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Aim: What changes subclinical hypothyroidism (SCH) causes on the 12-lead surface electrocardiogram (ECG) has remained elusive. We examined the relationship between subclinical hypothyroidism and cardiac electromechanics, including P wave and QRS axes on ECG and cardiac functions by 2D speckle-tracking echocardiography (2D-STE). Material and Method: This cross-sectional study included 109 SCH patients who presented to the internal disease outpatient clinic between November 10, 2018, and January 30, 2019. ECG, 2D-STE images, and laboratory findings at admission were recorded for all patients. Findings were compared with a sex and age-matched control group of 74 healthy adults.Results: The median age of the patients was 41 (IQR, 34–50) years, and 76.1% were female. QTc interval was significantly longer in the patient group than in the control group.[435 ms (IQR, 421–457) vs. 424 ms (IQR, 412–438), p=0.001]. The remaining ECG features, including P wave and QRS axes, were similar between the patient and control groups. There were no significant differences between the patients and control group regarding laboratory and echocardiography findings, including left ventricle global longitudinal strain.Conclusion: According to our findings, individuals with SCH exhibited no change in myocardial mobility as measured by strain echocardiography. In addition, SCH may not cause significant ECG changes, except that these patients have a longer QTc interval than subjects with euthyroidism.

Dextrocardia with situs inversus has an incidence of 1 in 10,000 and is a rare cardiac anomaly in which the heart is located in the right hemithorax with the axis directed to the right and caudally. Patients with dextrocardia present a diagnostic challenge, especially in the setting of acute coronary syndrome. The left circumflex artery (LCx) is the least frequent culprit artery for acute myocardial infarction (AMI) in the general population. An electrocardiogram (ECG) has very low sensitivity for detecting ST-segment elevation myocardial infarction (STEMI) if the culprit lesion is in the LCx. The coexistence of dextrocardia and LCx occlusion increases the difficulty of diagnosis via ECG. We herein present a case of dextrocardia and LCx-related STEMI.Coronary heart disease and AMI occur at the same frequency in patients with dextrocardia as in the general population. Notably, given the rarity of dextrocardia, only a few reports to date have described the existence of AMI as a result of acute LCx occlusion in a patient with dextrocardia.

Giriş: Daha öncedenyapılan çalışmalar, inflamatuvar belirteçlerin koroner arter hastalığı olanhastalarda yeni başlayan atriyal fibrilasyon (AF)’un gelişimi ile ilişkiliolduğunu göstermiştir. Bununla birlikte, ST yükselmeli miyokart infarktüslü(STEMİ) hastalarda AF gelişimi için serum C-reaktif protein (CRP)’in serumalbumin oranı (CAR)’na göre prediktif değeri henüz araştırılmamıştır. Bunedenle, bu çalışmada, primer perkütan koroner girişim (pPKG) yapılan STEMİhastalarında AF’ı öngörmedeki değerini değerlendirmeyi amaçladık. Hastalar ve Yöntem:Bu çalışma, pPKG uygulanan 1153 STEMİ hastasına ilişkin verilerin geriyeyönelik analiz edilmesi ile yapıldı. CRP düzeyleri immünoturbidimetrik yöntemegöre ölçüldü ve serum albumin düzeyleri bromkresol yeşili yöntemiyle analizedildi. CAR, CRP değerlerinin serum albumin oranı olarak tanımlandı. Bulgular: Hastanedekalış sırasında AF insidansı %5.2 (n= 62 hasta) idi. AF olan hastalar, AFolmayanlara kıyasla yüksek CAR değerlerine sahipti. Çok değişkenli lojistik regresyonanalizleri, yüksek CAR değerinin AF’ın bağımsız bir belirleyicisi olduğunuortaya koydu (OR: 3.280, %95 CI: 1.564-6.878; p= 0.002). Ayrıca, ROC curveeğrilerinin karşılaştırıldığında, CAR’ın öngörücü performansının sırasıyla CRPve albuminden daha yüksek olduğunu göstermiştir. Sonuç: Bu çalışmadapPKG ile tedavi edilen STEMİ hastalarında yüksek CAR değerlerinin AF gelişimiile bağımsız olarak ilişkili olduğunu gözlemledik., Introduction:Previous studies reported that inflammatory markers are associated with thedevelopment of new-onset atrial fibrillation (NOAF) in patients with coronaryartery disease. However, the predictive value of serum C-reactive protein (CRP)to serum albumin ratio (CAR) for the development of NOAF in patients with STelevation myocardial infarction (STEMI) has not been investigated yet. Hence,the aim of the present study was to evaluate the potential utility of the CARin predicting NOAF in patients with STEMI who underwent primary percutaneouscoronary intervention (pPCI). Patients and Methods:The present study was a retrospective analysis of the data related to 1153patients with STEMI who underwent pPCI. CRP levels were measured according tothe immunoturbidimetric method, and serum albumin levels were analyzed by thebromocresol green method. The CAR was defined as the serum CRP level divided bythe serum albumin level. Results: Theincidence of NOAF during in-hospital stay was 5.2% (n= 62 patients). Patientswith NOAF had higher CAR values than those without NOAF. Multivariate logisticregression analyses revealed that elevated CAR value was an independentpredictor of NOAF (odds ratio 3.280, 95% confidence interval 1.564-6.878; p=0.002). Furthermore, comparison of receiver operating characteristic curvesyielded that the predictive performance of CAR was higher than CRP and albuminalone, respectively. Conclusion: In thepresent study, we observed that elevated CAR values were independentlyassociated with NOAF development in patients with STEMI treated with pPCI.