Browsing by Author "Kyriakakis, Charles"

Now showing 1 - 4 of 4
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    Chronic coronary syndromes - time to reassess the evidence
    (South African Heart Association, 2018) Kyriakakis, Charles
    No abstract available.
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    Persistant left superior vena cava – the value of an agitated saline contrast study
    (South African Heart Association, 2014) Moses, Jane; Kyriakakis, Charles; Weich, Hellmuth; Rossouw, Pieter; Herbst, Philip; Doubell, Anton
    A persistant left superior vena cava (PLSVC) draining to the coronary sinus (CS) is the most common venous anomaly of the thorax, affecting approximately 0.5% - 2% of the general population, and is present in up to 10% of patients with other congenital cardiac anomalies.(1) The embryological development of the thoracic venous system is complex and subject to significant variation. Usually, most of the left cardinal system involutes, leaving only the coronary sinus, which drains the cardiac veins, and the ligament of Marshall (a remnant of the left superior vena cava).(2) The presence of a PLSVC is usually an incidental finding at either echocardiography, cardiac catheterisation or device implantation.(1) The typical echocardiographic findings are that of a dilated CS, which can be appreciated on the parasternal long axis view, the parasternal short axis at mitral valve level, the apical 2 chamber view and a modified apical four chamber view scanning down to visualise the CS (Figure 1). A contrast study with agitated saline (“bubble study”) done via the left brachial vein will demonstrate the dilated CS draining into the right atrium (Figure 2).
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    Tri-leaflet mitral valves – when lightning strikes thrice
    (South African Heart Association, 2016) Van Rensburg, Annari; Pecoraro, Alfonso; Kyriakakis, Charles; Herbst, Philip; Doubell, Anton
    ENGLISH ABSTRACT: Mitral valves are well known to be bi-leaflet structures with attachments from both leaflets (anterior and posterior) to both papillary muscles (anterolateral and posteromedial). Congenital abnormalities of the mitral valve, although well described, are quite rare. These abnormalities can involve either the leaflet (cleft mitral valve) or the subvalvular apparatus (parachute mitral valve) or even occur as accessory mitral valve tissue (accessory mitral valve leaflet). These can occur in isolation, or in association with other congenital abnormalities. A tri-leaflet mitral valve is a novel echocardiographic finding that has only been described in 6 patients in 4 different case reports.(1-4) We report on 3 patients recently found to have trileaflet mitral valves in the setting of atrioventricular concordance and normal offset of the AV valves at our out-patient clinic.
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    When opportunity knocks
    (South African Heart Association, 2016) Van Rensburg, Annari; Kyriakakis, Charles; Pecoraro, Alfonso; Herbst, Philip
    ENGLISH ABSTRACT: Constrictive pericarditis remains a common medical problem in developing countries where it frequently complicates tuberculous pericarditis. In addition, it is not infrequently seen in the developed world in the context of previous cardiac surgery, chest irradiation and even idiopathic pericarditis.(1) The diagnosis of pericardial constriction is often elusive and delays between the onset of symptoms and final diagnosis is the norm. Given the potential curability of this cause of heart failure and the fact that various features of chronicity in the disease portend a poor prognosis, recognising the disease early is of paramount importance.(1) The haemodynamics of constriction, particularly in more pronounced cases, produces a set of interesting clinical findings that the vigilant physician can elicit. A useful, and often neglected clinical feature, is that of a diastolic precordial or epigastric impulse, the palpable equivalent of an audible diastolic pericardial knock. This short report illustrates this unique clinical finding and explains the haemodynamics responsible for it. We also briefly review other commonly found clinical findings that assist in making the diagnosis of constrictive pericarditis.