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Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group; and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.

a b s t r a c tBackground: Heart failure is one of the most leading cause of death worldwide, but the mechanical characteristics of the pulmonary system in these patients have not been studied enough. The aim of this study was to measure mechanical pulmonary changes in patients with congestive heart failure (CHF) by using impulse oscillometry (IOS), which can obtain data by simpler means and independently from respiratory muscle strength. Materials and methods:We assessed 24 CHF patients and 24 controls by spirometry and IOS using the Jaeger IOS system. IOS measures central and peripheral airway resistances (R20, R5) and central and peripheral reactances (X20, X5) using sound waves with different frequencies, which superimposed on the patients respiratory tidal volume and then records reflects. P value < 0.05 was taken to be significant. Results: The mean age of patients and controls was 61 AE 10 and 57 AE 7 years, respectively. The mean ejection fraction (EF) was 37 AE 17% for patients and 55 AE 7% for controls. Patients had a lower X5 (À0.20 AE 0.13 vs À0.13 AE 0.07; P < 0.05), forced expiratory volume in 1 second (FEV1; 2.26 AE 0.68 vs 3.09 AE 0.82: P < 0.01 L/min), and forced vital capacity (FVC; 2.55 AE 0.86 vs 3.32 AE 0.87; P < 0.05) compared to the controls. They also had elevated R5: 0.37 AE 0.21 vs 0.27 AE 0.09; P < 0.06). X5 was correlated with spirometric abnormalities (P < 0.05) and was lower in patients than in controls. Conclusion: X5 was lower and R5 was higher in patients than in controls. CHF patients can be assessed by IOS more comfortable than by spirometry. IOS can reliably measure peripheral airway resistance in this group of patients.

Introduction: Atrial myxomas are the most common primary heart tumors. Because of nonspecific symptoms, early diagnosis may be a challenge [1] [2]. Left atrial myxoma may or may not produce characteristic findings on auscultation. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection. Cardiac myxoma is located mostly in left atrium [3]. This was amazing huge mass of cardiac myxoma in unusual part of the heart with the patient showed significant response to anticoagulation after presumed recurrence of tumor. Case Presentation: A case of giant right atrial myxoma mimicking the right ventricular tumor is described. Surgery was performed in 41 years old female and the fist like tumor with its stalk was excised. Surprisingly it recurred after 2 month as the smaller tumor was completely resolved with anticoagulation therapy. In addition because of previous normal echocardiography that was done for another reasons, we estimated the speed of tumor's growth (3 millimeter/month). Conclusion: To sum up a very large myxoma in right ventricle may only present with occasional dyspnea and we can diagnose it with precise evaluation and with performing on time echocardiography.

Aim:The aim was to assess the effect of renal angioplasty with stent on systolic, diastolic, and mean arterial blood pressure (MAP) in awake and sleep time with ambulatory blood pressure (ABP) monitoring (Holter monitoring).Materials and MethodsPatients with angiographically proven atherosclerotic renal artery stenosis (RAS) were referred to the Angiography Department of Imam Hospital for intervention during a 1-year period from June 2008 to December 2009. Primary stent placement was attempted by a single operator in 27 severe RAS cases although 1 case was omitted from the study because of technical failure. Pre- and postprocedure creatinine levels, ejection fraction (EF), history of diabetes mellitus (DM), and ABP were obtained. Twenty-six (17 men, 9 women; average age, 62.6 years; age range, 90-21 years) consecutive patients participated in the study.Results:All patients had severe hypertension resistant to multiple medications; 10 patients had impaired renal function (serum creatinine level greater than 130 µmol/L). A total of 3 (11.5%) patients had congestive heart failure, and 10 (37.7%) were diabetic. Hypertension was cured in 1 (4%) patient, had improved in 23 (88.4%) patients, and had failed to respond to treatment in 2 (7.6%). Serum creatinine decreased significantly from 1.46 ± 0.89 to 1.35 ± 0.61 mg/dL (P<0.05).Conclusion:Percutaneous transluminal angioplasty for atheromatous RAS rarely cures hypertension, but improved blood pressure control is often achieved.