapy and to find out the relationship between PAI-1 and ACE serum levels and the short-term outcome. Pretreatment ACE and PAI-1 plasma levels of 184 patients with acute myocardial infarction, treated with thrombolytic therapy were determined. Failure of thrombolysis was considered when reperfusion was delayed as assessed by noninvasive reperfusion criteria, reinfarction, and impaired left ventricular function. High plasma level of ACE (> 50 U/L), PAI-1 (> 43 ng/ml) and both was found in 57, 108 and 32 patients respectively. Subjects with high ACE plasma levels were characterized by impaired LV systolic function (79.0% vs. 75.0%), new Q-wave (88.4% vs. 74.2%), less reperfusion arrhythmia (19.3% vs. 22.8%) and prolonged hospitalization (70% vs. 66%) but no statistical significance was observed. High enzymes levels of PAI-1 were observed with higher incidence of anterior myocardial infarction (50.0% vs. 41.0%), lesser ST segment resolution (65.6% vs. 58.8%), reinfarction (6.3% vs. 5.9%), and impaired LV systolic function (90.6% vs. 76.0%), and prolonged hospitalization (70.4% vs. 63.4). There was a statistically significant difference between thrombolytic agents in the presence of high ACE regarding hospital overstay (p = 0.02). While the presence of high PAI-1 was significantly affect the degree of ST-segment resolution (p = 0.03). Conclusion: High plasma ACE and/or PAI-1 plays a considerable role in the higher incidence of unsuccessful reperfusion and impaired left ventricular function after thrombolytic therapy. A rapid diagnostic tool that enables physician of detecting those enzymes before giving thrombolytic therapy may change the strategy of treatment to offer another effective revascularization method.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/1635756" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="1a2eb6d6a9747b960f7caf7d230f1225" rel="nofollow" data-download="{"attachment_id":17010533,"asset_id":1635756,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/17010533/download_file?st=MTczOTkxMzgxNiw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_1635756 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="1635756"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 1635756, container: ".js-paper-rank-work_1635756", }); 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This may play an important role in the unsuccessful recanalization after thrombolytic therapy. The aim of this study is to assess the clinical and biochemical markers of reperfusion after different types of thrombolytic therapy and to find out the relationship between PAI-1 and ACE serum levels and the short-term outcome. Pretreatment ACE and PAI-1 plasma levels of 184 patients with acute myocardial infarction, treated with thrombolytic therapy were determined. Failure of thrombolysis was considered when reperfusion was delayed as assessed by noninvasive reperfusion criteria, reinfarction, and impaired left ventricular function. High plasma level of ACE (\u003e 50 U/L), PAI-1 (\u003e 43 ng/ml) and both was found in 57, 108 and 32 patients respectively. Subjects with high ACE plasma levels were characterized by impaired LV systolic function (79.0% vs. 75.0%), new Q-wave (88.4% vs. 74.2%), less reperfusion arrhythmia (19.3% vs. 22.8%) and prolonged hospitalization (70% vs. 66%) but no statistical significance was observed. High enzymes levels of PAI-1 were observed with higher incidence of anterior myocardial infarction (50.0% vs. 41.0%), lesser ST segment resolution (65.6% vs. 58.8%), reinfarction (6.3% vs. 5.9%), and impaired LV systolic function (90.6% vs. 76.0%), and prolonged hospitalization (70.4% vs. 63.4). There was a statistically significant difference between thrombolytic agents in the presence of high ACE regarding hospital overstay (p = 0.02). While the presence of high PAI-1 was significantly affect the degree of ST-segment resolution (p = 0.03). Conclusion: High plasma ACE and/or PAI-1 plays a considerable role in the higher incidence of unsuccessful reperfusion and impaired left ventricular function after thrombolytic therapy. A rapid diagnostic tool that enables physician of detecting those enzymes before giving thrombolytic therapy may change the strategy of treatment to offer another effective revascularization method.","publication":"Journal of Thrombosis and Thrombolysis","publication_with_fallback":"Journal of Thrombosis and 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Dysfunction","url":"https://www.academia.edu/Documents/in/Left_Ventricular_Dysfunction"},{"id":426578,"name":"Cardiac Output Monitoring","url":"https://www.academia.edu/Documents/in/Cardiac_Output_Monitoring"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":489727,"name":"Prognosis","url":"https://www.academia.edu/Documents/in/Prognosis"},{"id":747845,"name":"Cardiomyopathies","url":"https://www.academia.edu/Documents/in/Cardiomyopathies"},{"id":2463800,"name":"Severity of Illness Index","url":"https://www.academia.edu/Documents/in/Severity_of_Illness_Index"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool"}],"publication_year":2007,"publication_year_with_fallback":2007,"paper_rank":null,"all_time_views":41,"active_discussion":{}}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_2602495" data-work_id="2602495" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/2602495/Left_internal_mammary_artery_injury_requiring_resuscitative_thoracotomy_a_case_presentation_and_review_of_the_literature">Left internal mammary artery injury requiring resuscitative thoracotomy: a case presentation and review of the literature</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_2602495" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA). Method. A case presentation treated at the Level I trauma center at Hamad General Hospital, in Doha, Qatar and review of the literature on LIMA injuries reported cases. Results. LIMA injury as a cause of hemothorax is not uncommon, but to our knowledge our case is the first massive tension hemothorax with witnessed cardiac arrest reported in the literature requiring emergency thoracotomy, performed in trauma room, with full recovery. Conclusion. Injury to the LIMA with massive tension hemothorax requires immediate resuscitative thoracotomy.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/2602495" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="0d2b0d8c842b9564bb676357ed0526fa" rel="nofollow" data-download="{"attachment_id":50562799,"asset_id":2602495,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50562799/download_file?st=MTczOTkxMzgxNiw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="1679792" href="https://cornell.academia.edu/AymanElMenyar">Ayman El-Menyar</a><script data-card-contents-for-user="1679792" type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_2602495 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="2602495"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 2602495, container: ".js-paper-rank-work_2602495", }); });</script></li><li class="js-percentile-work_2602495 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 2602495; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_2602495"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_2602495 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="2602495"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 2602495; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=2602495]").text(description); $(".js-view-count-work_2602495").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_2602495").removeClass('hidden') })</script></div></li></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_2602496" data-work_id="2602496" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/2602496/Delayed_presentation_of_traumatic_intraperitoneal_rupture_of_urinary_bladder">Delayed presentation of traumatic intraperitoneal rupture of urinary bladder</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Blunt injury of the urinary bladder is well known and usually associates pelvic fractures. Isolated bladder injury is a rare condition and on the other hand, delayed bladder perforation is an extremely rare entity. Herein, we described an... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_2602496" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Blunt injury of the urinary bladder is well known and usually associates pelvic fractures. Isolated bladder injury is a rare condition and on the other hand, delayed bladder perforation is an extremely rare entity. Herein, we described an unusual case of isolated delayed intraperitoneal bladder rupture that occurred on the third post injury day in a young male in the absence of free intraperitoneal fluid and pelvic fracture. The diagnostic workup, course and the need for surgical repair of the injury is presented.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/2602496" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="3244b9bda7db58d5802b6223994037f0" rel="nofollow" data-download="{"attachment_id":50562807,"asset_id":2602496,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" 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container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_2602496 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="2602496"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 2602496; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=2602496]").text(description); $(".js-view-count-work_2602496").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_2602496").removeClass('hidden') })</script></div></li></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_2602497" data-work_id="2602497" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/2602497/Presentation_and_outcome_of_traumatic_spinal_fractures">Presentation and outcome of traumatic spinal fractures</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/2602497" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="8574908322a4c60ae193192f860c89f3" rel="nofollow" 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type="text/json">{"id":1679792,"first_name":"Ayman","last_name":"El-Menyar","domain_name":"cornell","page_name":"AymanElMenyar","display_name":"Ayman El-Menyar","profile_url":"https://cornell.academia.edu/AymanElMenyar","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_2602497 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="2602497"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 2602497, container: ".js-paper-rank-work_2602497", }); });</script></li><li class="js-percentile-work_2602497 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 2602497; 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$(".js-view-count-work_2602497").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="2602497"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">3</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="4933" rel="nofollow" href="https://www.academia.edu/Documents/in/Spine">Spine</a>, <script data-card-contents-for-ri="4933" type="text/json">{"id":4933,"name":"Spine","url":"https://www.academia.edu/Documents/in/Spine","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6637" rel="nofollow" href="https://www.academia.edu/Documents/in/Fracture">Fracture</a>, <script data-card-contents-for-ri="6637" 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