Medicine and Health Sciences Commons^™

Risk Factors For Neurological Complications And Short-Term Outcomes After Pediatric Heart Surgery: A Retrospective Analysis, ​​Muhammad ​ Shahzad, ​Yasser Abdulrhman ​ Alheraish, ​​Bushra ​ Algethami, Linah Abdulmohsen Algheryafi, Salma Kamel, Rawan Ghunaim, ​​Zohair Yousef ​ Alhalees

Journal of the Saudi Heart Association

Objective: To assess the risk factors associated with neurological complications and poor short-term outcomes following pediatric heart surgery.

Methodology: A cross-sectional study was conducted in a cardiac intensive care unit between June 2019 and June 2022. The data of all children less than 15 years old who underwent open-heart surgery and had CT brain were extracted from hospital records. The primary outcome was the incidence of CNS insult, and secondary outcomes included death after surgery, length of stay in ICU and hospital. Data analysis was performed using SPSS version 23, and a p-value less than or equal to 0.05 was …

Clinical And Procedural Characteristics Of Successful Transcatheter Device Closure Of Ostium Secundum Atrial Septal Defect In Symptomatic Children Weighing <15 Kg: A Retrospective Study Spanning One Decade From South India, Shobhit Priyanshu Joseph, Mirza Shohiab Ur Riyaz, Jesu Krupa, Shruti Irene Varghese, Gayathri Bhuvaneswaran Kartha, Oommen K. George, Paul V. George, John Jose, Viji Samuel Thomson

Journal of the Saudi Heart Association

Objectives: This retrospective study sought to determine the feasibility of transcatheter atrial septal defect device closure in patients less than 15 kg, as well as to assess complication rates and the reasons for unsuccessful device closure.

Background: In general, the risks associated with transcatheter atrial septal defect device closure are believed and reported to be relatively low, but the evidence stems from trials involving adults and older children. Current guidelines do not recommend atrial defect closure in device closure in children < 15kg, due to limited data available for feasibility and safety of device closure in this group of patients.

Methods: Retrospective review of all patients who underwent elective transcatheter closure of ostium secundum atrial septal defect between September …

Mid-Term Clinical And Hemodynamic Outcomes In Middle Age Patients Post Trifecta™ (Abbott) Aortic Valve Replacement: A Single-Center Study, Feras H. Khaliel, Mohammed Suliman Al Aboud, Suha A. Althibait, Saber Yezli, Elaf A Al Muaythir, Bandar Alamro, Domenico Galzerano

Journal of the Saudi Heart Association

Background: Trifecta™ is an externally wrapped bovine pericardial aortic valve with a favorable hemodynamic performance and acceptable rate of freedom from structural valve degeneration. However, recent reports of early Trifecta valve failure question its durability. Rheumatic valve disease in middle age population is predominant, there is no data on the Trifecta performance, durability or safety available worldwide over the middle age population, as well as there is no previous reports from Middle East region. We report on mid-term clinical and hemodynamic performance of Trifecta valve in middle age population with small aortic annuls, a single centre report. Methods: A retrospective …

Retrograde Type A　Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair, Hideki Sasaki, Yukihide Numata, Shinji Kamiya, Yoshiaki Sone, Miki Asano

Journal of the Saudi Heart Association

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

Systolic Pulmonary Artery Pressure Thresholds Predictive Of Dyspnea On Stress Doppler Echocardiography In Mitral Stenosis, Saléha Lehachi, Fadila Daimellah, Saida Khelil, Zakia Bennoui, Djohar Hannoun, Youcef Laid, Rachid Mechmeche, Mohand Said Issad

Journal of the Saudi Heart Association

Background. On Stress Doppler Echocardiography (SDE) in mitral stenosis, the systolic pulmonary artery pressure (SPAP) threshold at peak exercise recommended by the guidelines as an indication for percutaneous mitral commissurotomy (PMC) used to be 60 mmHg. However, because of the paucity of studies, that threshold has been controversial. The Europeans stopped using the value in 2007, followed by the Americans in 2014.

Objective. Determine SPAP thresholds on SDE at peak exercise and post-exercise predictive of dyspnea as an indication for PMC in mitral stenosis.

Method and results. Three hundred mitral stenosis patients with a mitral valve area (MVA) ≤ 2 …

Characteristics Of Patients Undergoing Electrophysiologic Procedures In A Tertiary Hospital In Saudi Arabia, Abdullah A. Aljammaz, Meshaal K. Alghanim, Ibraheem Altamimi, Mohammed A. Alshwieer, Albaraa Sabbagh, Abdulrahman S. Alsayed, Faisal G. Al-Zahrani, Mohammad F. Almanjomi, Sameer Qutub, Wael A. Alqarawi

Journal of the Saudi Heart Association

Introduction: The electrophysiology field has progressed rapidly over the last 2 decades. No study has examined the characteristics of patients and types of electrophysiology procedures performed in the Kingdom of Saudi Arabia. This is important given our distinctly different demographic composition and health system. As such, we sought to describe the characteristics of consecutive patients presenting for electrophysiology procedures in our tertiary care hospital.

Methods: Data was collected from the electrophysiology database at King Khalid University Hospital for procedures performed between April 2016 and November 2022. Patients’ characteristics were retrieved from the electronic medical record. Procedures were categorized into supraventricular …

Epidemiological, Bacteriological, And Evolutive Features Of Children Hospitalized For Infective Endocarditis In A Tertiary Tunisian Pediatric Department, Houda Ajmi, Rahma Herch, Hela Elghali, Dalel Ben Sliman, Mohamed Ben Rejeb, Sameh Mabrouk, Fadoua Majdoub, Salsabil Nouir, Lamia Tilouche, Abdelhalim Trabelsi, Saoussan Abroug, Jalel Chemli

Journal of the Saudi Heart Association

Background: Infective endocarditis is a rare condition in childhood, and there is limited data on this disease in Tunisia.

Objective: This study aims to analyze the epidemiological profile, bacteriological data, and prognosis of infective endocarditis in children admitted to the pediatric department of a University Hospital in Tunisia.

Methods: We conducted a comparative cross-sectional study in the pediatric department of Sahloul Teaching Hospital in Sousse, a tertiary referral hospital in Tunisia. The study included all children aged ≤ 18 years with infective endocarditis admitted to the tertiary referral center for pediatrics in Sahloul University Hospital from January 1994 to December …

Ischemic Stroke Revealing Libman-Sacks Endocarditis: A Case Report, Malak Alaoui Yazidi, Fatima Zahra Merzouk, Hajar Rabii, Hicham Benyoussef, Ilham Bensahi, Rachida Habbal

Journal of the Saudi Heart Association

Libman-Sacks endocarditis (LSE) is a characteristic but rare feature of systemic lupus erythematosus (SLE), which can be found in association with antiphospholipid syndrome (APS), exposing the patient to an increased embolism risk, particularly the occurrence of ischemic stroke. We present a case involving a 64-year-old man who was admitted for ischemic stroke accompanied by a fever. Cardiac investigation revealed mitral vegetations along with severe mitral regurgitation. The diagnosis of Libman-Sacks endocarditis associated with SLE and APS was made after a laboratory work-up showing negative blood cultures and positive antibodies. This case underlines the importance of early diagnosis for better management …

A Systematic Review And Meta-Analysis Of The Prevalence And Risk Factors In Cardiac Implantable Electronic Device Malfunction, Abdullah Saeed, Abdullah Alshafea, Monerah Alqthami, Abdulrahman Bin Saeed, Foton A. Alahmri, Norah S. Alqahtani, Fatimah A. Al-Muslat, Atheer Alqahtani

Journal of the Saudi Heart Association

Introduction: Cardiac implantable electronic devices (CIED) include permanent pacemakers (PPMs), implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. They treat several cardiac issues and are dependent on batteries; however, similar to any medical equipment, they can fail. The prevalence and risk factors for CIED malfunction must be understood for earlier detection and better patient outcomes. Material and methods: A comprehensive search was conducted through electronic bibliographic sources (PubMed and Cochrane) until January 2023 in order to identify reviews, cohort studies and case reports pertaining to CIED. The primary outcome is the probability of CIED malfunction. The secondary outcome …

Prevalence And Predictors Of Venous Stenosis Following First Transvenous Cardiac Implantable Electronic Device Implantation., ​Qayoom Yousuf, Aamir Rashid, Imran Hafeez, Hilal Rather, Ishrath Syed, Altaf Hussain Mir, Suheel Ahmad Mir, Ajaz ​ Lone

Journal of the Saudi Heart Association

Objectives: Very few studies have been done on Venous stenosis following the first transvenous cardiac device implantation. We aimed to assess the prevalence and predictors of Venous stenosis/Occlusion following the first transvenous cardiac device implantation with venous angiography at one year of follow-up. Methods: This study was a single-center prospective, observational study. Demographic, clinical, procedural, and device data was collected. All patients underwent a preimplant contrast and repeated venography at twelve months to look for upper limb venous anatomy, obstruction, or collaterals. Results: A total of 146 patients were included in the final analysis. 60 (41 %) patients developed some …

Position Statement On In-Hospital/Clinic Point-Of-Care Coagulation Testing For Anticoagulation Monitoring In Saudi Arabia, Fakhr Al Ayoubi, Malak Al Mashali, Mohamed Hassan Abdallah, Mohamed Al Sheef, Tarek Owaidah

Journal of the Saudi Heart Association

Objectives: Hospital overload is a persistent occurrence in daily practice. Interventions such as point-of-care testing (POCT) are needed to alleviate the pressure faced by healthcare providers and administrators. Methods: An invited panel of experts from Saudi Arabia was formed under the auspices of the Saudi Heart Association in order to discuss local treatment gaps in the management of patients receiving anticoagulation therapy. This was done in a series of meetings, which resulted in the development of official recommendations for the implementation of POCT for anticoagulation monitoring in the country. Recommendations were based on a comprehensive literature review and international guidelines …

The Interventions To Improve Medication Adherence In Coronary Heart Disease Patient: A Systematic Review, Amanda Marselin, Lia Amalia, Lucia Kris Dinarti

Journal of the Saudi Heart Association

Objective: The clinical outcome and quality of life of CHD patients are greatly influenced by medication adherence. Non-adherence of CHD patients to treatment results in sub-optimal clinical outcomes and increasing costs. This study aims to describe effectiveness of the intervention to improve the medication adherence in CHD patients. Methods: Systematic review methodology was used in this study. Scopus and PubMed were used to search the relevant article systematically. The outcome measured was medication adherence in coronary heart disease patients. Results: Final screening was 31 articles that met the inclusion criteria in this study of 788 articles. Selection processes the article …

Acceptance, Awareness, Attitude, And Practices Toward Heart Transplantation: A Saudi Based Survey, Walid Abukhudair, ​​Ahmad Zaki ​ Hafiz, ​​Mohammed Abdullah ​ Alosaimi, ​​Fares Abu ​ Alaynayn, ​​Fahad Abdullah ​ Alosaimi, ​​Rehab Ahmed ​ Karam, ​​Tamer Mohamed ​ Abdelrahman

Journal of the Saudi Heart Association

Introductions: The awareness of brain death and heart donation (HD) among the Saudi population remains limited, coupled with negative attitudes toward heart donation, resulting in a significant gap between the demand for donor hearts and the available supply. This study aimed to comprehensively understand the current perceptions, attitudes, and practices of the Saudi population regarding HD, as well as identify the obstacles. The ultimate goal was to strengthen the local donor pool. Methods: A cross-sectional study was conducted from March to May 2023, employing a self-administered internet survey. The survey collected demographic information, assessed awareness, attitudes, and practices related to …

Left Ventricular Noncompaction Cardiomyopathy And Myocardial Bridging Association : A Coincidence Or A Usual Association ?, Abdessamad Couissi, Saleh Obeidat, Amine Mamoune Boutaleb, Rachida Habbal

Journal of the Saudi Heart Association

Left ventricular non compaction (LVNC) is a rare congenital disease. It occurs due to an arrest of the myocardial fibers compaction during embryogenesis. Myocardial bridge (MB) is a coronary anomaly in which the myocardium covers segments of the coronary arteries. We report a rare case of 62-year-old women who was diagnosed with the association of LVNC and MB revealed by chest pain and dyspnea. Some similar cases were reported in the last two decades suggesting that we may be in front of a usual yet underdiagnosed association. To our knowledge, this is the first case described in the Arab World.

Evaluation Of Telephone Cardiopulmonary Resuscitation Performance In Current Practice In Saudi Arabia, Meshary Binhotan, Joanne Turnbull, Graham Petley, Nawfal Aljerian, Mohammad Altuwaijri

Journal of the Saudi Heart Association

Objectives: Out-of-hospital cardiac arrest (OHCA) is a global health problem with a low survival rate. Telephone cardiopulmonary resuscitation (T-CPR) guidance by emergency medical services (EMS) dispatchers can improve CPR performance and, consequently, survival rates. Accordingly, the American Heart Association (AHA) has released performance standards for T-CPR in current practice to improve its quality. However, no study has examined T-CPR performance in Saudi Arabia. Therefore, this study aims to evaluate T-CPR performance in the Saudi Arabian EMS system.

Methods: A retrospective observation of OHCA calls in current practice was conducted in Riyadh, Saudi Arabia. OHCA calls were reviewed to identify those …

Cardiac Rehabilitation In Abu Dhabi: A Retrospective Investigation Of Program Delivery, Participants, And Factors Associated With Program Completion Utilizing A Hospital Registry, Aaron Heisey Thrush

Journal of the Saudi Heart Association

Objectives: Investigations into the provision of cardiac rehabilitation from the Arabian Gulf countries are rare, despite suffering from an unusually high prevalence of cardiovascular disease. This study reports patient and program characteristics from an exercise-based cardiac rehabilitation program in Abu Dhabi, and factors associated with program completion. Methods: Data was drawn from the institution’s cardiac rehabilitation registry, populated from the electronic medical record of patients enrolled in the hospital-based cardiac rehabilitation program, from 2015 to 2022. The program was administered by physical therapist and nurse specialists and guided by individualized exercise parameters. Completion of the program was defined as attendance …

Recognizing A “Hot Phase” Of An Arrhythmogenic Left Ventricular Cardiomyopathy: A Case Report, Margarida Cabral, Sara Fernandes, Catarina Ruivo, Hélia Martins, João Morais

Journal of the Saudi Heart Association

A 35-year-old male, with a medical history of acute myocarditis, presented with palpitations. Further investigation revealed non-sustained ventricular tachycardia and a slightly reduced left ventricular systolic function. Cardiac magnetic resonance showed extended late gadolinium enhancement of the left ventricle and fat infiltration. Genetic testing was positive for a pathogenic desmoplakin mutation, fulfilling the criteria of arrhythmogenic left ventricular cardiomyopathy. In conclusion, the authors described a case of a mimicked acute myocarditis at a young age in a patient with an arrhythmogenic left ventricular cardiomyopathy. Therefore, the genetic study is essential for both diagnosis and management.

Congenital Complete Heart Block Complicated By Atrial Flutter Diagnosis And Management, Ali A. Alakhfash, Abdulrahman Almesned, Abdullah Alqwaiee, Hashem D. Alqurashi, Waleed Almanea, Mesned Abdulrahman

Journal of the Saudi Heart Association

Seventeen-month-old child was diagnosed in utero to have congenital complete heart block. The mother has Sjogren’s syndrome with high Anti Ro antibodies. The baby was delivered at term with a heart rate of 55 to 60 beats per minute. Echocardiography revealed a structurally normal heart with a small atrial septal defect and moderate patent ductus arteriosus. At the age of 17 months, he developed atrial flutter which was aborted using electrical cardioversion in the Cath lab. No recurrence of the atrial flutter during a one-year follow-up.

Heart Failure Burden In Oman As A Mid-East Exemplar Versus Global Perspectives: An Integrative Review, Maryam Alharrasi, Chandrani Isac, Joy Kabasindi Kamanyire

Journal of the Saudi Heart Association

Heart failure (HF), a clinical syndrome caused by a structural and functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and pulmonary congestion. This study intends to investigate the state of heart failure (HF) in Oman and assess it in comparison of global trends. Ten published literatures from the past 20 years were included after a thorough search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar). These studies were reviewed considering the global literature. We have observed an increase in HF cases especially in older adults, over the past two decades in Oman. Acute coronary syndrome …

The Prevention And Cardiac Rehabilitation Group Of The Saudi Heart Association Recommendations Regarding Establishing A Cardiac Rehabilitation Service, Abdulhalim Jamal Kinsara, Raghdah Aljehani, Jadwiga Wolszakiewicz, Adam Staron, Muteb A. Alsulaimy

Journal of the Saudi Heart Association

Cardiac rehabilitation (CR) is a cornerstone in the secondary prevention of cardiovascular disease (CVD). Comprehensive cardiac rehabilitation has obtained the highest class of recommendation and the level of evidence for the treatment of patients with ST-segment elevation myocardial infarction, after myocardial revascularization, with chronic coronary syndromes, and in patients with heart failure (HF). Comprehensive cardiac rehabilitation should be implemented as soon as possible, be multi-phasic, and adjusted to the individual needs of the patient. CR is still suboptimally used, and many cardiac centers do not have such services (2). The provision of CR services should be based on standards and …

Early Identification And Management Of Heart Failure In Patients With Diabetes Mellitus In The United Arab Emirates: A Call To Action, Firas Al Badarin, Lina Yasine, Rabih Hijazi, Susan Abu Khalaf, Wael Al Mahmeed, Yosef Manla, Feras Bader

Journal of the Saudi Heart Association

Heart failure (HF) is a common and serious complication of diabetes mellitus (DM) that remains widely under-recognized. Multidisciplinary management protocols for patients with concurrent DM and HF are not widely utilized in the Middle East/ Gulf region, particularly in the United Arab Emirates. Since early identification of patients with DM and HF will likely lead to initiation of therapies known to prevent adverse cardiovascular events and subsequently improve patient prognosis, we aim to highlight the importance of early recognition of HF in diabetic patients. We will also describe existing management challenges in the region, especially the lack of multidisciplinary care …

Leiomyosarcoma Of The Inferior Vena Cava Extending To The Right Atrium And Ventricle, Naif Saad Alghasab, Mohammad Alruwayeh, Abdulaziz A. Algharras, Amin Mulji

Journal of the Saudi Heart Association

Primary tumors originating from the inferior vena cava (IVC), namely leiomyosarcoma, present significant challenges due to their poor prognostic features, including extensive extension and a substantial tumor burden. In this case, we present a 55-year-old female patient complaining of abdominal discomfort and vague abdominal pain. Additionally, we provide a comprehensive summary encompassing key aspects related to symptomatology, diagnostic approaches, treatment, and prognostic indicators. We also discuss the complexities involved in managing primary tumors of the inferior vena cava, emphasizing the critical significance of adopting a multidisciplinary team-based approach.

Utilization Of Prophylactic Antibiotics For Cardiac Patients Undergoing Dental Procedures In Saudi Arabia: A Retrospective Study., Fayez Elshaer, Abdulelah (Hamad) Alsaeed, Sultan (Nasser) Alfehaid, Hassan (Mohammad) Aloraini, Turki (Eid) Alshammari, Fakhir Alayoubi

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the characteristics of antibiotic prophylaxis (AP) utilization and the level of adherence of King Saud University Medical City (KSUMC) staff to the latest American Heart Association (AHA) guidelines for AP for infective endocarditis (IE) in cardiac patients undergoing dental procedures. Methods: The study was conducted as a retrospective cohort study to investigate the relationship between AP in dental procedures and cardiac patients admitted in the surgical wards of KSUMC between 2015 and 2021. All cardiac patients who underwent dental procedures were included in the study. We excluded patients with long-term or concurrent antibiotic use …

Cardiovascular Disease In Saudi Arabia: Facts And The Way Forward, Adel Abdulkader Tash, Rasha Fahad Al-Bawardy

Journal of the Saudi Heart Association

While some risk factors for cardiovascular diseases (CVDs) are non-modifiable, other determinants like obesity, hypertension, type-2 diabetes and dyslipidemia can be mitigated by a wide plethora of measures to control CVD morbidity/mortality. Those determinants have been on the rise in Saudi Arabia, exacerbated by sedentary lifestyle. The Saudi Vision 2030 focuses include the reduction of CVD clinical and economic burden to scale-up vitality and longevity; in a new era of comprehensive healthcare. From a health economics standpoint, CVDs entail a burden on healthcare systems directly through expenditure and indirectly through years living with the disease, low productivity, premature morbidity and …

The Role Of Neutrophil To Lymphocyte Ratio And Its Common Clinical Outcomes Among Patients With Non-St Elevation Acute Coronary Syndrome, Javed Jalbani, Khalid Iqbal Bhatti, Muhammad Tariq Sallar, Ahsan Mujtaba Baig, Palwasha Tariq, Faisal Ahmed, Ali Ammar, Vicky Kumar

Journal of the Saudi Heart Association

Objectives: To evaluate the admission neutrophil-to-lymphocyte ratio (NLR) for risk stratification for in-hospital outcomes and complications in non-ST-elevation acute coronary syndrome (non-ST-ACS) patients. Methods: We recruited consecutive patients with non-ST-ACS. The NLR was obtained and stratified as low, intermediate, and high-risk based on6.0, respectively. The new ST-T changes, arrhythmias, contrast-induced nephropathy (CIN), and mortality were recorded. Results: Median NLR was 3 [2.1-5.3] for 346 patients with 19.9% and 30.6% in high- and intermediate-risk group. New ST-T changes were observed in 3.5%(12) out of which 8, 3, and 1 patient in low, intermediate, and high-risk group (p=0.424), respectively. Arrhythmias were observed …

Incidence And Risk Factors For Chylothorax After Pediatric Heart Surgeries: Retrospective Analysis Of A Large Institution Database​, ​Muhammad Shahzad, Yasser Abdulrhman Alheraish, ​​Bushra ​ Algethami, ​​Patricia ​ Machado, Reem Mohamed Essa Beheri, Gamal Mohamed, Fared Khouqeer, Zohair Al Halees

Journal of the Saudi Heart Association

Background: Risk factors for postoperative chylothorax in children who had cardiothoracic procedures are not always clear. Due to complex course in post-operative care, It’s always challenging to find the risk factors, and their management. Objective: The aim of our study was to identify the incidence, risk factors and effective treatment approaches for chylothorax after pediatric heart surgery. Methods: Children who had the cardiac surgery and subsequently developed chylothorax were included in the study. The ratio of the experimental group to the control group was 1:2. Decannulations of extracorporeal membrane oxygenation (ECMO) were not included in the analysis of patient outcomes. …

The Prevalence Of Electronic Cigarette Use Among College Students Of Taibah University And Symptoms Of Cardiovascular Disease, Talal Alzahrani, Marwan Fahad Alhazmi, Ahmed Naji Alharbi, Feras Talal Alahmadi, Amer Nasser Alhubayshi, Bader Ahmed Alzahrani

Journal of the Saudi Heart Association

Background: Electronic cigarettes (e-cigarettes) have been increasing in popularity among young adults due to the misconception about the safety of e-cigarettes. Our study aims to identify the prevalence rate of e-cigarette use among college students, the reason behind their use, and the relationship between the use of electronic cigarettes and cardiovascular symptoms among college students. Methods: An online questionnaire was sent to students of Taibah University between 2021 and 2022. Data from this survey were analyzed to obtain the prevalence of e-cigarette use among Taibah University students and to compare the demographic and health characteristics differences between e-cigarette users and …

Reversible Cardiomyopathy, What Should The Clinicians Keep In Mind? A Case Report, Abdulmajeed A. Alzahrani, Saud A. Bahaidarah, Zuhair N. Al-Hassnan, Gaser A. Abdelmohsen

Journal of the Saudi Heart Association

Primary carnitine deficiency (PCD) is an autosomal recessive disorder characterized by decreased carnitine levels essential for Beta oxidation in various organs, including the heart. Early diagnosis and treatment of PCD can revert cardiomyopathy. A 13-year-old girl presented with heart failure due to dilated cardiomyopathy and severe cardiac dysfunction; following L carnitine treatment, the patient's clinical conditions improved, and cardiac functions returned to normal within weeks. Investigations revealed PCD; regular L carnitine has been provided, all cardiac medications are discontinued, and the patient is doing well. We believe PCD should be ruled out in every patient with cardiomyopathy.

A Clot In Transit: A Cause Of Death Or A Bystander?, Al-Zahraa Almahlawi, Mohammad Alghamdi, Mutaz Althobaiti, Duha Alahmadi, Yazeed Almalki, Rahaf Alsahli, Hamdan A Jahdali, Jinan Shamou, Salim Baharoon

Journal of the Saudi Heart Association

Introduction: The clot in transit is a rare manifestation of thromboembolic disease occurring usually in the setting of PE and frequently associated with poor outcomes. The best therapeutic option is not well established. We describe a series of 35 patients diagnosed with clots in transit including their therapeutic interventions and outcome between the period January 2016 to December 2020. Methods: a retrospective chart review of all patients with an Echocardiogram showing thrombi in the right heart chambers including patients with thrombus in the presence of central lines or other devices. We exclude patients where masses were described as tumors or …

Nhc/ Sha 2023 Focused Update Of The 2019 Guidelines For The Management Of Heart Failure, Waleed Al Habeeb, Adel Tash, Abdelfatah Elasfar, Ali Almasood, Abeer Bakhshi, Fayez Elshaer, Fakhr Al Ayoubi, Kamal Alghalaini, Maryam Alqaseer, Mosaad Alhussein, Osama Almogbel, Shukri Alsaif, Yahia Alhebeshi

Journal of the Saudi Heart Association

Background: The burden of cardiovascular diseases is undeniable in local populations, who have high mortality rates and a young age of disease onset. A systematic review of emerging evidence and update of the Saudi Heart Association (SHA) 2019 heart failure (HF) guidelines was therefore undertaken. Methodology: A panel of expert cardiologists reviewed recommendations of the 2019 guidelines following the Saudi Heart Association methodology for guideline recommendations. When needed, the panel provided updated and new recommendations endorsed by the national heart council that are appropriate for clinical practice and local resources in Saudi Arabia. Recommendations and conclusion: The focused update describes …