Cardiology Commons^™

Defying The Vicious Cycle: An Intriguing Case Of Brash Syndrome, Ahmed Shehadah, Himal Kharel, Pulkit Gandhi

Advances in Clinical Medical Research and Healthcare Delivery

BRASH Syndrome is a rare and life-threatening condition marked by the combination of bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia. This case report presents a 79-year-old female with acute kidney injury, hyperkalemia, and severe bradycardia without typical EKG changes associated with hyperkalemia. The aim of this article is to provide a comprehensive overview of BRASH syndrome, including its clinical manifestations, underlying pathophysiology, diagnostic approaches, and management strategies. The patient's presentation, laboratory findings, and response to treatment support the diagnosis of BRASH syndrome. The syndrome's pathogenesis involves a vicious cycle of bradycardia, renal failure, AV nodal blockade, and …

The Prevalence And Impact Of Obesity On The Outcomes Of Patients Undergoing Transcatheter Mitral Valve Repair Using Mitraclip - A National Inpatient Sample Analysis 2016 To 2020., Garba Rimamskep Shamaki, Favour Markson, Osarenren Idemudia, Andrew Murphy, Tamunoinemi Bob-Manuel, Akanimo Antia, David Corteville

Advances in Clinical Medical Research and Healthcare Delivery

Background: Low Body Mass Index (BMI) is associated with poor outcomes in patients who undergo various cardiac interventions. Studies on patients with elevated BMI have produced mixed results. Our study aims to evaluate the impact of obesity on the in-hospital outcomes of patients undergoing transcatheter mitral valve repair using MitraClip in the United States.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify patients who underwent transcatheter mitral valve repair using MitraClip. Patients less than 18 years, with protein-energy malnutrition and rapid weight loss, were excluded. Our final study population was classified into Obese (BMI ≥ 30 …

Kounis Syndrome – Anaphylaxis-Induced Acute Coronary Syndrome, Austin T. Thacker Do, Brachman Herzig Oms, Brendan Robinson Do, Ahad Anjum Do

Advances in Clinical Medical Research and Healthcare Delivery

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions.

Minoca - A Rarity Of It's Own And The Importance Of Cardiac Mri, Abdullah A. Orakzai, Deeptanshu Jain Md, Muhammad Osama, Syeda Sarah Raza, Soon-Il Song

Advances in Clinical Medical Research and Healthcare Delivery

Myocardial infarction with non-obstructive coronary arteries (MINOCA) disease is a diagnostic dilemma with clinical evidence of acute myocardial infarction (AMI) with normal coronary arteries. MINOCA is a complex issue; the management of the patients needs to be focused on identifying the core problem. Cardiac magnetic resonance (CMR) imaging is a non-invasive diagnostic tool that can play an important role in enabling clinicians to build a differential diagnosis in patients with MINOCA and also identify other non-ischemic aetiologies of myocardial injury. We present a challenging case of a patient with MINOCA with MI in small proximal septal artery distribution revealed on …

Bi-Atrial Thrombus Via Patent Foramen Ovale With Medical Noncompliance: A Case Report, Reid Mccullough, Ayesha Cheema, Owesh Contractor, Krystal Tomsky-Jackson

Advances in Clinical Medical Research and Healthcare Delivery

Numerous diagnoses in the hospital setting require anticoagulation. With different etiologies, certain specific assessments may not have a treatment plan that is studied extensively in evidence-based medical texts. In these uncommon situations, management may not have clear medical guidelines for successful treatment. We present a case of bi-atrial thrombus via PFO with concurrent pulmonary embolism, extensive clot burden history, and the plan to move forward with Angiovac. In patients with this specific history and pathology, modern procedures like Angiovac should be considered and discussed.

Pseudo-Wellens Syndrome: A Rare Entity Associated With Cocaine Use, Mohamed Salah Mohamed, Syed Hamza Waheed, Amir Mahmoud, Anas Hashem, Bipul Baibhav, Abdullah M. Firoze Ahmed

Advances in Clinical Medical Research and Healthcare Delivery

Wellens syndrome usually indicates critical left anterior descending artery (LAD) occlusion. Pseudo-Wellens syndrome consists of criteria of Wellens syndrome in the absence of critical LAD occlusion. We report a case of Pseudo-Wellens syndrome related to cocaine use. A 52-year-old male with a medical history of hypertension and diabetes, presented with acute retrosternal chest pain of 3 days duration. Physical examination was unremarkable. EKG on presentation showed deep T-wave inversions in leads V2 to V5. Highly sensitive troponin was elevated. The patient admitted to using cocaine daily for the past two months. Due to concerns for Wellens syndrome, the patient had …

Hydroxychloroquine Induced Cardiomyopathy, Mohamed Salah Mohamed, Katrina Wojciechowski, Scott Feitell, Muhammad Osama, Anas Hashem, Jayesh Patel, Amir Mahmoud, Ali Abdelhay, Prakash Upreti, Soidjon Khodjaev

Advances in Clinical Medical Research and Healthcare Delivery

Hydroxychloroquine (HCQ) is one of the immunomodulatory medications used in treatment of autoimmune diseases. Rarely, HCQ can cause serious complications, such as cardiotoxicity. We present a rare case of HCQ-induced cardiomyopathy. 60-year-old female patient with a medical history of SLE on chronic HCQ therapy for 28 years, preexisting non-ischemic cardiomyopathy and heart failure with reduced ejection fraction for 7 years, and complete heart block status post pacemaker insertion presented with acute chest pain and severe weight loss. Patient underwent coronary angiogram that showed normal coronaries and right-sided heart catheterization that showed acute heart failure. Echocardiogram showed LVEF of 30% with …