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Article ; Online: Biventricular Endomyocardial Fibrosis in a Patient With Chronic Myeloid Leukemia-Classical Imaging Diagnosis Not to Be Missed.

Shams, Pirbhat / Tipoo Sultan, Fateh Ali

CASE (Philadelphia, Pa.)

2024 Volume 8, Issue 3Part B, Page(s) 249–252

Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Case Reports
ISSN	2468-6441
ISSN (online)	2468-6441
DOI	10.1016/j.case.2023.12.001
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Article: Cardiac magnetic resonance features and outcomes of patients with non-compaction cardiomyopathy - A retrospective follow-up from Pakistan.

Shams, Pirbhat / Tipoo, Fateh Ali

Annals of medicine and surgery (2012)

2022 Volume 80, Page(s) 103962

Abstract: Background: The exact prevalence of left ventricle non-compaction cardiomyopathy (LVNC) in south Asians is not known and phenotypic CMR characteristics, clinical features, and outcomes of LVNC remain unknown for the SA population.: Objective: To ... ...

Abstract	Background: The exact prevalence of left ventricle non-compaction cardiomyopathy (LVNC) in south Asians is not known and phenotypic CMR characteristics, clinical features, and outcomes of LVNC remain unknown for the SA population. Objective: To evaluate clinical characteristics, cardiac magnetic resonance imaging features, and outcomes of patients with left ventricle non-compaction. Methods: This was a retrospective study of 294 patients undergoing cardiac MRI (CMR) for evaluation of cardiomyopathy from 2011 to 2020. Patients were stratified based on the presence or absence of left ventricle non-compaction (LVNC). Clinical characteristics, CMR features, and outcomes were evaluated. Results: Out of 294 patients, 18 patients had LVNC, with a prevalence of 6.1%. The mean age was 32 ± 13 years, and the majority were males (78%). The mean EF by echo was 36 ± 14 and by CMR was 31 ± 16 and the mean LV mass was 151 g. The mean LVEDV was 290 ± 154 and the mean LVESV was 211 ± 126. LGE was present in 33% of patients. The majority had uniform LV non-compaction (56%) followed by predominantly anterolateral and apical involvement (28%). Mitral regurgitation was the most common valvular pathology (33%). On follow-up of 37 months, the majority experienced at least one all-cause MACE (69%), while 14% of patients experienced mortality on follow-up. When compared with dilated cardiomyopathy patients without LVNC, the subjects were younger (p = 0.002) and had higher EF by an echocardiogram (0.001) and a lower arrhythmia hospitalization (p = 0.039). No difference was observed in overall MACE outcomes, mortality, and CMR features. Conclusion: The prevalence of LVNC is low in the studied population. Patients with LVNC have younger age, higher EF by echocardiogram, and lower arrhythmia hospitalization when compared with patients with dilated cardiomyopathy without evidence of LV non-compaction. The presence of LVNC does not confer an increased risk of MACE.
Language	English
Publishing date	2022-06-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2022.103962
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Article ; Online: Best management of patients with malignant pericardial effusion: A comparative study between imaging-guided pericardiocentesis and surgical pericardial window.

Baqi, Abdul / Ahmed, Intisar / Shams, Pirbhat

Journal of clinical and translational research

2023 Volume 9, Issue 3, Page(s) 206–211

Abstract: Background: The clinical course of malignancies is frequently complicated by third spacing in body cavities, including pericardial effusion. What remains the optimal management for malignant pericardial effusion is a dilemma.: Aim: We aimed to ... ...

Abstract	Background: The clinical course of malignancies is frequently complicated by third spacing in body cavities, including pericardial effusion. What remains the optimal management for malignant pericardial effusion is a dilemma. Aim: We aimed to compare 30-day outcomes of imaging-guided pericardiocentesis and surgical pericardial window in patients with malignant pericardial effusion. Methods: A retrospective observational study was done at a tertiary care hospital. We reviewed hospital record files of 91 consecutive patients admitted with malignant pericardial effusion from January 2010 to December 2019 and requiring imaging-guided pericardiocentesis or pericardial window. Results: A total of 71 patients were included in the final analysis. Most patients were male (68%). The mean age was 45 years. Hypertension was the most common comorbid condition. Lymphoma or leukemia (39%) was the most common cause of malignant pericardial effusion followed by lung cancer (28%). About 57.7% of patients underwent pericardiocentesis, and the remainder underwent surgical pericardial window (42.3%). The overall procedural success was 97.2%, and the overall mortality was 5.6%. The success rate was similar when pericardiocentesis was compared with the surgical pericardial window ( Conclusion: There is a higher rate of recurrence following isolated pericardiocentesis but a comparable mortality difference between the two procedures. Complication rates can be reduced by improving surgical technique and peri-operative management. Meticulous surgical care, infection precautions, and good glycemic control in this immunocompromised subset can preserve the pericardial window as a better management option. Relevance to patients: Pericardial window is a promising and effective management option for patients with recurrent malignant pericardial effusion, but it comes at the cost of bleeding and infection. More extensive trials are needed to understand better the long-term outcomes of pericardial window or pericardiocentesis in patients with malignant effusion.
Language	English
Publishing date	2023-06-02
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	3019815-X
ISSN	2424-810X ; 2382-6533
ISSN (online)	2424-810X
ISSN	2382-6533
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Article: Clinical Characteristics, Cardiac Magnetic Resonance Features, and Outcomes of Patients with Dilated Cardiomyopathy - An Experience from a South Asian Country.

Shams, Pirbhat / Sultan, Fateh Ali Tipoo

Journal of clinical imaging science

2021 Volume 11, Page(s) 40

Abstract: Objectives: The objectives of the study were to evaluate the clinical presentation, cardiac magnetic resonance (CMR) features, and outcomes of patients with dilated cardiomyopathy (DCM).: Material and methods: A retrospective study was conducted at a ...

Abstract	Objectives: The objectives of the study were to evaluate the clinical presentation, cardiac magnetic resonance (CMR) features, and outcomes of patients with dilated cardiomyopathy (DCM). Material and methods: A retrospective study was conducted at a tertiary care center of Pakistan. All patients who underwent CMR for further evaluation of DCM during the period of 2011-2019 and in whom CMR confirmed the diagnosis of DCM, were included in the study. Patients were followed up in the year 2020 for all-cause mortality and cardiovascular hospitalizations. Results: A total of 75 patients were included in the study. The mean age was 38.7 ± 13 with the majority ( Conclusion: LVSV, LVEF by CMR, and PE were significantly associated with all-cause MACE. LGE was associated with higher mortality. Our cohort had a relatively younger age of presentation and diagnosis, and a greater mortality on follow-up, when compared with other regions of the world.
Language	English
Publishing date	2021-07-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2601233-9
ISSN	2156-5597 ; 2156-7514
ISSN (online)	2156-5597
ISSN	2156-7514
DOI	10.25259/JCIS_126_2021
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Article ; Online: Lateral ST-elevation myocardial infarction after donation of COVID-19 convalescent plasma in a naïve donor.

Shams, Pirbhat / Tipoo, Fateh Ali

BMJ case reports

2021 Volume 14, Issue 3

Abstract: A 34-year-old man presented with central chest pain heralded by bilateral arm numbness, tingling and pain soon after donation of 1000 mL of COVID-19 convalescent plasma (CP). ECG showed ST-elevation in lateral leads and coronary angiogram showed large ... ...

Abstract	A 34-year-old man presented with central chest pain heralded by bilateral arm numbness, tingling and pain soon after donation of 1000 mL of COVID-19 convalescent plasma (CP). ECG showed ST-elevation in lateral leads and coronary angiogram showed large thrombus in diagonal branch of the left anterior descending artery. The patient underwent successful thrombus aspiration and percutaneous coronary intervention of diagonal branch. In this report, we describe a case of coronary thrombosis leading to ST-elevation myocardial infarction in a naïve plasma donor after donation of COVID-19 CP.
MeSH term(s)	Adult ; Blood Donors ; COVID-19/blood ; COVID-19/therapy ; Coronary Angiography/methods ; Coronary Thrombosis/complications ; Coronary Thrombosis/diagnosis ; Coronary Thrombosis/therapy ; Electrocardiography/methods ; Humans ; Immunization, Passive/adverse effects ; Male ; Percutaneous Coronary Intervention/methods ; Plasma ; SARS-CoV-2 ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/etiology ; ST Elevation Myocardial Infarction/therapy ; Thrombectomy/methods ; Treatment Outcome ; COVID-19 Serotherapy
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-242542
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Article ; Online: Reverse Takotsubo Cardiomyopathy Following A Case Of Suspected Meningoencephalitis And Literature Review.

Shams, Pirbhat / Ahmed, Intisar / Khan, Aamir Hameed

Journal of Ayub Medical College, Abbottabad : JAMC

2022 Volume 33, Issue 4, Page(s) 695–697

Abstract: Reverse Takotsubo cardiomyopathy is a rare variant of stress cardiomyopathy. A 22-year-old male presented with altered mentation and fever. He was intubated due to low Glasgow Coma Scale. CT head plain showed diffuse cerebral oedema. Patient had raised ... ...

Abstract	Reverse Takotsubo cardiomyopathy is a rare variant of stress cardiomyopathy. A 22-year-old male presented with altered mentation and fever. He was intubated due to low Glasgow Coma Scale. CT head plain showed diffuse cerebral oedema. Patient had raised troponin-I and echocardiogram revealed reduced ejection fraction with hyperdynamic apical segments and akinetic basal to mid segments suggestive of reverse Takotsubo cardiomyopathy (rTCM). Association of rTCM with neuropsychiatric disorders such as intracranial/epidural haemorrhages and anorexia nervosa has been defined. However, it is rare to have rTCM with meningoencephalitis.
MeSH term(s)	Adult ; Echocardiography ; Humans ; Male ; Meningoencephalitis/diagnosis ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/etiology ; Young Adult
Language	English
Publishing date	2022-02-03
Publishing country	Pakistan
Document type	Case Reports ; Review
ZDB-ID	2192473-9
ISSN	1819-2718 ; 1025-9589
ISSN (online)	1819-2718
ISSN	1025-9589
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Article: A comparison of cardiology training in Pakistan and the United States.

Iltaf Satti, Danish / Minhas, Abdul Mannan Khan / Ijaz, Sardar Hassan / Khan, Muhammad Shahzeb / Samad, Zainab / Hussain, Aliza / Shams, Pirbhat / Shahab, Hunaina / Baloch, Farhala / Virani, Salim S

Proceedings (Baylor University. Medical Center)

2024 Volume 37, Issue 2, Page(s) 369–371

Language	English
Publishing date	2024-02-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703932-8
ISSN	1525-3252 ; 0899-8280
ISSN (online)	1525-3252
ISSN	0899-8280
DOI	10.1080/08998280.2023.2288474
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Zs.A 6987: Show issues

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Article ; Online: Clinically isolated aortitis presenting as inferior ST-elevation myocardial infarction due to an unruptured sinus of Valsalva aneurysm: a rare and forgotten cause of acute coronary syndrome in a young patient with no evidence of systemic vasculitis.

Baqi, Abdul / Shams, Pirbhat / Ahmed, Intisar / Tariq, Muhammad

BMJ case reports

2021 Volume 14, Issue 5

Abstract: A 21-year-old man presented with chest pain, diaphoresis and dyspnoea. Electrocardiogram (ECG) showed inferior ST-elevation myocardial infarction. Troponin I was positive. Patient underwent left heart catheterisation, which revealed normal epicardial ... ...

Abstract	A 21-year-old man presented with chest pain, diaphoresis and dyspnoea. Electrocardiogram (ECG) showed inferior ST-elevation myocardial infarction. Troponin I was positive. Patient underwent left heart catheterisation, which revealed normal epicardial coronary arteries except for right coronary artery which could not be engaged. CT coronary angiogram was done, which revealed large right sinus of Valsalva aneurysm giving rise to a pinched out right coronary artery. Patient underwent composite graft replacement of aortic valve, aortic root and ascending aorta along with a saphenous vein graft to right coronary artery. He was discharged in stable condition on fifth postoperative day. Biopsy of the aneurysmal tissue was suggestive of vasculitic aetiology. There was no evidence of systemic vasculitis and Magnetic Resonance Angiography (MRA) screen was negative for Takayasu's arteritis. Our patient was, hence, diagnosed with clinically isolated aortitis leading to ST elevation myocardial infarction due to an unruptured sinus of Valsalva aneurysm.
MeSH term(s)	Acute Coronary Syndrome ; Adult ; Aortitis ; Humans ; Male ; ST Elevation Myocardial Infarction ; Sinus of Valsalva/diagnostic imaging ; Systemic Vasculitis ; Young Adult
Language	English
Publishing date	2021-05-24
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-239683
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Article ; Online: Prevalence and Outcomes of Myocarditis in Dengue-Infected Patients Admitted to a Tertiary Care Hospital of Low-Middle Income Country.

Baqi, Abdul / Ur Rehman, Fazal / Memon, Pirbhat Shams / Omair, Syed Furrukh

Global heart

2022 Volume 17, Issue 1, Page(s) 44

Abstract: Background: Myocarditis is a challenging diagnosis due to the heterogeneity of clinical presentations. Myocarditis can present with a mildly raised cardiac enzyme to severe myocarditis leading to congestive heart failure, arrhythmias, cardiogenic shock, ...

Abstract	Background: Myocarditis is a challenging diagnosis due to the heterogeneity of clinical presentations. Myocarditis can present with a mildly raised cardiac enzyme to severe myocarditis leading to congestive heart failure, arrhythmias, cardiogenic shock, and death. It is a predictor of morbidity and mortality in dengue-infected patients. The exact prevalence of dengue myocarditis and its outcomes are unknown in Pakistan. Objectives: We aim to study the prevalence and association of myocarditis with the length of stay in the hospital and mortality of dengue-infected patients. Methods: A retrospective observational study done at a tertiary care hospital. We reviewed hospital record files of 1008 consecutive patients with dengue viral infection admitted from November 2018 to November 2019. Results: Out of 1008 dengue-infected patients, 55.4% of patients were older than 35 years and 68.4% were males. Hypertension (HTN) was the most common comorbid condition. The prevalence of myocarditis in hospitalized dengue-infected patients was 4.2%. All (100%) of dengue myocarditis patients had raised cardiac troponin I (cTn-I), 59.5% of patients had at least one electrocardiography (ECG) change, and 24% had reduced ejection fraction (EF) (defined as EF < 55%). On multivariable analysis, patients with raised cTn-I levels (adjusted odds ratios = 5.29; [95% confidence interval (CI): 2.16-12.96]) and abnormal echocardiography (ECHO) [aOR = 4.38; 95% CI: 1.26-15.27)] had a prolonged hospital stay (>3 days). Raised cTn-I levels (aOR = 8.2; [95% CI: 1.83-36.84]) was significantly associated with in-hospital mortality. Conclusions: Raised cTn-I is the predictor of length of stay and in-hospital mortality in dengue-infected patients. Atrial fibrillation, diabetes mellitus, hypertension, low serum bicarbonate, high serum creatinine, and any abnormality on echocardiography were associated with adverse outcomes in dengue-infected patients.
MeSH term(s)	Arrhythmias, Cardiac/complications ; Dengue/complications ; Dengue/epidemiology ; Female ; Humans ; Hypertension/complications ; Male ; Myocarditis/epidemiology ; Myocarditis/etiology ; Observational Studies as Topic ; Prevalence ; Retrospective Studies ; Tertiary Care Centers
Language	English
Publishing date	2022-06-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2629633-0
ISSN	2211-8179 ; 2211-8160
ISSN (online)	2211-8179
ISSN	2211-8160
DOI	10.5334/gh.1129
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Article ; Online: Takotsubo Like Cardiomyopathy with Concomitant Pheochromocytoma: A Rare Presentation.

Shams, Pirbhat / Ahmed, Intisar / Siddique, Sabeeh / Abbas, Farhat / Khan, Aamir Hameed

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2022 Volume 32, Issue 11, Page(s) 1483–1485

Abstract: Pheochromocytoma classically presents with headache, diaphoresis, palpitations and, raised blood pressure. Rarely, it manifests as cardiomyopathy. Herein, we present a case of a 42-year woman who presented with heart failure and on work-up was found to ... ...

Abstract	Pheochromocytoma classically presents with headache, diaphoresis, palpitations and, raised blood pressure. Rarely, it manifests as cardiomyopathy. Herein, we present a case of a 42-year woman who presented with heart failure and on work-up was found to have pheochromocytoma leading to Takotsubo-like cardiomyopathy. The biochemical profile revealed raised serum metanephrines and normetanephrines. CT abdomen showed a left adrenal mass. Within two weeks of presentation and before surgical excision of the mass, she recovered from cardiomyopathy. After medical optimisation, the patient underwent elective adrenalectomy, which on histological evaluation revealed pheochromocytoma. Key Words: Cardiomyopathy, Pheochromocytoma, Adrenal mass.
MeSH term(s)	Humans ; Female ; Pheochromocytoma/complications ; Pheochromocytoma/diagnosis ; Pheochromocytoma/surgery ; Takotsubo Cardiomyopathy/etiology ; Takotsubo Cardiomyopathy/complications ; Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/surgery ; Adrenalectomy ; Cardiomyopathies/complications
Language	English
Publishing date	2022-11-14
Publishing country	Pakistan
Document type	Case Reports
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2022.11.1483
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