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Background: Pulmonary embolism (PE) is a major cause of morbidity and mortality worldwide, and has significant negative impacts on quality of life, healthcare costs, and longevity. Registries have been created to record ‘real-life’ clinical features and management of patients with PE. Aim: We aimed to describe a comprehensive view of the clinical presentation, demographic data, treatment modalities and short-term outcome at hospital discharge and 3 months after discharge for patients presented with acute pulmonary embolism at Tanta university hospital to improve the level of care of those patients. Methods: This study was conducted on 150 patients with confirmed acute PE presented to Tanta university hospitals. The study duration was 1 year from April 2019 to May 2020. Results: We focused on a group of common risk factors for PE and determined prevelance of each in our enrolled patients, we found increase some risk factors obesity and bed rest > 3 days were the most prevalent risk factors followed by active cancer, estrogen use and lower limb fracture. Symptoms in this study are near to other registries and ESC guidelines 2019 with the commonest symptom was dyspnea and chest pain and the least symptom was hemoptysis. Certain ECG signs more prevalent in our patients and these signs related to RV strain with sinus tachycardia the commonest sign followed by S1Q3T3 sign and the least was right axis deviation. Conclusion: Presence of active cancer and patients with high risk stratification were independent predictors of mortality. Other factors associated with increased mortality were impaired RV systolic function, high PESI score, presence of RBBB in ECG and presence of congestive heart failure. Increased risk of bleeding in male patients with intermediate high or high risk category especially those received UFH and fibrinolytic therapy. Previous history of VTE was independent predictors of VTE recurrence.

Background: Left ventricular (LV) dysfunction is the single most accurate predictor of death and one of the most common and lethal consequences after ST segment elevation myocardial infarction (STEMI) that has been substantially decreased by primary percutaneous coronary intervention (PCI). This research investigated the impact of duration of ischemia on the severity and improvement of wall motion abnormalities after revascularization and 40-day follow-up. Methods: This study was performed on 60 STEMI patients, treated with 1ry PCI and distributed in two groups; group1: 37 patients presented early before 12h and group II: 23 patients presented late after 12h. Echocardiogram (ECHO) was done for ejection fraction (EF) and resting segmental wall motion abnormalities (RSWMA) detection after revascularization within 24 h of hospitalization and follow up after 40 days. Results: MI complication showed insignificant difference between both groups. Wall motion score index (WMSI) values in group I were significantly decreased relative to group II during the follow-up period (p=0.001). Major improvement in LV ejection fraction from hospital admission to follow-up (p=0.001) in group I from the beginning of chest pain compared to group II. Correlation between time to wire crossing and WMSI showed significant positive correlation after 40 days in group I (p=0.016) with significant negative correlation with EF after 40 days in group I (p=0.018). Conclusions: Ischemic patients with ≤ 12 hours symptoms showed a significant degree of recovery from RWMA on follow up after 40 days.

Objectives: to study the relation between atrial fibrillation (AF) and in-hospital outcome in patients with acute coronary syndrome (ACS) who were treated by primary percutaneous coronary intervention (PCI). Methods: This study was conducted on 80 patients admitted with ACS and treated with primary PCI at cardiovascular medicine department Tanta university hospitals starting from January 2020 till January 2021. The primary end points are all cause mortality and major adverse cardiovascular events (MACE) including a composite of death, nonfatal re-infarction, target vessel revascularization (TVR), new onset congestive heart failure, contrast induced nephropathy (CIN), or stroke during hospitalization. Patients was divided into 2 groups: Group 1: consisted of 40 consecutive AF-patients treated by primary PCI. Group 2: consisted of 40 consecutive sinus rhythm-patients treated by primary PCI. Results: Patients in AF group showed significantly older age, lower systolic and diastolic blood pressure, higher heart rate, higher Killip class II-IV, more inferior STEMI presentation, higher CK-MB, more RCA as infarction related artery, more moderate to sever mitral regurgitation, more patient developed congestive heart failure during hospitalization, and higher overall MACE during hospitalization. Univariate and multivariate regression analysis were performed to investigate the possible predictors of AF in the study population. In univariate regression analysis, older age, higher CKMB level, higher degree of mitral regurgitation, enlarged left atrium, and RCA as infarction related artery were correlated with AF. In the multivariate regression analysis, using model adjusted for aforementioned parameters, older age, higher CK-MB level, enlarged left atrium diameter, and RCA as infarction related artery independently predicted AF. Univariate and multivariate regression analyses were performed to investigate the possible predictors of overall in-hospital MACE in the study population. In univariate regression analysis, smoking, Killip II-IV, high creatinine level, lower ejection fraction, higher end systolic diameter, and AF were correlated with MACE. In the multivariate regression analysis, using model adjusted for aforementioned parameters, Killip II-IV, higher creatinine level, and AF independently predicted MACE. Conclusion: Patients older in age, with higher CK-MB level, enlarged left atrial diameter, and RCA as infarction related artery had higher incidence of AF during ACS. Patient with AF who presented with ACS had a higher incidence of heart failure during hospitalization. The independent predictors of MACE in our study were AF, Killip II-IV, and higher creatinine level.