Digital Commons Network^™

A “Fishy” Situation, Rare Pathogen And Presentation In Prosthetic Valve Infective Endocarditis, Nichole Schtupak, Patrick Kennedy, Darko Pucar, Linda Godinez, Jodi-Ann Chin, Kristen Selema, Dipan Uppa, Antonio Lewis, Marcelo Helguera

DMSc Student Publications

Lactococcus garviae (L. garviae) is a gram-positive coccus belonging to the Streptococcaceae family. While primarily a pathogen in fish farms causing hemorrhagic sepsis, it can act as a rare opportunistic pathogen in humans. A 2021 case report by Bravo et al. documented less than 30 cases of infective endocarditis caused by L. garviae worldwide at that time. This case report describes the 27th documented case globally and 7th documented case in the USA of L. garviae causing infective endocarditis of a prosthetic valve.
L. garviae is found in unpasteurized dairy products, raw fish, and meat (pork, beef, and …

New Onset Dyspnea In A Patient With Pacemaker, What Does The Ecg Tracing Show?, Jakob Nypaver, Robert Libera Do, Arun Kundra, Ravi Choxi

Transformative Medicine (T-Med)

Dual chamber pacemakers are programmed to allow for AV synchrony. Whenever a patient with a dual chamber pacemaker with underlying sinus rhythm presents with AV dissociation, the lack of AV synchrony should be questioned. The authors present a case of new onset dyspnea diagnosed as pacemaker syndrome. The diagnosis was initially delayed due to underlying ventricular paced rhythm as misidentified as normal pacemaker behavior.

A 69-year-old female with a past medical history of 2:1 atrioventricular block status post dual-chamber pacemaker implant presented with complaints of new onset shortness of breath and dyspnea. The ECG showed a ventricular rate of 66 …

Highlights Of The 2023 Brano Heart Failure Forum, Bela Merkely, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2023 BHHF forum was held on the 13^th thru 15^th of September 2023 in Budapest, Hungary. It was attended by over 100 faculty from 16 countries. In addition, participation through online streaming was available. Throughout the forum, 16 sessions focused on challenges and solutions …

Takotsubo Cardiomyopathy Associations And Risk Factors, Erik Aranda-Michel, Cassandra Knott, Andrew Fisher, S Blake Wachter

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

The Use Of Angiovac In Large Sized Vegetations With Tricupsid Valve Infective Endocarditis, Haris Ahmed, Ly Tran, Youssef Al Saghir

South Atlantic Division GME Research Day 2024

No abstract provided.

Covid-19 Affects Cardiovascular System 6 Months After Symptoms In Pediatric, Al Hussein Mustafa Zahran Ahmed, Alsayed Ali Abdou Almarghany, Ahmed Ali Faheem Abdo, Moustafa Mohamed Mohamed Eldeib, Ali Elsayed Ali Elagamy, Abdou Mohamed Abdou Mahmoud, Mostafa Abd Elazeem Hassan Ahamed, Ahmed Ali Ali Assem, Hossam M. Farid El-Zamek, Abdelmaaboud M. M. Omar

Al-Azhar International Medical Journal

Background: Coronavirus disease 2019 (COVID-19), which resulted in a global pandemic, is caused by severe acute respiratory syndrome coronavirus 2. We aimed to highlight the cardiovascular involvement in children after 6 months of COVID-19 recovery, Aim and Objectives: To highlight the cardiovascular involvement in children after 6 months of COVID-19 since this has the potential for morbidity and mortality in this age group, Patients and Methods: This observational cross-sectional descriptive study was conducted on 42 pediatrics aged-19 after 6 months at hospitals from January 2022 to February 2023. All patients were subjected to full history taking, clinical examination, laboratory investigations …

Point-Of-Care Ultrasound For The Diagnosis Of Frequent Cardiovascular Diseases: A Review, Ernesto Calderon Martinez, Edna Diarte, Diana Othon, Leonardo Rodriguez Reyes, Daniel A. Aguirre Cano, Carolina Cantu Navarro, Maria G. Ycaza, David Arriaga Escamilla, Jinal Choudhari, George Michel

School of Medicine Publications and Presentations

Point-of-care ultrasound (POCUS) has emerged as an indispensable diagnostic tool in cardiology, particularly within the emergency department. This narrative synthesis provides a comprehensive exploration of POCUS applications in cardiovascular diseases, elucidating its multifaceted roles and addressing challenges. The review delves into the technical attributes of POCUS, emphasizing its noninvasive nature, radiation-free qualities, and suitability for non-radiologists. It navigates through educational strategies, stressing the importance of structured programs for the seamless integration of POCUS into clinical practice. Highlighting its efficacy, the synthesis discusses POCUS applications in various scenarios such as dyspnea, chest pain, cardiac arrest, aortic dissection, pericardial effusion, and pulmonary …

Rare Presentation Of Postpericardiotomy Syndrome After Left Atrial Myxoma Removal, Jessy Feng, Shyama Appareddy, Yaman Gibran, Aryana Garza, Jacqueline Luevano, Gustavo Garcia

School of Medicine Publications and Presentations

Postpericardiotomy syndrome (PPS) is a known complication of cardiac valve surgery, but it has not been commonly reported as a postoperative complication of cardiac myxoma removal. A 78-year-old female with hypertension and atrial fibrillation presenting with angina was found to have a large left atrial myxoma (7.5 cm × 4.4 cm). The myxoma was resected; however, 1-week postoperation hemoglobin and blood pressure decreased with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Limited transthoracic echocardiogram (TTE) showed moderate pericardial effusion, confirming the diagnosis of PPS. This case highlights the importance of monitoring patients postremoval of myxoma for symptoms of …

Association Between E-Cigarette Use And Myocardial Infarction: A Systematic Review And Meta-Analysis, Muhammad Talal Ashraf, Asim Shaikh, Muhammad Shakeel Khuzzaim Khan, Naseer Uddin, Muhammad Arham Bin Kashif, Syed Hassan Ahmed Rizvi, Hammad Khalid, Stafford Jude Sam, Affan Sohail

Department of Medicine

Background: The popularity of e-cigarettes has risen dramatically over the last few years, particularly among the younger population. Although the use of combustible cigarettes has established evidence to be associated with the development of several adverse cardiopulmonary diseases, the investigations regarding the prospective long-term effects of e-cigarette use on the cardiovascular system have just begun. We set to investigate if there is an association between the history of MI and e-cigarette use among smokers and non-smokers?
Methods: The current review aims to assess the association of myocardial infarction with e-cigarette consumption. PubMed, Google Scholar, and Cochrane Central Register of Controlled …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

The 2022 American College Of Cardiology Expert Consensus On The Role Of Nonstatin Therapies: An Expert-Guided Tour, Mini G Varughese, Christie M Ballantyne

The Texas Heart Institute Journal

No abstract provided.

Appropriateness Of Inpatient Transthoracic Echocardiography In A Community Hospital With A New Cardiology Fellowship Program, Christian D. Avalos, Y. Wady Aude

Research Colloquium

Background: The 2011 Appropriate Use Criteria (AUC) for echocardiography was developed to guide in the rational use of high quality cardiovascular imaging. Transthoracic echocardiography (TTE) orders with seemingly inappropriate indications were repeatedly identified at our hospital. Our goals were to identify the percentage of inappropriate TTEs, find a correlation between ordering physicians and appropriateness of TTEs, and reduce the inappropriate use of TTEs in the inpatient setting.

Methods: After implementing a required free-text indication for TTE orders, the indications of 100 random TTEs were retrospectively categorized as appropriate, inappropriate, and uncertain based on the AUC. TTEs for cardiac evaluation prior …

Hiccups: Nerve Irritation Or Masquerading As Acute Coronary Syndrome, Dessiree Cordero, Patrik Schmidt, Franklin Sosa, Maulin Patel, Eduard Sklyar

Journal Articles

The typical clinical presentation of acute coronary syndrome (ACS) includes chest pain that may radiate to the left arm, shoulder, jaw, and neck, accompanied by diaphoresis, dyspnea, nausea, vomiting, and hiccups, which have been observed as the sole symptom of presentation. The mechanism of hiccups involves the activation of the vagus and phrenic nerves, leading to the activation of the diaphragm and intercostal muscles. Several hypotheses link hiccups to ACS, associating irritation of the left anterior descending artery with activation of sympathetic phrenic and vagal nerves. This case report highlights the occurrence of hiccups in patients with inferior and right …

Coronary Artery Stent Stenosis Assessment In Coronary Ct Angiography, Mohammad Farouk Aggag, Mahmoud El-Shamy, Ahmed Osama Abbas El-Kattan

Al-Azhar International Medical Journal

Background: Coronary artery stenting is the most important minimally invasive treatment for symptomatic coronary artery disease. But because in-stent restenosis occurs at a somewhat high rate, invasive angiography is now commonly utilised to assess stent patency.Objective: The objective of the study is to examine how multidetector CT scans can assist physicians in making decisions regarding the placement of coronary artery stents in patients who have chronic chest pain or who have myocardial ischemia. Method: A total of 40 individuals had multislice CT angiography of the coronary arteries between February 2022 and August 2022 as part of this study. Such patients …

Highlights Of The 2022 Brano Heart Failure Forum: Part Two, Ugolino Livi, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2022 BHFF forum was held on the 6^th thru 8^th of September 2022 in Trieste, Italy. It was attended by over 94 faculty from 14 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions …

Targeting Myocardial Equilibrative Nucleoside Transporter Ent1 Provides Cardioprotection By Enhancing Myeloid Adora2b Signaling, Wei Ruan, Jiwen Li, Seungwon Choi, Xinxin Ma, Yafen Liang, Ragini Nair, Xiaoyi Yuan, Tingting W Mills, Holger K Eltzschig

Journal Articles

Previous studies implicate extracellular adenosine signaling in attenuating myocardial ischemia and reperfusion injury (IRI). This extracellular adenosine signaling is terminated by its uptake into cells by equilibrative nucleoside transporters (ENTs). Thus, we hypothesized that targeting ENTs would function to increase cardiac adenosine signaling and concomitant cardioprotection against IRI. Mice were exposed to myocardial ischemia and reperfusion injury. Myocardial injury was attenuated in mice treated with the nonspecific ENT inhibitor dipyridamole. A comparison of mice with global Ent1 or Ent2 deletion showed cardioprotection only in Ent1-/- mice. Moreover, studies with tissue-specific Ent deletion revealed that mice with myocyte-specific Ent1 deletion (Ent1loxP/loxP …

Highlights Of The 2022 Brano Heart Failure Forum: Part One, Ugo Livi, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2022 BHHF forum was held on the 6^th thru 8^th of September 2022 in Trieste, Italy. It was attended by over 94 faculty from 14 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions …

Correlation Of Tei Index Assessed By Different Echocardiographic Methods In Patient With Acute Myocardial Infarction Receiving Different Reperfusion Treatment In Comparison With Ef And Diastolic Function, Mahmoud Elsayed Nofal, Abdelhamid Esmail Abdelhamid, Mohamed Hesham Hassan Ezzat

Al-Azhar International Medical Journal

Background: Acute myocardial infarction (AMI) is a common cardiac condition with high morbidity and mortality worldwide. A common complication of AMI is heart failure (HF). HF is the most significant predictor of mortality among AMI patients. So, a significant echocardiographic measurement for post-AMI patient is to assess the left ventricular systolic function via left ventricular ejection fraction (LVEF). As such, Tei index, which simultaneously measures relaxation and contraction velocities, may be of a prognostic importance in those presenting with AMI that may go unmissed with the isolated evaluation of LVEF. Objectives: this work was done to correlate MPI evaluated by …

Comparison Of Rcha2ds2-Vasc Score And Cha2ds2-Vasc Score For Prediction Of No-Reflow Phenomenon In Patients With St-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention, Ahmed Ibrahim Yousef Elsherif, Mamdouh Helmy Eltahan, Alhussien Mustafa Zahran

Al-Azhar International Medical Journal

Background: During primary PCI, about 95% of blocked coronary vessels are reopened. Therefore, it is the best applicable reperfusion strategy for acute STEMI.

Study aim: The objective was to investigate the significance of the RCHA2DS2-VASc score and CHA2DS2-VASc score in predicting the no-reflow phenomenon in STEMI patients undergoing Primary PCI.

Patients and Methods: In this cohort study, 80 patients with acute STEMI who undergone Primary PCI (40 patients had no-reflow and 40 patients without no-reflow) who were admitted to the coronary care units of October 6 University Hospital and Al-Azhar University Hospitals between September 2021 and March 2022 were included …

The Impact Of Sars-Cov-2 Virus On Acute Coronary Syndrome Patients Correlated With Clinical, Echocardiographic And Coronary Angiographic Outcome, Mohamed Nagdy Wadid, Monir Osman Amein, Wael Mohamed Attia, Khaled Mohammed Ibrahim Halima, Ibrahim Metwaly Bauomy

Al-Azhar International Medical Journal

Background; COVID-19 pandemic has led to many negative problems for all aspects of society. While respiratory symptoms are typically most severe manifestations of COVID-19 infection, SARS-CoV-2 infection may be responsible for diversity of potentially severe cardiovascular manifestations, mainly in studied cases with pre-existing cardiovascular conditions, Aim and objectives; to evaluate impact of SARS-CoV-2 virus on acute coronary syndrome patients and correlate it with clinical presentation, Echocardiography and coronary angiography outcome, Subjects & techniques: This was case control research, has been happened in Department of cardiology Al-Azhar University on 300 patients divided on three groups presented with acute coronary syndrome, STEMI …

Value Of Optical Coherence Tomography (Oct) In The Management Of Borderline Culprit Lesions In Patients With St-Segment Elevation Myocardial Infarction (Stemi), Hamada Alsheikh, Mohamed Abdelghani, Mansour Mostafa, Monier Osthman, Hassan Khalaf, Moataz Elsanan

Al-Azhar International Medical Journal

No abstract provided.

Cha2ds2-Vasc-Hs Score As A Predictor Of No-Reflow In Patients With St-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Intervention, Sameh Refaat Hassan Allam, Alhussein Mostafa Zahran, Mohamed Ahmed Mohamed Elagami

Al-Azhar International Medical Journal

Background: Current guidelines for acute ST-segment elevation myocardial infarction (STEMI) patients declared primary percutaneous coronary intervention (PPCI) as the mainstay reperfusion strategy. However, the no-reflow phenomenon(NRP) is a major drawback. The longer ischemia lasts, the more likely NRP is to occur causing more myocardial cells damage.

Aim of the Work: to correlate between the CHA2DS2VAScHS score and NPR in patient presented with STEMI and treated with PPCI.

Methods: Case-control study that included one hundred patients presented with STEMI and treated with PPCI. Patients were further divided into group(A) in which patients developed no-reflow (NR) after PPCI and group(B) in which …

Role Of Intravascular Ultrasound In Minimizing The Use Of Contrast In Percutaneous Coronary Intervention In Patients With Chronic Stable Angina And Chronic Kidney Disease Stageiii, Mahmoud Rady Abd Elzaher, Mohammad Ahmed Mosaad, Mohamed Saad Elgammal, Ayman Abdelaziz Abdelraman

Al-Azhar International Medical Journal

Background: Percutaneous coronary procedures (PCIs) are frequently guided by intravascular ultrasonography (IVUS) (PCIs). because it can precisely measure the size of the lumen, plaque, and vessel. The aim of this work was to evaluate role of intravascular ultrasound in minimizing the use of contrast in PCI in patients with chronic stable angina and chronic kidney disease stage III and incidence of acute kidney injury after IVUS based PCI and angiographic based PCI in chronic kidney disease stage III patients. Methods: 50 patients with stage III chronic renal disease and chronic stable angina, both diabetic and non-diabetic, were enrolled in this …

Value Of Intravascular Ultrasound Guidance In Patients Undergoing Unprotected Left Main Coronary Artery Stenting, Abduallah Abdelzaher Elbohy, Mansour Mohamed Mostafa, Khaled M Y El Nady, Ibrahim Abdelfattah Yasin

Al-Azhar International Medical Journal

Background: Intravascular ultrasound (IVUS)is a new imaging technique that facilitate the process of coronary intervention. The angiographic evaluation of left main lesions significance is always questionable, IVUS detect the significance, guide the procedure and some studies proves a benefit in mortality.

Aim of the Work: We aimed to determine if intravascular ultrasonography (IVUS) guided Left Main coronary intervention may enhance clinical results compared with angiographic-guided Left main coronary PCI.

Patients and Methods: 60 patients who were eligible for Left Main Coronary Intervention were split into two groups for this controlled trial between 2021 and 2022 at the Maadi Military Hospital …

Association Of Coronary Artery Disease Assessed By Ct-Calcium Score With Left Ventricular Diastolic Dysfunction, Mohamed Sayed Abd Allah Ateya, Islam Shawky Abdel-Aziz Saif-Alyazal, Mohammad Abdelghani Abdelzaher

Al-Azhar International Medical Journal

Background: Early onset and quiet progression are characteristics of atherosclerotic vascular disease, due to the release of vasoactive mediators and the reduced generation of nitric oxide by an endothelium that is dysfunctional, non-obstructive atherosclerotic plaques encourage functional changes in vascular tone, such as diastolic dysfunction.

Aim of the work: Explore the relationship between sub clinical coronary atherosclerosis presenting by abnormal calcium score and left ventricular diastolic function.

Patients and Methods: This study was an observational control study and conducted on 100 consecutive patients who presented mild symptomatic or asymptomatic for checkup at New Cairo Police Hospital during the study period, …

Predictors Of Improvement After Device Closure Of Atrial Septal Defect In Patients Above 30 Years, Abdullah Hamed Abd Elsamea, Abd Elmohsen Mustafa Abdu, Ibrahim Faragallah Said, Mohmmed Osama Taha

Al-Azhar International Medical Journal

Background: Atrial septal defects constitute around 25-30% of recent diagnoses of congenital heart defects in adults & the most common a cyanotic shunt lesion in adult as well. Aim of work: Assessment of enhancement of heart performance after device closure Assessment of symptomatic improvement after device closure. Patients and Methods: This study was involved 30 cases with atrial septal defect (ASD) who underwent closure of ASD with device closure. Results: Comparison among pre & post ASD device closure regarding echocardiogram data. There were significant statistical alterations in comparison amongst the pre & post ASD device closure regarding LVESV (P

Association Of Vitamin D Status With Severity Of Acute Coronary Syndrome, Sherif Hussein Nasr Ghander, Ahmed Abo Zaid, Essam Ahmed Khalil, Mohamed Abdelhady Abo Ahmed, Yasser Radwan Mohamed

Al-Azhar International Medical Journal

Background: Due to the existence of its receptor in cardiomyocytes, vitamin D deficiency influences alterations in these cells. People who have low levels of 25OHD in their blood are more likely to get an acute myocardial infarction (MI).

Aim of the work: to assess the level of vitamin D (concentrations of 25-OHD in serum) in people having acute coronary syndrome (ACS) and its relationship to the extent of the condition.

Methods: This Cross-sectional work was performed on 50 individuals. Age ranged from 32 to 82 diagnosed with ACS. All patients were subjected to left ventricular function (estimated ejection fraction (EF) …

Evaluation Of Successful Percutaneous Coronary Intervention For Right Coronary Artery Chronic Total Occlusion On Improvement Of Right Ventricular Systolic Function And Reverse Remodeling, Mostafa Attia Al Sawasany, Ahmad Mohammad Hassaan, Hazem Khaled Mustafa Abd El Hameed

Al-Azhar International Medical Journal

Background: Lesions with TIMI grade 0 flow for over three months are chronic total occlusions. Chronic coronary occlusions cause ventricular arrhythmias and poor outcomes. CTO difficulties and failure rates were increased even among seasoned PCI operators. 38–50% of CTO patients had RCAs. Right ventricular echocardiography was disregarded in the past. After depending largely on qualitative assessment in past, American Society of Echocardiography & European Association of cardiovascular imaging now offer many quantitative methods for assessing the RV. Aim: To correlate the relationship between Successful percutaneous coronary intervention for right coronary artery chronic total occlusion & improvement of Right ventricular functions. …

Patient-Specific Analysis Of Aortic Hemodynamics And Wall Shear Stresses In Patients Undergoing Pediatric Bariatric Surgery Using 2d Phase-Contrast Mri, Oluwaferanmi S. Akande, Joao Soares, Nathan Hargan, Dr. Uyen Truong, Haeung Kang, David Lanning

Undergraduate Research Posters

Patient-Specific Analysis of Aortic Hemodynamics and Wall Shear Stresses in Patients Undergoing Pediatric Bariatric Surgery using 2D Phase-Contrast MRI

Feranmi Akande¹ Nathan Hargan² Haesung Kang³ David Lanning³ Uyen Truong⁴ João S. Soares¹

¹ Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University

² Department of Mechanical & Nuclear Engineering, College of Engineering, Virginia Commonwealth University

³ Department of Cardiology, Children’s Hospital of Richmond, Virginia Commonwealth University

Introduction: Severe obesity among today’s youth is a rising epidemic within the United States. Emerging research has linked childhood obesity with shortened life expectancy and early …

Incidence And Severity Of Pulmonary Hypertension Among Patients With Chronic Kidney Disease, Mamdouh Maher

Journal of Medicine in Scientific Research

Chronic kidney disease (CKD) is a major health problem and is closely linked with cardiovascular disease. Pulmonary hypertension (PH) is considered a common comorbidity in CKD patients. In all, 100 patients were included in our study. Transthoracic echo Doppler study was performed to measure pulmonary artery systolic pressure based on tricuspid jet. The prevalence of PH in CKD patients in our study was 60%; prevalence and severity had significant association.

The hemodialyzed group showed a higher prevalence of PH with a more severe PH.

Our study had provided evidence that PH is a common comorbidity in CKD patients and is …