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Spontaneous Coronary Artery Dissection in Multiple Gestation Peripartum Period
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Background: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).

Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.

On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogram showed normal sinus rhythm with Nonspecific ST Abnormality. The first set of troponins less than 0.03, the second set shows troponins 0.18 and D-dimer 2340. The chest x-ray was unremarkable. An echocardiogram showed only mild to moderate mitral valve regurgitation. CT angiography of the chest showed no evidence of pulmonary embolism. She was started on a heparin drip and catheterization the next day showed no atherosclerotic coronary artery disease, but SCAD of inferior diagonal first branch noted. No intervention was done, heparin was stopped. The patient was started on aspirin, statin, Clopidogrel, Metoprolol, and Lisinopril per cardiology recommendation.

Conclusions: As an internist and primary care provider, we should keep Non-atherosclerotic SCAD in mind when a young female patient presents with acute chest pain. More studies are needed to find out the optimal management.

Current recommended conservative medical management includes long-term aspirin, beta blocker, and one year of clopidogrel, with the addition of a statin in patients with dyslipidemia.

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Publication Date
Sun Dec 10 2017
Journal Name
Al-academy
The Composition of design according to norm renovation in the interior design space
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The interior spaces represent a true reflection of the concepts and values ​​of humanity and requirements; were interested in current research ongoing changes that have occurred in those human values ​​and requirements over time, even pat each time warp its values ​​and its own requirements. Those changes, which receive Bdilalha the spaces linked by a renewal which guarantees the interior design of the spaces of sustainability and bio-coordinated. Launched search from an initial perception that those associated with the changes of the spaces through time that have not been subject to examination and supervision, they will constitute a continuing threat of losing the ties with the past under the pretext of modernization and mo

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Publication Date
Tue May 16 2023
Journal Name
Political Sciences Journal
Defense Diplomacy: The role of the French military bases in the African continent
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This research seeks to study the role of military bases in activating defense diplomacy, with a focus on studying the case of France in the African continent, which relied on its military bases as a tool to implement its foreign policy. The research explains the concept of defense diplomacy and its relationship to military bases as an effective tool to strengthening bilateral relations between the state's parties. The research focuses on studying the effectiveness of military bases as a tool for activating French defense diplomacy, and studying the goals that French foreign policy seeks to achieve through its intervention or presence in the African continent. In addition to the geopolitical reasons that prompted France to move to

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Engineering
Performance Evaluation of Pump Station of Main Outfall Drain in AL Nassiriyah City
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The Main Outfall drain pumping station in Nassiriyah is an important part in operation  system of the Main Outfall Drain (MOD) where it reduces the water levels in the U/S area of its and converted through Syphon freely under the Euphrates, its consists of several parts: U/S Basin, Station Building which contains 12 pumps, and Head Basin with Syphon, This station suffers from high levels especially in D/S area due to the current situation which is represented by establishing of dyke with pipes on MOD which located at 24 km from D/S of pumping station and Al-Khamisiyah Canal which located at 2.3 km from the U/S of dyke which feeds(Al Hammar Marsh) during drought season, several scenarios were adopted in order to expl

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
Directive Vision Transformations in Iraqi Political Theatre: محمد عبدالرضا حسين-سهى طه سالم
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  The creative arts in general and the theatre in specific represent man's rushing and carving for freedom, goodness and beauty, and the relation between creativity and freedom has always been fluctuating following the censorship pressures of all types and shapes the political, religious and social. Since the theatre is the closest and more touching creative art to the problems of the society of numerous types and levels and it was and has always been playing an enlightening role in shedding light on what the societies experiencing with crises and problems in all directions. The theatre, thus, derives the essence of existence from life, through topics concerned with what the human being is. It seeks to be the real witness and partne

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Graphical significance To (if) and (if) the two cops in Surat al-Maidah
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Many writers and scientists hardly differentiate between the two instruments of use
(If) and (if) to convergence in the meaning, as they perform the meaning of the penalty and condition, as the answer relates to his condition, but when linguistic meditation we find a great difference in use in terms of meaning, so this research came to reveal these meanings and was extrapolated applied in Surat al-Maidah By counting the verses in which (if) and (if) the cops were given and looking at their contexts, the connotation of the cops in most places was within the context of probability, which is the origin of its use, given in twenty places of Surat al-Ma'idah, and it had multiple connotations according to the contexts of the verses received

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Design requirements according to the formal integration in the design of interior spaces
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The formal integration of the interior spaces in general and the commercial spaces of the watch shops in the large commercial centers in particular is the goal that the designers aim to reach in order for the interior space to become successful in terms of the design idea and its characteristics. Implementation mechanism. One of the reasons for achieving formal integration in the interior spaces of watch shops is the requirements of the design that must be available in these spaces to reach a state of formal integration between the interior and the exterior so that the space becomes fully integrated in all respects. Because of the aforementioned reasons for dealing with the research, through four chapters: The first chapter included the

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
Song and motivation in language class: Chanson et motivation en classe de langue
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Songs are considered as an educational and a substantial dependable references used in teaching and learning, particularly the so - called foreign language learning that allows learners to adapt to the target language culture and to develop their language learning skills including: listening comprehension, reading comprehension, speaking and writing. Consequently, it can be said that the Francophone songs with the musical richness and resonance specifically facilities French language learning skills  for all levels of education and achieve short and long terms predetermined educational language learning goals.  

     In fact, language learning through songs method does not only include the

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Publication Date
Sun Oct 01 2023
Journal Name
Fuel
Matrix acidizing in carbonate rocks and the impact on geomechanical properties: A review
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Acid treatment is a widely used stimulation technique in the petroleum industry. Matrix acidizing is regarded as an effective and efficient acidizing technique for carbonate formations that leads to increase the fracture propagation, repair formation damage, and increase the permeability of carbonate rocks. Generally, the injected acid dissolves into the rock minerals and generates wormholes that modify the rock structure and enhance hydrocarbon production. However, one of the key issues is the associated degradation in the mechanical properties of carbonate rocks caused by the generated wormholes, which may significantly reduce the elastic properties and hardness of rocks. There have been several experimental and simulation studies regardi

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Publication Date
Mon Oct 31 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The adoption of green management in Iraqi construction industry: The challenges and benefits
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Concrete strength development by using magnetized water in normal and self-compacted concrete
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Abstract<p>The main objective of this work was to adopt an environmentally friendly technology with enhanced results. The technology of magnetic water (MW) treatment system can be used in concrete mixture production instead of potable water (PW) to improve both workability and strength. Two types of concrete were adopted: normal concreter production with two grades 25 and 35 MPa and the self-compacted concrete (SCC) with 35 MPa grade. The concrete mixes containing MW instead of PW results showed that, for 25 MPa grade, an improvement in a compressive strength of 15.1, 14.8, and 10.2% was achieved for 7, 28, and 90 days, respectively. For 35 MPa grade, an improvement of 13.6, 11.5, and </p> ... Show More
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