Nurturing research – are we on track?

The annual South African Heart Congress is a prominent beacon on the South African cardiology landscape. Few of us would deny that it is an event not to be missed. However, should we analyse the reasons why this is an important event we may struggle to reach consensus. It is an opportunity to establish and nurture relationships with colleagues practicing in various parts of our country. More importantly, it is also an opportunity to establish and nurture relationships with colleagues from the rest of Africa and other continents. We have established a track record of attracting many of the international pacesetters in cardiovascular medicine and the congress provides an ideal opportunity to keep abreast of the latest developments in our field, but critics will say that we can gain the same exposure and more by attending international meetings such as the European Society of Cardiology (ESC) Congress. The SA Heart Congress provides a platform that allows industry to build relationship with the clinicians and to introduce them to their products. However, one may argue that there are other mechanisms and opportunities to achieve this, both locally and internationally

3D image of Inoue balloon inflation during mitral valvuloplasty

Mitral balloon valvuloplasty is an important intervention in the armory of the cardiologist, offering a safe and effective percutaneous option in the treatment of patients with mitral stenosis

The management of tuberculous pericardial effusion : experience in 233 consecutive patients

The original publication is available at http://www.cvja.co.za/Aim: We report on the 30-day and one-year outcome of consecutive effusive pericarditis patients, including those with tuberculous pericarditis, over a six-year-period. Methods and Results: Patients with large pericardial effusions requiring pericardiocentesis were included in the study after having given written informed consent. Clinical and radiological evaluations were followed by echo-guided pericardiocentesis, and extended daily intermittent drainage via an indwelling pigtail catheter. A standard short-course anti-tuberculous regimen was initiated. A total of 233 patients was included. One hundred and sixty-two patients had pericardial tuberculosis (TB), including 118 (73%) with microbiological and/ or histological evidence of TB and 44 (27%) diagnosed on clinical and supportive laboratory data. Over the six-year period, two patients developed fibrous constrictive pericarditis after receiving adjuvant corticosteroid therapy. The 30-day mortality (8.0%) was statistically higher for HIV-positive patients (corresponding mortality 9.9%) than for HIV-negative patients (6.2%; p=0.04). The oneyear all-cause mortality was 17.3%. It was also higher for HIV-positive (22.2%) than for HIV-negative patients (12.3%; p=0.03). Cardiac mortality was equal for HIVpositive and -negative patients. Conclusion: Tuberculous pericardial effusions responded well to closed pericardiocentesis and a six-month treatment of antituberculous chemotherapy. The former was effective and safe irrespective of HIV status.Publishers' versio

Double atrial heart sound in a patient with 2:1 atrioventricular block

CITATION: Pecoraro, A. J., Doubell, A. F. & Herbst, P. G. 2017. Double atrial heart sound in a patient with 2:1 atrioventricular block, SA Heart, 14(1):44-45, doi:10.24170/14-1-1879.The original publication is available at http://www.journals.ac.za/index.php/SAHJNo abstract availablehttp://www.journals.ac.za/index.php/SAHJ/article/view/1879Publisher's versio

An approach to the patient with suspected pericardial disease

Diseases of the pericardium commonly manifest in one of three ways: acute pericarditis, pericardial effusion and constrictive pericarditis. In the developed world, the most common cause of acute pericarditis is viral or idiopathic disease, while in the developing world tuberculous aetiology, particularly in sub-Saharan Africa, is commonplace owing to the high prevalence of HIV. This article provides an approach to the diagnosis, investigation and management of these patients

Post-traumatic, intrapulmonary arteriovenous fi stula: Diagnosis by trans-oesophageal echocardiography

Image in Cardiolog

An approach to the patient with suspected pericardial disease

Diseases of the pericardium commonly manifest in one of three ways: acute pericarditis, pericardial effusion and constrictive pericarditis. Inthe developed world, the most common cause of acute pericarditis is viral or idiopathic disease, while in the developing world tuberculousaetiology, particularly in sub-Saharan Africa, is commonplace owing to the high prevalence of HIV. This article provides an approach to thediagnosis, investigation and management of these patients

Data sharing: A new editorial initiative of the international committee of medical journal editors. Implications for the editors´ network

The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiolog

Data sharing: A new editorial initiative of the international committee of medical journal editors. Implications for the editors´ network

The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiolog

The role of chest radiography in diagnosing patients with tuberculous pericarditis

The original publication is available at http://www.cvja.co.za/Aim: To describe the abnormalities on chest X-ray (CXR) in patients presenting with tuberculous pericardial effusions. Methods: One hundred and seventy patients presented to Tygerberg Hospital with large pericardial effusions (epi-pericardial separation > 10 mm). All patients had a diagnostic work-up, which included CXR, ECG, two-dimensional echocardiography and HIV serology. Echocardiography was followed by pericardiocentesis and drainage. Pericardial fluid was analysed for adenosine deaminase (ADA), Ziehl Neelsen (ZN) stain, bacterial and mycobacterial cultures. Sputum was sent for ZN stain and mycobacterial cultures. Tuberculous pericardial effusions were diagnosed according to predetermined criteria. Results: The diagnosis of tuberculous pericarditis was made in 53% (n = 90) of patients with pericardial effusions. Forty-one of the subjects (45.5%) were HIV positive. All patients had an enlarged cardiac silhouette and in the majority of cases, the cardiac shadow was globular with distinct margins. The cardiothoracic ratio (CTR) exceeded 0.55 in all patients. The amount of fluid drained correlated with the radiographic finding of cardiac enlargement. Conclusion: In developing countries where TB is very prevalent, CXR plays an important role in the identification of large pericardial effusions. Although sonography will still be required for a definite diagnosis, the results of this study show that CXR is a useful screening tool.Publishers' versio