Medicine and Health Sciences Commons^™

Covid-19 And Arrhythmias: A Review Of Cardiac Electrophysiology Associated With Sars-Cov-2, Kashmala Khan, Francis Dimtri, Carlos Vargas, Thomas Alexander

HCA Healthcare Journal of Medicine

Coronavirus infectious disease 2019 (COVID-19) has become one of the most recognized viral illnesses to date. Most people infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a benign clinical course, but there have also been catastrophic outcomes. Although, notoriously known to affect the respiratory system, extra-pulmonary manifestations have also been established. An increasing number of people have been reported to present with cardiac manifestations, which include but are not limited to arrhythmias. The cardiac conduction system can be damaged by various mechanisms in patients infected with SARS-CoV-2. In this review, we will attempt to briefly describe the arrhythmogenic …

Managing May-Thurner Syndrome And Associated Complications Throughout Pregnancy And Postpartum, Jessica A. Young, Stephen Zweibach, Nicole L. Plenty, Tiffany Tonismae

OB-GYN

No abstract provided.

Comparison Of The Performance Of The Ncdr Cathpci Score And Mehran Score To Predict Acute Kidney Injury Post-Percutaneous Coronary Intervention, Michelle Nguyen, S. Mustajab Hasan, Steven Quach, Sai Guduru, Faisal Rahim, Aiham Albaeni, Khalid Abusaada

HCA Healthcare Journal of Medicine

Background: A comparison of acute kindney injury (AKI) post-percutaneous coronary intervention (PCI) prediction models is lacking. In this study, we aim to compare the National Cardiovascular Data Registry (NCDR) CathPCI score to the Mehran score in acute coronary syndrome (ACS) vs non-ACS patients.

Methods: We included patients who received PCI at our facility between July 2015 and December 2017. We excluded patients without a pre- and/or post-PCI serum creatinine, patients on dialysis at the time of PCI and patients with missing variables required to calculate the predictive scoring model. The primary outcome of this study was AKI post-PCI. Performance of …

Flash Pulmonary Edema: A Case And Review Of Left Ventricular Non-Compaction Cardiomyopathy, Paula J. Watts, Oliver S. Garbo, Wendy Barrett, Michael Kopstein, Ryan Maybrook, Dmitriy Scherbak

HCA Healthcare Journal of Medicine

Left ventricular non-compaction cardiomyopathy is an uncommon type of cardiomyopathy caused by malformation of the myocardium during embryogenesis. This results in trabeculations within the ventricular wall that can affect the left and, less commonly, right ventricles. Presentation ranges from clinically asymptomatic to life-threatening arrhythmias. It is a rare and relatively unknown form of cardiomyopathy, though thought to be underdiagnosed. Prevalence is increasing due to improvements in imaging and awareness. Management is similar to that of other cardiomyopathies including angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, beta-blockers, diuretics, automatic implantable cardioverter defibrillator placement and cardiac transplantation. We present a case of a …

A Complication Of Acute Myocardial Infarction, Nakeya Dewaswala, Robert Dean Chait

HCA Healthcare Journal of Medicine

Ventricular septal rupture (VSR) is a rare complication after acute myocardial infarction (MI). The case presents an apical four chamber echocardiogram showing mid-septal discontinuity with lateral to medial movement of the transected ventricular septum during systole and diastole. Color Doppler demonstrates flow across the septum with extensive anatomic destruction of the ventricular septum.

Kounis Syndrome, Charles Doerner, Mark Sawh, Tamer A. Amer, Konstantinos Marmagkiolis

West Florida Division Virtual Research Day 2020

Kounis syndrome, also known as allergic vasospastic angina, is a type of acute coronary syndrome caused by an allergic reaction or immune response to a substance.[1] It is essentially an “allergic angina” which is believed to be caused by mast cell activation and release of cytokines and histamine causing spasm of the artery leading to acute coronary syndrome and acute myocardial infarction. Stress cardiomyopathy (Takotsubo syndrome), which predominantly affects post-menopausal women, may also occur in anaphylaxis where transient ventricular dysfunction associated with regional ventricular wall abnormalities extending beyond the regions of coronary blood supply ensues.[2] The suspected prevalence of Kounis …

Bedside Point Of Care Ultrasound Diagnosing Bilateral Valve Involvement In Infective Endocarditis, Corey Cole, Alfredo Tirado, Jonathan Schwadron

West Florida Division Virtual Research Day 2020

Endocarditis is a well known complication of intravenous drug abuse which classically affects the tricuspid valve. It is usually diagnosed by formal echocardiogram and positive blood cultures. Vegetations involving both the mitral and tricuspid valves are rare, occurring in less than 5% of all cases of infective endocarditis. 1 Here we report a case of a patient with vegetations on both valves which was discovered by point of care ultrasound.

End The Glow!, Roli Kushwaha, Anthony Furiato, Justin Mcnamee

West Florida Division Virtual Research Day 2020

Aortic dissection (AD) is part of a group of acute aortic syndromes consisting of intramural aortic hematoma, penetrating aortic ulcer, and aortic rupture. On its own, the incidence is ~3 to 8 cases per 100,000 per year, and up to 25% of cases are missed. The in-hospital mortality when treated is 27%, and with a 2% increase in mortality/hour. Imaging modalities like CT angiography, TEE, and MRA have made improved diagnosis of the disease, but are costly, potentially harmful, time consuming, and require patient stability when in use (1). The key question we have as emergency department providers is if …

Evolving De Winter Presentation Of Acute Myocardial Infarction, Caroline Shepherd, Anthony Furiato

West Florida Division Virtual Research Day 2020

de Winter ECG pattern first detailed in 2008 in a case series Diagnostic criteria

• Tall, prominent, symmetric T waves in the precordial leads
• Upsloping ST segment depression >1mm at the J-point in the precordial leads
• Absence of ST elevation in the precordial leads
• ST segment elevation (0.5mm-1mm) in aVR

Strongly correlated with acute LAD occlusion

Progressive Collateral Stenosis Leading To Symptomatic Chronic Total Occlusion, Farhan Shah, Andrew Maiolo

Capital Division Virtual Research Day 2020

Chronic total occlusion is defined as the complete obstruction of a coronary artery, with TIMI 0 or TIMI 1 flow, and an occlusion duration of greater than 3 months. We present a case of symptomatic chronic total occlusion in a functional 79 year old female with no past history of coronary artery disease, previously asymptomatic due to robust collateral circulation.

A Case Of Pacemaker Syndrome Mimicking A Heart Failure Exacerbation, Seline Haci, Som Aftabizadeh, Senthil Thambidorai, Karan Gupta, Ahsan Khan, Aman Patel, Kimberly Wilson, Anand Subramanian

Cardiology

No abstract provided.

Differences In Outcomes Of St-Segment Elevation Myocardial Infarction In African American Women Versus Women From Other Races: A United States National Study., Tasleem Katchi, Sanja Virani, Shaun Smithson, Bryan Curry

Cardiology

No abstract provided.

Diagonal 1 And Mid-Lad Myocardial Bridge With Elevated Troponin Enzymes, Ronak Patel Do

Cardiology

No abstract provided.

Diabetic Cardiomyopathy: Understanding The Independent Relationship Between Diabetes And Heart Failure, W. Tyler Crawley, Rage Geringer Md, Jason Snarr Do, Elizabeth Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Reverse Takotsubo-Like Cardiomyopathy And Pheochromocytoma, Patryk Purta, Dmitriy Scherbak Do, Michael Gruber Md, Oliwier Dziadkowiec

Cardiology

No abstract provided.

Phlegmasia Cerulea Dolens In May Thurner Syndrome: A Threat To Life & Limb, Matt Mcmaster, Rage Geringer Md, Gregory Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Catch 22 : To Anticoagulate Or Not To Anticoagulate, Muhammad Madkour, Patrick Hu

Internal Medicine

No abstract provided.

A Five Chambered Heart, George Hanna, Javad Savoj, Syed Iftikhar, Scott Kubomoto, Patrick Hu

Internal Medicine

No abstract provided.

Assessment Of Guideline Recommended Anti-Coagulation Rates For Atrial Fibrillation In An Outpatient Resident Clinic, Kanav Gupta Md, Emily Langnas Do, Zahra Khaled, Travis Tagami Do, Alexandra Halalau Md

Internal Medicine

No abstract provided.

Ablation Of Persistent Atrial Fibrillation Substrate In Sinus Rhythm Does Not Lead To An Underestimation Of Fibrotic Atrial Myopathy: A Pilot Study, David Goldgrab Do, Sokol Kalaveshi Md, Jose Luis Henao Md, Ruifang Yang Md, Jearim Craig, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: Ablation of persistent atrial fibrillation (peAF) is associated with a worse outcome. Fibrotic atrial myopathy (FAM) is thought to play a role in the progression of AF. Estimation of left atrial voltage can vary significantly based on whether mapping is performed in fibrillatory conduction or sinus rhythm (SR). Selection of a voltage scale (VS) may lead to an over/under estimation of FAM. We determined the prevalence of advanced atrial myopathy (FAM > = 2) in SR compared to historical cohort ablated in peAF.

Methods: A homogenous group of peAF patients who underwent ablation in SR following cardioversion were …

Is The Thomas Ring An Effective Approach To Prevent Recurrence Of Persistent Atrial Fibrillation With Advanced Atrial Fibrosis?, Ruifang Yang Md, Jose Luis Henao Md, David Goldgrab Do, Sokol Kalaveshi Md, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: Pulmonary vein isolation (PVI) with the Thomas ring (TR, single ring posterior wall isolation) has been shown to reduce recurrence of primarily paroxysmal atrial fibrillation (AF). Atrial fibrosis, as an important pathophysiological contributor, is directly linked to AF recurrence and resistance to therapy. The effect of TR ablation on outcomes of persistent AF (peAF) with advanced atrial fibrosis has not been adequately studied.

Methods: Observational series of three peAF patients (Tab.) who underwent TR. The degree of atrial fibrosis was determined by electroanatomic bipolar voltage mapping (CARTO, Diamond Bar, CA, USA). The reduced voltage areas (Fig.) reflected …

A Crescent Lesion Set Avoiding Esophageal Contact Is Not Inferior To Standard Waca For Paroxysmal Afib: A Pilot Study, Jeraim Craig, David Goldgrab Do, Sokol Kalaveshi, Ruifang Yang Md, Jose Luis Henao, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: Radiofrequency ablation using wide area circumferential ablation (WACA) is the standard approach for paroxysmal atrial fibrillation (pAF). Invariably the posterior wall requires RFA to isolate the pulmonary veins (PV). However, excessive heating of the posterior wall can lead to catastrophic esophageal injury. It has been reported that pulmonary vein isolation can be achieved without fully encircling the PV antra. When WACA is not feasible then a semilunar/crescent lesion set (CL) limiting posterior wall ablation can be considered.

Methods:A non‐randomized prospective study comparing highly symptomatic patients with pAF who underwent WACA with a study group who had a …

Cardioversion Of Persistent Atrial Fibrillation Before High Energy Ablation Does Not Improve Outcomes In Short Term Follow Up: Preliminary Analysis, Ruifang Yang Md, Sokol Kalaveshi Md, David Goldgrab Do, Jose Luis Henao Md, Stephen Mester Md, Christian Perzanowski Md

Cardiology

Introduction | Objectives: The optimal approach of ablating persistent Atrial Fibrillation (peAF) has yet to be defined. By convention, mapping/ablation of peAF is most often performed in AF. The success of ablation hinges on catheter contact and achieving lesion transmurality. We theorized that ablation efficacy would improve during sinus rhythm (SR) given stability and predictability of catheter contact.

Methods: Non‐randomized comparison of peAF patients who underwent ablation in SR under a new practice protocol versus a cohort of peAF ablated in AF. The lesion set was the same for both groups, WACA ± BOX. Study group was treated with higher …