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Articles 61 - 90 of 1929
Full-Text Articles in Diseases
Contemporary Nonfemoral Access For Tavr: Comparative Outcomes Of Transcarotid, Transsubclavian/Transaxillary, And Transcaval Approaches, Yves Najm Mrad, Snehalkumar Patel
Contemporary Nonfemoral Access For Tavr: Comparative Outcomes Of Transcarotid, Transsubclavian/Transaxillary, And Transcaval Approaches, Yves Najm Mrad, Snehalkumar Patel
Gulf Coast Division GME Research Day 2026
No abstract provided.
Catheter Ablation Versus Anti-Arrhythmic Drug Therapy For Atrial Arrhythmias In Hypertrophic Cardiomyopathy: A Real-World Cohort Study, Revanth Reddy Bandaru, Nishant Nerella, Suman Pasupuleti
Catheter Ablation Versus Anti-Arrhythmic Drug Therapy For Atrial Arrhythmias In Hypertrophic Cardiomyopathy: A Real-World Cohort Study, Revanth Reddy Bandaru, Nishant Nerella, Suman Pasupuleti
West Florida Division GME Research Day 2026
No abstract provided.
Prophylactic Distal Perfusion Catheters In Femoral Va-Ecmo: Association With Lower Limb Ischemia And Major Limb Outcomes (Systematic Review & Meta-Analysis), Yves Najm Mrad, Snehalkumar Patel
Prophylactic Distal Perfusion Catheters In Femoral Va-Ecmo: Association With Lower Limb Ischemia And Major Limb Outcomes (Systematic Review & Meta-Analysis), Yves Najm Mrad, Snehalkumar Patel
Gulf Coast Division GME Research Day 2026
No abstract provided.
Congenital Heart Defects, Children's Health School Services
Congenital Heart Defects, Children's Health School Services
School Guides
Educator guide about how to support students with congenital heart defects.
Relationship Between Exception Request For Higher Listing Urgency And Aggressiveness In Accepting Heart Offers, Jorim Parmar, Yingxian Liu, Devika Adusumilli, Luke Taylor, Shakir Al-Ezzi, Usman Khan, Claudio Bravo, Claudius Mahr, Song Li
Relationship Between Exception Request For Higher Listing Urgency And Aggressiveness In Accepting Heart Offers, Jorim Parmar, Yingxian Liu, Devika Adusumilli, Luke Taylor, Shakir Al-Ezzi, Usman Khan, Claudio Bravo, Claudius Mahr, Song Li
North Texas GME Research Forum 2026
BACKGROUND: Transplant programs may submit exception requests to upgrade a listed patient’s priority, often anticipating a higher likelihood of accepting marginal or high-risk donor organs. This study explores whether exception request status is associated with increased risk tolerance in organ acceptance.
METHODS: We conducted a retrospective analysis using data from the Scientific Registry of Transplant Recipients (SRTR), focusing on adult patients (≥18 years) listed for heart transplantation. Statistical analyses were performed using SAS/STAT 14.1. Descriptive statistics summarized demographic and clinical variables. Baseline characteristics were compared between recipients with and without exception requests. Primary analysis: Mixed-effects linear regression was used to …
Prognostic Value Of Systemic Inflammatory Indices For Predicting Mace In Nstemi Patients Undergoing Pci, Boney Lapsiwala, Aditya Sharma, Usman Khan, Jorim Parmar, Justin Soloman, Veeranna Vibhuti, Mehdi Khalafi
Prognostic Value Of Systemic Inflammatory Indices For Predicting Mace In Nstemi Patients Undergoing Pci, Boney Lapsiwala, Aditya Sharma, Usman Khan, Jorim Parmar, Justin Soloman, Veeranna Vibhuti, Mehdi Khalafi
North Texas GME Research Forum 2026
Background: Cardiovascular diseases (CVD) account for nearly one-third of global mortality, with ischemic heart disease caused by a mismatch between myocardial oxygen supply and demand. Despite advances in percutaneous coronary intervention (PCI) and contemporary pharmacotherapy, patients with non–ST-segment elevation myocardial infarction (NSTEMI) continue to experience substantial residual risk for major adverse cardiovascular events (MACE). As traditional risk stratification tools have limited ability to identify high-risk individuals, interest has shifted toward biomarkers reflecting inflammatory pathways central to atherosclerosis and plaque instability. Hematologic inflammatory markers including pan inflammatory value (PIV), systemic immune inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) initially …
Double Trouble: A Rare Co-Existence Of Hypertrophic Obstructive Cardiomyopathy And Anomalous Origin Of The Right Coronary Artery, Greeshma Molugu, Srinivasan Rajaganapathy, Seline Haci, Machaiah Madhrira
Double Trouble: A Rare Co-Existence Of Hypertrophic Obstructive Cardiomyopathy And Anomalous Origin Of The Right Coronary Artery, Greeshma Molugu, Srinivasan Rajaganapathy, Seline Haci, Machaiah Madhrira
North Texas GME Research Forum 2026
Introduction: Hypertrophic obstructive cardiomyopathy (HOCM) and anomalous origin of the right coronary artery (RCA) are well-known but rare congenital heart diseases that are recognized as independent leading causes of sudden cardiac death(SCD). The independent prevalence of both these conditions is less than 1%. The co-occurrence of these two conditions is seldom ever reported in the literature. We present an extremely rare case of HOCM and the anomalous origin of the RCA in the same individual.
Background: A 67-year-old male with no significant past medical history presented for chest pain and palpitations. EKG showed atrial fibrillation with rapid ventricular response. Troponin …
High-Flow Ectatic Anomalous Right Coronary Artery From The Pulmonary Artery With Stimulant-Induced Cardiomyopathy: A Case Report, Prithvi Basu Roy, Danish Bawa, Louis Orlando
High-Flow Ectatic Anomalous Right Coronary Artery From The Pulmonary Artery With Stimulant-Induced Cardiomyopathy: A Case Report, Prithvi Basu Roy, Danish Bawa, Louis Orlando
MidAmerica Division GME Healthcare Symposium 2026
No abstract provided.
Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner
Microgravity-Induced Alterations In Left Atrial Hemodynamics And Thrombogenic Risk: Insights From Healthy And Atrial Fibrillation Models, Grace M. Hoeppner
Dissertations, Master's Theses and Master's Reports
Background: Microgravity exposure alters cardiovascular loading, yet its impact on left atrial flow dynamics and thrombotic risk remains poorly understood. This study investigates how spaceflight-relevant microgravity-induced changes in cardiac outflow affect left atrial hemodynamics in healthy individuals and patients with atrial fibrillation.
Methods: Patient-specific left atrial models were generated for three healthy individuals and three AF patients. Computational fluid dynamics (CFD) simulations were performed using each patient’s baseline mitral outflow waveform and two modified waveforms representing short- and long-duration post-flight cardiac loading changes derived from echocardiographic observations. Hemodynamic metrics included left atrial velocity, time averaged wall shear stress, oscillatory shear …
Effect Of Plant-Based Vs. Standard American Diet On Cardiovascular Parameters In College Students, Timothy J. Horanic
Effect Of Plant-Based Vs. Standard American Diet On Cardiovascular Parameters In College Students, Timothy J. Horanic
Honors Undergraduate Theses
This study examines how adherence to different dietary patterns—specifically a plant-based diet compared to the standard American diet—can influence physiological indicators tied to cardiovascular health, including heart rate variability (HRV), blood pressure (BP), and heart rate (HR). Among these markers, HRV is considered especially sensitive to autonomic nervous system (ANS) regulation and may offer earlier insight into physiological stress or dysfunction than HR or BP alone. Although nutritional habits are widely believed to impact heart health, few investigations have focused on how specific long-term diets affect autonomic and cardiovascular metrics in healthy, college-aged adults. This study aims to investigate if …
Sex Differences In Clinical Characteristics, Treatment, And Outcomes Of Cardiovascular Disease: Kenya Heart Registry Analysis, Lilian Mbau, Martha Gulati, Mzee Ngunga, Jasmit Shah, Felix Barasa, Jeilan Mohamed, Anders Barasa, Bernard Gitura, Harun Otieno, Etienne Amendezo
Sex Differences In Clinical Characteristics, Treatment, And Outcomes Of Cardiovascular Disease: Kenya Heart Registry Analysis, Lilian Mbau, Martha Gulati, Mzee Ngunga, Jasmit Shah, Felix Barasa, Jeilan Mohamed, Anders Barasa, Bernard Gitura, Harun Otieno, Etienne Amendezo
Internal Medicine, East Africa
Background Cardiovascular disease is the leading cause of death globally, with approximately 80% of these deaths occurring in low- and middle-income countries. Sex differences in cardiovascular disease are well described in high-income countries but limited in low- and middle-income countries.
Objectives This study sought to evaluate the sex differences in clinical presentation, cardiovascular risk profile, diagnosis, treatment, and outcomes among patients in the Kenya Heart Registry.
Methods Data were prospectively collected from 3 tertiary hospitals, including patients with heart failure, acute coronary syndrome, venous thromboembolism, and atrial fibrillation. Primary outcomes were in-hospital and 6-month mortality, as well as sex-specific differences …
Myxedema Coma With Cardiogenic Shock: Diagnostic Challenges And Risks Of Amiodarone In Acute Thyroid Failure, Munachiso Egbo, Jean Ramos-Cardona, Gunjan Mundhra, Veniamin Melnychuk, Suzanne Martinez
Myxedema Coma With Cardiogenic Shock: Diagnostic Challenges And Risks Of Amiodarone In Acute Thyroid Failure, Munachiso Egbo, Jean Ramos-Cardona, Gunjan Mundhra, Veniamin Melnychuk, Suzanne Martinez
South Atlantic Division GME Research Days 2026
No abstract provided.
Percutaneous Vegetectomy As An Emerging Alternative For Tricuspid Valve Endocarditis, Alexander Patel, Elias Wakim, William Zvagelsky, Ebad Ur Rahman, Youssef Al-Saghir, Ahmed Zaky
Percutaneous Vegetectomy As An Emerging Alternative For Tricuspid Valve Endocarditis, Alexander Patel, Elias Wakim, William Zvagelsky, Ebad Ur Rahman, Youssef Al-Saghir, Ahmed Zaky
South Atlantic Division GME Research Days 2026
No abstract provided.
How Does Pulse Field Ablation Compare To Radiofrequency Ablation In The Creation Of Cavotriscupid Isthmus Line In Patients With Atrial Arrythmias?, Sharul Saxena, Veniamin Melnychuk, Sadhana Jonna, Gunjan Mundhra, Firas El Sabbagh
How Does Pulse Field Ablation Compare To Radiofrequency Ablation In The Creation Of Cavotriscupid Isthmus Line In Patients With Atrial Arrythmias?, Sharul Saxena, Veniamin Melnychuk, Sadhana Jonna, Gunjan Mundhra, Firas El Sabbagh
South Atlantic Division GME Research Days 2026
No abstract provided.
A Rare Case Of Ticagrelor-Induced Delirium, Mhd Osama Srour, Ebad Ur Rahman, Aliha Syeda, Tehmina Patel, Mubbasher Syed
A Rare Case Of Ticagrelor-Induced Delirium, Mhd Osama Srour, Ebad Ur Rahman, Aliha Syeda, Tehmina Patel, Mubbasher Syed
South Atlantic Division GME Research Days 2026
No abstract provided.
Acute Stemi Hours After Cabg From Distal Lima–Lad Graft Occlusion Complicated By Ellis Iii Perforation During Pci Successfully Treated With A Covered Stent, Eboselumen Aigbe, Brett Sasseen `
Acute Stemi Hours After Cabg From Distal Lima–Lad Graft Occlusion Complicated By Ellis Iii Perforation During Pci Successfully Treated With A Covered Stent, Eboselumen Aigbe, Brett Sasseen `
South Atlantic Division GME Research Days 2026
No abstract provided.
Duplex Ultrasound For Detecting Functional Popliteal Vein Entrapment: A Case Series, Ebad Rahman, William Zvagelsky, Alexander Patel, Mubbasher Syed
Duplex Ultrasound For Detecting Functional Popliteal Vein Entrapment: A Case Series, Ebad Rahman, William Zvagelsky, Alexander Patel, Mubbasher Syed
South Atlantic Division GME Research Days 2026
No abstract provided.
Shone Syndrome: Where Childhood Repair Is Just The Beginning, William Zvagelsky, Ebad Rahman, Ibrahim Fahdi
Shone Syndrome: Where Childhood Repair Is Just The Beginning, William Zvagelsky, Ebad Rahman, Ibrahim Fahdi
South Atlantic Division GME Research Days 2026
No abstract provided.
Can An Atrial Fibrillation Template Comprehensively Address Modifiable Risk Factors For Atrial Fibrillation Patients?, Sharul Saxena, Jyoti Moorjani, Sadhanna Jonna, Firas El Sabbagh
Can An Atrial Fibrillation Template Comprehensively Address Modifiable Risk Factors For Atrial Fibrillation Patients?, Sharul Saxena, Jyoti Moorjani, Sadhanna Jonna, Firas El Sabbagh
South Atlantic Division GME Research Days 2026
No abstract provided.
Clinical Outcomes And Economic Impact Of Coronary Intravascular Lithotripsy In Calcified Lesions: Insights From Contemporary Real-World Registries, Ebad Rahman, Alexander Patel, William Zvagelsky, Mubbasher Syed, Youssef Al Saghir
Clinical Outcomes And Economic Impact Of Coronary Intravascular Lithotripsy In Calcified Lesions: Insights From Contemporary Real-World Registries, Ebad Rahman, Alexander Patel, William Zvagelsky, Mubbasher Syed, Youssef Al Saghir
South Atlantic Division GME Research Days 2026
No abstract provided.
Concomitant Transcatheter Edge-To-Edge Repair For Mitral And Tricuspid Regurgitation For Polyvalvular Disease, Omar Khan, Matthew Summers
Concomitant Transcatheter Edge-To-Edge Repair For Mitral And Tricuspid Regurgitation For Polyvalvular Disease, Omar Khan, Matthew Summers
Department of Medicine Faculty Publications
This patient is a 77-year-old male with non-ischemic cardiomyopathy, severe tricuspid regurgitation, and moderate mitral regurgitation who underwent simultaneous transcatheter edge-to-edge repair of both mitral and tricuspid valves. Post-procedure, the patient exhibited significant symptomatic improvement and reduced regurgitation severity, highlighting the feasibility of dual-valve TEER in high-risk patients.
Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja
Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja
Department of Medicine Faculty Publications
Background
Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems.
Case Summary
A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame.
Discussion
This case demonstrates a structured, stepwise …
Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen
Distinguishing Acute Cardiac Events From Chronic Troponin Elevation: Integrating High-Sensitivity Troponin Trends With Objective Ischemic Evidence Under The 4th Udmi Across Diverse Renal Function Profiles, Aidan Fernandez, Amanda Green, Silvija Milanovic, Eric Han, Asia Elbooz, Michael Petrauskis, Justin Nippert, Michael Marchick, Nicholas Maldonado, Mohammed Ruzieh, Elizabeth Warren, Matthew Shaw, Lars Beattie, Brandon Allen
Florida Journal of Emergency Medicine (FJEM)
The Fourth (4th) Universal Definition of Myocardial Infarction (UDMI) provides a standardized framework to enhance diagnostic accuracy and clinical decision-making. However, challenges can arise due to the use of subjective clinical assessment in diagnostic criteria or in the presence of impaired renal clearance. This study modifies the 4th UDMI by requiring objective ischemic evidence to improve consistency in myocardial infarction (MI) classification and applies it across diverse patient populations.
In this retrospective study, patients who presented to the emergency department (ED) with 99th percentile high sensitivity cardiac troponin (hs-cTn) values were classified using the modified 4th UDMI into the categories …
Quality Improvement (Qi) Project Aimed At Reducing 30-Day Hospital Readmissions For Patients With Congestive Heart Failure (Chf) Through Checklist Implementation, Gary Gutierrez
Seton Hall University Dissertations and Theses (ETDs)
Abstract
Congestive Heart Failure (CHF) remains a leading cause of preventable 30-day hospital readmissions,
especially in outpatient and transitional care settings. This quality improvement (QI) initiative was
launched within a private internal medicine practice in Essex County, New Jersey, to address this issue
by implementing a standardized CHF management checklist. The checklist focused on four key
components: (a) comprehensive medication reconciliation, (b) tailored patient education, (c) timely
follow-up appointments, and (d) improved interdisciplinary communication. By integrating evidence-
based practices into a structured workflow, the QI project aimed to improve care coordination,
empower patients to manage their condition, and reduce preventable …
The Right Kind Of Rarefaction: Coronary Microvascular Remodeling In Right Ventricle Failure, Cyrus Vahdatpour, Katharine Clapham, Steven M. Kawut, Kirk Jones, John J. Ryan, Danielle Petty, Shannon Talbot, Kimberly Dumoff, Ellen C. Keeley, Priti Lal, Andrew J. Bryant, Alex M. Parker, Jeremy A. Mazurek, Leonid Mirson, Andrew Murphy, Andrew Baird, Megan Schwietert, Alissa F. Schurr, Andrew Stein, Scott M. Hansen, Zhining Ou, Angela P. Presson, Dylan Miller
The Right Kind Of Rarefaction: Coronary Microvascular Remodeling In Right Ventricle Failure, Cyrus Vahdatpour, Katharine Clapham, Steven M. Kawut, Kirk Jones, John J. Ryan, Danielle Petty, Shannon Talbot, Kimberly Dumoff, Ellen C. Keeley, Priti Lal, Andrew J. Bryant, Alex M. Parker, Jeremy A. Mazurek, Leonid Mirson, Andrew Murphy, Andrew Baird, Megan Schwietert, Alissa F. Schurr, Andrew Stein, Scott M. Hansen, Zhining Ou, Angela P. Presson, Dylan Miller
Department of Pathology, Anatomy, and Cell Biology Faculty Papers
BACKGROUND: Right ventricular failure (RVF) is the primary determinant of outcomes in pulmonary hypertension (PH). Coronary microvascular dysfunction (CMD), defined by capillary rarefaction and endothelial dysfunction, may contribute to RVF but remains poorly characterized. CMD, defined by capillary rarefaction and endothelial dysfunction, may contribute to RVF through impaired myocardial oxygen delivery and fibrotic remodeling.
OBJECTIVES: To characterize right ventricle (RV) CMD and myocardial fibrosis in explanted human hearts and examine associations with echocardiographic and hemodynamic indices of RVF across PH subtypes.
METHODS: We retrospectively analyzed 57 adult patients who underwent orthotopic heart transplantation at 3 institutions (2023-2024). Explanted hearts were …
Single-Cell Transcriptomic Analysis Of Peripheral Blood Mononuclear Cells Reveals Key Immune Responses In St-Segment Elevation Myocardial Infarction, Zheng Zhang, Shengfang Wang, Yahui Liu, Gaohan Li, Qianqian Cheng, Wei Yang, Gan-Xin Yan, Chuanyu Gao
Single-Cell Transcriptomic Analysis Of Peripheral Blood Mononuclear Cells Reveals Key Immune Responses In St-Segment Elevation Myocardial Infarction, Zheng Zhang, Shengfang Wang, Yahui Liu, Gaohan Li, Qianqian Cheng, Wei Yang, Gan-Xin Yan, Chuanyu Gao
Department of Medicine Faculty Papers
BACKGROUND: Inflammation plays a crucial role in the pathogenesis of ST-segment elevation myocardial infarction (STEMI). However, the precise immunological mechanisms remain incompletely understood. Single-cell RNA sequencing (scRNA-seq) provides a powerful approach to dissect immune cell heterogeneity and dynamic changes at single-cell resolution.
METHODS: Peripheral blood mononuclear cells (PBMCs) were collected from 7 STEMI patients (within 6h after primary percutaneous coronary intervention) and 3 healthy controls. Single-cell suspensions were prepared and subjected to scRNA-seq using the 10x Genomics Chromium platform and Illumina NovaSeq 6000. Data were processed using Cell Ranger and analyzed with Seurat for quality control, clustering, and annotation. Differentially …
Diurnal Behavioral Outcomes And Bbb Integrity In Adult Male Shr And Wky Rats, Pallavi Shrivastava, Oluchukwu D. Biose, Riya Dahal, Abdallah Jwayyed, Rukayat A. Raji, Huijing Xia, Eric Lazartigues, Ifechukwude J. Biose
Diurnal Behavioral Outcomes And Bbb Integrity In Adult Male Shr And Wky Rats, Pallavi Shrivastava, Oluchukwu D. Biose, Riya Dahal, Abdallah Jwayyed, Rukayat A. Raji, Huijing Xia, Eric Lazartigues, Ifechukwude J. Biose
School of Graduate Studies Faculty Publications
Day and night neurobehavioral tests were performed for Spontaneously Hypertensive rats (SHR) and Wistar Kyoto rats (WKY) to establish an optimal testing window. Also, blood–brain barrier (BBB) integrity in brain areas related to cognition was measured to determine strain-specific differences. Six months old male SHR and WKY were randomly divided into day (i.e., 9–11 a.m.) and nighttime (i.e., 7–9 p.m.) testing regimen. Neurobehavioral tests included: Y-maze spontaneous alternation, open field, novel object recognition (NOR), and tail suspension test (TST). BBB integrity was measured in the cortex, hippocampus and striatum. WKY showed higher recognition memory at night compared to SHR and …
Hypertensive Remodelling: When Bigger Body Means Bigger Problems, Eric Lazartigues
Hypertensive Remodelling: When Bigger Body Means Bigger Problems, Eric Lazartigues
School of Medicine Faculty Publications
No abstract provided.
Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md
Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md
The Lahey Journal
Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents
Introduction
Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.
Methods
The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …
Managing Anticoagulation In A Patient With Calciphylaxis And Mechanical Valve: A Therapeutic Dilemma, Qutaiba Qafisheh, Abdalhakim Shubietah, Mohanad Qwaider, Muath A. Baniowda, Abdalrahman Assaassa, Roaa Aljunaidi, Abubakar Nazir
Managing Anticoagulation In A Patient With Calciphylaxis And Mechanical Valve: A Therapeutic Dilemma, Qutaiba Qafisheh, Abdalhakim Shubietah, Mohanad Qwaider, Muath A. Baniowda, Abdalrahman Assaassa, Roaa Aljunaidi, Abubakar Nazir
Division of Cardiology Faculty Papers
BACKGROUND: Calciphylaxis is a rare, life-threatening vasculopathic syndrome most commonly seen in end-stage renal disease (ESRD) and associated with high mortality. Vitamin K antagonists complicate management in patients with mechanical valves by potentially exacerbating vascular calcification while remaining essential for thromboprophylaxis.
CASE PRESENTATION: A 50-year-old woman with ESRD on hemodialysis and a mechanical mitral valve on warfarin presented with severe abdominal pain and rapidly progressive necrotic ulcers. Despite broad-spectrum antibiotics and sodium thiosulfate, lesions worsened. Biopsies were nondiagnostic; however, the clinical phenotype was consistent with calciphylaxis. A multidisciplinary team transitioned anticoagulation from warfarin to subcutaneous unfractionated heparin (UFH) (333 U/kg …