Isolated right coronary lesion and anterolateral papillary muscle rupture - case report and review of the literature

Ischemic rupture of the anterolateral papillary muscle is uncommon due to its dual blood supply. It usually follows an ischemic event involving branches of the left circumflex or left anterior descending arteries. We present a case of a patient admitted with an acute inferior wall myocardial infarction and an isolated distal right coronary artery occlusion. Acute mitral regurgitation with rupture of the anterolateral papillary muscle was diagnosed on the fifth post-infarction day. The patient underwent mitral valve replacement and coronary artery bypass grafting to the posterior descending artery. We conclude that anterolateral papillary muscle rupture may also result from an isolated right coronary lesion

Impact of inter-pregnancy interval on long-term endo-metabolic health of the offspring

Background: Inter-pregnancy interval (IPI), defined as the time interval between a live birth and estimated conception time of a subsequent pregnancy, has an established effect on perinatal outcome. The long-term impact of IPI on offspring is unknown. This study aimed to examine the effect of short and long IPIs on long-term endo-metabolic health of offspring.Subjects and Method: This population-based cohort study included singleton live births in parturient with at least one previous birth. Singleton deliveries between the years 1991-2014 in a regional tertiary medical center were included. Offspring were followed until 18 years of age for endo-metabolic related hospitalizations. Survival curves were used to compare cumulative incidence of endo-metabolic morbidity, and Cox proportional hazards models to control for confounders.Results: During the study period 144,397 deliveries met the inclusion criteria. Offspring following long IPIs exhibited higher rates of endo-metabolic related hospitalizations. Survival curve demonstrated a significantly higher cumulative incidence of endo-metabolic morbidity in the long IPI group (p<0.001). The Cox model demonstrated long IPI to significantly increase the risk for endo-metabolic related hospitalizations during childhood (aHR= 1.34, 95%CI= 1.06 to 1.70; p=0.015).Conclusion: Long IPI appears to have an independent impact on long-term endo-metabolic health of the offspring.Keywords: pregnancy interval, offspring, endocrine health, metabolic morbidity, obesityCorrespondence: Liron Seidman. The Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev. Ben-Gurion University Medical School, Soroka University Medical Center, 151 IzakRager Ave, Be’er-Sheva 84101, Israel. Email: [email protected]. Mobile: +972-524215808Journal of Maternal and Child Health (2020, 5(3): 321-330https://doi.org/10.26911/thejmch.2020.05.03.1