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Cardiac troponin I in sickle cell crisis [Letter]

Aslam, Ahmad K; Rodriguez, Carlos; Aslam, Ahmed F; Vasavada, Balendu C; Khan, Ijaz A
Gross and microscopic findings consistent with acute and healed myocardial injury without coronary artery disease have been described in autopsy studies of patients with sickle cell crisis. The present study was designed to determine whether serum levels of cardiac troponin I are elevated in sickle cell crisis. Cardiac troponin I levels were measured in 32 patients age>18 years with the admission diagnosis of sickle cell crisis. All patients had cardiac troponin I level drawn >24 h after the onset of symptoms. The clinical profile and electrocardiograms were analyzed. Out of 32 patients, 2 patients had serum cardiac troponin I elevated, both had presented with acute chest syndrome. Serum cardiac troponin I may be elevated during sickle cell crisis, possibly by myocardial ischemia resulting from microvascular coronary obstruction during sickle cell crisis.
PMID: 18178271
ISSN: 1874-1754
CID: 3855192

Prosthetic heart valves: types and echocardiographic evaluation

Aslam, Ahmad Kamal; Aslam, Ahmad Faraz; Vasavada, Balendu C; Khan, Ijaz A
In the last five decades multiple different models of prosthetic valves have been developed. The purpose of this article is to provide a comprehensive source of information for the types and the echocardiographic evaluation of the prosthetic heart valves.
PMID: 17434628
ISSN: 1874-1754
CID: 3855242

Cardiac effects of acute myelitis [Letter]

Aslam, Ahmed Faraz; Aslam, Ahmad Kamal; Vasavada, Balendu C; Khan, Ijaz A
Neurogenic stunned myocardium has been described in association with subarachnoid hemorrhage, Guillain-Barre syndrome, and metastatic brain tumors. We describe a case of neurogenic stunned myocardium associated with acute myelitis. A 27-year-old female presented with acute onset of quadriplegia, sensory deficit, and acute pulmonary edema. Magnetic resonance imaging was consistent with acute myelitis. Echocardiogram showed left ventricular ejection fraction of 35% with moderate to severe global hypokinesis. During the course of admission, she had several episodes of sinus bradycardia and high degree atrioventricular block. All cardiac abnormalities resolved completely in eight days of admission.
PMID: 16055208
ISSN: 0167-5273
CID: 3855212

Hypothermia: evaluation, electrocardiographic manifestations, and management

Aslam, Ahmed Faraz; Aslam, Ahmad Kamal; Vasavada, Balendu C; Khan, Ijaz A
Hypothermia-related cases typically occur after exposure to low ambient temperatures; however, numerous cases occur in individuals with no history of exposure to cold environment. Hypothermia is associated with such complications as acidosis, impaired myocardial function, bleeding diathesis, and decreased kidney and liver function. The well-known electrocardiographic manifestations of hypothermia are the presence of J (Osborn) waves, prolonged PR, QRS, and QT intervals, and atrial arrhythmias. The choice of rewarming therapy is based on the degree of hypothermia. The evaluation, electrocardiographic manifestations, and management of hypothermia are reviewed.
PMID: 16564768
ISSN: 1555-7162
CID: 3855232

Staphylococcus aureus infective endocarditis and septic pulmonary embolism after septic abortion [Letter]

Aslam, Ahmed F; Aslam, Ahmad K; Thakur, Abhash C; Vasavada, Balendu C; Khan, Ijaz A
We report a case of a 26-year-old female who after septic abortion developed tricuspid valve endocarditis with large vegetations, which subsequently resulted in embolism to right main pulmonary artery. Patient was treated with intravenous antibiotics and had a good recovery.
PMID: 16243121
ISSN: 0167-5273
CID: 3855182

Primary lymphedema tarda in an 88-year-old African-American male [Case Report]

Aslam, Ahmed Faraz; Aslam, Ahmad Kamal; Qamar, Muhammad Umair R; Levey, Robert
Primary lymphedema tarda is considered to be a congenital disease with delayed manifestations. We report a case of isolated lymphedema of the left upper extremity in an 88-year-old African-American male. The diagnosis of lymphedema was confirmed by lymphoscintigraphy, and appropriate diagnostic studies were done to rule out other known causes of lymphedema. Lymphoscintigraphic findings were consistent with idiopathic primary lymphedema. During the course of investigations, the patient was found to have adenocarcinoma in situ of the sigmoid colon with no evidence of metastatic spread. Based on the available data, we were unable to establish a causative relationship between colonic carcinoma and lymphedema in our patient. Therefore, this case can best be described as a case of Idiopathic primary lymphedema tarda. We emphasize the use of histopathologic examination in the diagnostic algorithm to rule out underlying malignant process only in patients with radionuclide findings suggestive of secondary lymphedema with no obvious etiology.
PMID: 16080675
ISSN: 0027-9684
CID: 3855222

Fatal splenic sequestration crisis with multiorgan failure in an adult woman with sickle cell-beta+ thalassemia [Case Report]

Aslam, Ahmed Faraz; Aslam, Ahmad Kamal; Dipillo, Frank
Acute splenic sequestration crisis is a potentially fatal condition mostly seen in children with sickle cell anemia (HbSS) up to 6 years of age. Sickle cell-beta thalassemia has been associated with development of splenic sequestration crisis in rare reports. There have also been rare reports of the development of fatal acute splenic sequestration crisis together with severe multiorgan failure in adult patients with sickle cell-beta thalassemia. We describe a case of fatal splenic sequestration crisis together with multiorgan failure in a 34-year-old African-American woman with sickle cell-beta thalassemia syndrome.
PMID: 15767820
ISSN: 0002-9629
CID: 3855202

QT interval prolongation in diphenhydramine toxicity [Letter]

Thakur, Abhash C; Aslam, Ahmad K; Aslam, Ahmed F; Vasavada, Balendu C; Sacchi, Terrence J; Khan, Ijaz A
Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval.
PMID: 15686790
ISSN: 0167-5273
CID: 3855172