Diseases Commons^™

Reducing Acute Healthcare Services With Self-Management Of Blood Pressure Monitoring Through Remote Patient Monitoring For Hypertensive Patients A Quality Improvement Project, Becky J. Wagner

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) affects nearly half of U.S. adults and remains a leading cause of preventable emergency department (ED) visits, hospitalizations, and healthcare costs due to poor blood pressure (BP) control (Fryar et al., 2024; Mullins et al., 2019). Traditional care models often lack the continuous monitoring and timely intervention needed for effective chronic disease management. Remote Patient Monitoring (RPM) provides an innovative approach by delivering real-time BP data, enabling early clinical intervention, and encouraging patient engagement in self-management (Omboni et al., 2020).

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of an RPM intervention in reducing acute healthcare …

Gender Differences In Presentation And Outcomes Of Spontaneous Coronary Artery Dissection (Scad): A Single Center Case Series Study, Abdul Nadeem Akhtar, Fnu Aisha, Aimen Binte Moazzam, Mohammad Omer Rehman Rana, Abida Perveen, Jahanzeb Malik

Journal of Community Hospital Internal Medicine Perspectives

Background: Spontaneous Coronary Artery Dissection (SCAD) is an important non-atherosclerotic cause of acute coronary syndrome (ACS), predominantly affecting younger females. Despite increasing recognition, data on gender-based differences in SCAD presentation and outcomes remain limited, particularly in South Asian populations.

Methods: This retrospective case series included 24 patients diagnosed with SCAD at Abbas Institute of Medical Sciences (AIMS) between January 2022 and March 2025. Patient demographics, clinical presentation, angiographic findings, management strategies, and outcomes were analyzed with a focus on gender-based differences.

Results: Of the 24 patients, 17 were female (70.8%) and 7 were male (29.2%). Females were younger and had …

Hidden Infarctions: Understanding And Managing Myocardial Infarction With Non-Obstructive Coronary Arteries Through A Multimodal Lens, Catalina Esquivel

Lynchburg Journal of Medical Science

Myocardial infarction with non-obstructive coronary arteries (MINOCA) accounts for 5–15% of myocardial infarctions and disproportionately affects women and minority populations. It is defined by clinical evidence of myocardial ischemia with

Double-Port Totally Endoscopic Mitral Valve Replacement Through A Prosthesis-Sized Working Incision With Posterior Subvalvular Preservation, Cao Dang Khang, Tran Duc Quang, Phan Quang Thuan, Vuong Ngoc Minh, Pham Tran Viet Chuong, Nguyen Hoang Dinh

Journal of the Saudi Heart Association

Objective: To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.

Methods: In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported …

Neural-Immune-Cardiovascular Axis: From Mechanistic Crosstalk To Therapeutic Targets In Cardiovascular Disease, Junkang Cheng, Shuang Gao, Haowei Zhang, Wei Gao, Zeyuan Mei, Xiaoling Liu, Jocelyn Gao, Chenghu Guo, Guipeng An

Student Papers, Posters & Projects

The neural-immune-cardiovascular axis represents an emerging and highly integrated physiological and pathophysiological concept, describing a complex bidirectional communication network between the nervous, immune, and vascular systems. This review systematically examines the pivotal role of this axis in maintaining cardiovascular homeostasis and in the pathogenesis of cardiovascular diseases. We first provide an overview of the fundamental signaling pathways between the components of this axis. Subsequently, we delve into the specific crosstalk mechanisms within the axis in the context of major cardiovascular conditions, including atherosclerosis, hypertension, and heart failure. A central focus is placed on critically evaluating the potential therapeutic targets and …

Left-Ventricular Non-Compaction Cardiomyopathy Presenting With Atrial Flutter With Rapid Ventricular Response, Sahil Ghay, Baneet Kaur, J. Armando Talavera, Koushik Sanku, Viky S. Loescher, Julien A. Exposito

Journal of Community Hospital Internal Medicine Perspectives

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare genetic cardiomyopathy characterized by prominent trabeculations and deep recesses that predispose to arrhythmias and heart failure. We describe a 42-year-old man with persistent tachycardia and exertional fatigue found to have CTI-dependent atrial flutter with 2:1 conduction. Transesophageal echocardiography showed severe biventricular dysfunction with an ejection fraction of 15%, and cardiac MRI confirmed LVNC with a non-compacted to compacted ratio of 3.3. After successful ablation and normal coronary angiography, he was diagnosed with LVNC. This case highlights an unusual presentation of LVNC with typical atrial flutter and underscores the value of cardiac MRI …

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

Background

Methods

U.S. Cardiovascular Mortality Before And During Covid-19: Cdc Wonder Vs Gbd Comparison, Mirza Ali Baig, Muhammad Umar, Carol Becker, Salim S. Virani, Dmitry Abramov, Xiaoming Jia, Abdul Minhas

Population Health, East Africa

No abstract provided.

From Skin To Spleen To Brain: Full-Spectrum Embolic Complications In Staphylococcus Aureus Endocarditis, Jose J. Loayza Pintado, Jorge Aboytes Trevino, Julian Galindo, Mohammad Aqeel, John Cauba, Joshua Nwose, Andres Suarez Parraga

Research Symposium

Background: Infective endocarditis (IE) results from bacterial adhesion to endocardial tissue and valvular apparatus. While viridans group streptococci and Enterococcus species are associated with subacute disease, Staphylococcus aureus, including methicillin-resistant strains (MRSA), is a leading cause of more acutely destructive presentations. The entry of these pathogens can occur through surgical and dental procedures, intravenous drug use, or less apparent etiology. Classic peripheral stigmata (Osler nodes, Janeway lesions, splinter hemorrhages, Roth spots) are now uncommon but clinically meaningful. Current guidelines emphasize rapid multimodality imaging to detect cerebral and systemic emboli in symptomatic IE. We present a 50-year-old man with S. aureus …

The Triple Threat: Hiv, Nonadherence, And Substance Use Driving Premature Coronary Events, Jose J. Loayza Pintado, Taiwo Ajani, Angelica Lopez Jesus, Aura Calderon, Jose Pena

Research Symposium

Background: People living with HIV (PLWH) experience nearly double the risk of premature atherosclerotic cardiovascular disease and often present with acute coronary syndromes at younger ages [1]. Chronic inflammation, immune activation, and drug–drug interactions between antiretrovirals and antiplatelet agents further contribute to accelerated atherosclerosis and poor outcomes after percutaneous coronary intervention (PCI) [2,3]. Importantly, in-stent restenosis (ISR) remains disproportionately frequent in PLWH despite modern drug-eluting stents, with medication nonadherence compounding risk [4]. We present a young woman with HIV and recurrent myocardial infarction due to rapid ISR, underscoring the impact of inflammation, adherence, and pharmacologic interactions on secondary prevention.

Case …

From Risk Factor To Cause Of Death: Hypertensive Heart Disease And The Changing Composition Of Heart Disease Mortality In Texas Compared With The United States, 1999–2020, Jose J. Loayza Pintado, Angelica Lopez Jesus, Aura Calderon, Jorge Aboytes Trevino, Daniela Hernandez

Research Symposium

Background: Heart disease mortality has declined nationwide, but Texas continues to experience higher rates than the United States overall. At the same time, hypertensive heart disease (HHD) has become more prominent within cardiovascular mortality statistics. Whether this shift reflects a growing hypertension-driven contribution to the Texas–U.S. gap has not been well quantified. We compared long-term trends in HHD mortality and the presence of HHD on death certificates among heart disease deaths in Texas versus the United States.

Methods: We analyzed CDC WONDER Underlying Cause of Death and Multiple Cause of Death files, 1999–2020, restricted to decedents aged ≥25 years. HHD …

Self-Reported Gum Bleeding, Oral Health Behaviors, And Cardiovascular Risk Indicators Among Adults Aged 45-70 In A Community Dental Setting., Kimberleigh Edwards

Population Health Leadership and Analytics Theses

Cardiovascular disease remains a leading cause of morbidity and mortality among adults in the United States, particularly during midlife and older adulthood. Periodontal inflammation and poor oral hygiene behaviors have been linked to increased cardiovascular risk through systemic inflammatory pathways. This exploratory cross-sectional study described patterns of self reported gum bleeding, oral hygiene behaviors, and cardiovascular risk factors among 29 adults aged 45 to 70 at a community dental clinic using the researcher-developed Oral and Heart Health Study Questionnaire. Fourteen participants reported both gum bleeding and at least one cardiovascular risk factor. Participants who reported inconsistent flossing and infrequent professional …

Evaluating The Market Withdrawal Of Andexanet Alfa, Jordyn Linfield, Addisyn Cooper, Alexander Defranco, Emma Gerding, Jessica Kelley, Tyler Henney, Connor Dains, Brenna Hissong, Brittany Bates

Pharmacy and Wellness Review

The coagulation cascade comprises intrinsic, extrinsic, and common pathways that converge when thrombin converts fibrinogen (factor I) into fibrin, leading to fibrin mesh formation, stabilization of the platelet plug, and ultimately thrombus formation. Inhibition of the coagulation cascade can be achieved with a variety of anticoagulant medications, including direct oral anticoagulants (DOACs). The mechanism of action of DOACs is to inhibit either factor Xa or thrombin. Reversal of anticoagulation remains an important clinical consideration when managing patients on DOACs who experience serious bleeding events. Andexanet alfa is a recombinant, modified human factor Xa protein previously indicated for patients receiving rivaroxaban …

Fda Approval Of Etripamil For The Treatment Of Paroxysmal Supraventricular Tachycardia, Kiley Devoll, Daniella Egbujor, Katy Grainger, Katherine Cook, Victoria Niese, Connor Dains, Brenna Hissong, Andrew Roecker

Pharmacy and Wellness Review

Paroxysmal supraventricular tachycardia (PSVT) is characterized by sudden, brief, intermittent episodes that result in a heart rate of 150 to 250 beats per minute (bpm). PSVT is difficult to diagnose, making proper treatment challenging. According to the 2015 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) guidelines, current pharmacologic recommendations for PSVT include adenosine, verapamil, diltiazem, or nonpharmacologic vagal maneuvers.¹ These treatments each have a variety of adverse effects, contraindications, and dosing considerations, which highlight a need for novel therapies for the acute treatment and maintenance of PSVT.¹ The NODE-301 trial assessed the safety and …

Lovastatin Potentiates The Function Of Α7-Nicotinic Acetylcholine Receptors, Dmytro Isaev, Keun-Hang Susan Yang, Murat Oz

Pharmacy Faculty Articles and Research

Background/Objectives: Statins are currently one of the most commonly used cholesterol-lowering drugs. In recent years, in addition to their well-known effects on the cardiovascular system, statins have been shown to exert beneficial effects in the progression of various neuropsychiatric and neurodegenerative diseases. Methods: In this study, the effects of lovastatin on the function of α7-nicotinic acetylcholine (nACh) receptors expressed in rat hippocampus and Xenopus oocytes were investigated. Results: In whole-cell patch clamp studies in hippocampal neurons, 21-day chronic (20 mg/kg), but not acute (20 min), lovastatin treatment caused significant potentiation of choline (a selective agonist for α7 nACh receptors)-induced currents …

Projected U.S. Cardiovascular Disease Burden From Heat Exposure For Future Greenhouse Gas Scenarios, Gokul Parmeswaran, Sai Rahul Ponnana, Santosh Kumar Sirasapalli, Niketh Surya, Tong Zhang, Zhuo Chen, Jean-Eudes Dazard, Salil V. Deo, Sanjay Rajagopalan

Faculty Scholarship

Importance: Climate change may reverse decades of improvements in cardiovascular disease (CVD) mortality in the US; however, comprehensive regional projections of heat-related CVD burden in the US are unavailable. Objective: To use the county-level observed (2010-2016) heat-related CVD burden in the US to obtain the projected rates through 2050 according to the mean (shared socioeconomic pathway [SSP] 2-4.5) and high (SSP5-8.5) greenhouse gas (GHG) emission pathways. Design, Setting, and Participants: This cross-sectional ecological analysis used county-level summary data including all counties in the contiguous US from 2010 through 2016 as baseline data with projections to 2030 and 2050 under SSP …

Maternal Cardiovascular Outcomes In Pregnancies Complicated By Pulmonary Hypertension: A Multicenter Cohort Study, Ali Eidy, Aiden Tang, Tarun Bomma, Prit Patel, Asa Smith-Villegas, Ali Awad Md

Medical Student Research Symposium

Title: Maternal Cardiovascular Outcomes in Pregnancies Complicated by Pulmonary Hypertension: A Multicenter Cohort Study

Authors: Ali Eidy, BS, Aiden Tang, BS, Tarun Bomma, BS, Prit Patel, BS, Asa Smith-Villegas, BS, Ali Awad, MD

Background: Routine pregnancies exhibit a considerable amount of cardiovascular strain, which is only amplified when complicated by pulmonary hypertension (PH). Despite advances in PH treatment and therapy, there is limited data that shows the outcomes of PH on maternal cardiovascular health. This study evaluated these risks across a large, diverse cohort to better understand how PH affects maternal hemodynamics and cardiac functions.

Methods: Using the TriNetX Research …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Management Of Libman-Sacks Endocarditis: The Role Of Anticoagulation And Immunosuppressive Therapy, Klaudia Matanaj, Demi Poulathas, David Altimore

Rowan-Virtua Research Day

Background: Libman-Sacks endocarditis (LSE) is a nonbacterial thrombotic endocarditis detected in 10-40% of patients with systemic lupus erythematosus (SLE), depending on imaging modality. LSE is strongly associated with antiphospholipid syndrome (APS). The condition significantly increases the risk of cerebrovascular accidents and inpatient mortality compared to SLE without cardiac involvement. Despite these serious complications, optimal management remains uncertain. Objective: To review the current evidence on the pathophysiology and management of LSE. Methods: A literature review was conducted using 12 peer-reviewed articles addressing LSE pathophysiology, clinical outcomes, and treatment strategies. Results: Combination anti-inflammatory and antithrombotic therapy achieved 76% …

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Ai-Augmented Digital Auscultation For Point-Of-Care Screening Of Valvular Heart Disease: A Systematic Review And Meta-Analysis, Harshal Parmar, Akhila Archakam, Nikhila Archakam, Wesley Kim, Eduard Koman Md

Rowan-Virtua Research Day

Background: Valvular heart disease (VHD) affects >10% of adults aged 75+ yet remains underdiagnosed when asymptomatic due to declining auscultatory proficiency. AI-augmented digital auscultation offers a point-of-care screening solution, though no meta-analysis has pooled diagnostic accuracy across VHD subtypes in adults using echocardiography as the reference.

Methods: A systematic review and meta-analysis were conducted per PRISMA guidelines. PubMed, Embase, Cochrane, IEEE Xplore, and Scopus were searched without date restriction. Studies applying AI or machine learning to digital auscultation or phonocardiography for VHD classification in adults with echocardiographic reference and patient-level diagnostic metrics were included. Studies using only public datasets, pediatric …

Incidence Of Stroke Post Pulmonary Thrombectomy: Implications For Periprocedural Management, Rohan Umrani, Rameez Shahid, Luai Tabaza

Rowan-Virtua Research Day

Background: The incidence of stroke after pulmonary thrombectomy (PT) remains unknown. Given the incidence of patent foramen ovale (PFO) of 25% in autopsy studies, the concern for paradoxical embolus in this patient population warrants evaluation of periprocedural management.

Methods: We queried the EPIC EHR at Virtua Health in New Jersey for all patients who underwent PT from 2021-2025, categorized by utilization of the Inari Flowtriever system or the Penumbra thrombectomy device. We assessed post-PT cerebrovascular accident (CVA), PFO presence by transthoracic echocardiogram (TTE), and gender via descriptive statistics. Age, average anesthesia time and procedure supply cost were assessed via two-sided …

Methadone-Associated Qt Prolongation: The Importance Of Early Recognition And Monitoring In The Emergency Department, Uma Murrugappan, Kelsey Murray, James Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 43-year-old female with cervical cancer and bilateral percutaneous nephrostomy tubes receiving high-dose methadone maintenance therapy who presented to the emergency department with bilateral flank and abdominal pain. She denied cardiac symptoms. Electrocardiogram obtained during evaluation revealed marked QT prolongation (QTc 596 ms) following recent methadone dose escalation. The patient was placed on continuous cardiac monitoring and intravenous magnesium was ordered. While intravenous access was being obtained, she developed polymorphic ventricular tachycardia consistent with torsades de pointes and became pulseless. Advanced cardiac life support was initiated including defibrillation and magnesium administration, with return of spontaneous …

Case Report: Termination Of Svt Using A Modified Vagal Maneuver With A 10-Cc Syringe, Romina Noormohammadi, Kelsey Murray, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Supraventricular tachycardia (SVT) is a common cardiac arrhythmia encountered in emergency departments and is characterized by a rapid regular rhythm originating above the ventricles. Initial management of hemodynamically stable SVT typically includes vagal maneuvers followed by pharmacologic therapy such as adenosine if non-pharmacologic methods fail. However, vagal maneuvers are frequently unsuccessful due to improper patient execution or insufficient vagal stimulation. We present the case of a 76-year-old female with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and hyperlipidemia (HLD) who presented with palpitations and was found to have SVT at 156 beats per minute on electrocardiogram. A Valsalva …

Case Report: Vertebral Artery Dissection After Cervical Manipulation, Devin Hoover, Emily Bolinger, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 22-year-old female who presented with dizziness and vomiting after recent cervical manipulation who was diagnosed with a dissection of the vertebral artery. Dizziness can have a variety of causes including vascular etiologies, cerebellar and brainstem lesions, ocular problems, trauma, and others. In the setting of a known trauma and acute vestibular symptoms, it is prudent to consider vascular injuries.

Persistent Hypotension Following Viral Illness- Pocus For Pericardial Effusion, Peter Killian, Kelsey Murray, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

A pericardial effusion is defined as a build up of fluid in the pericardial space, the lining around the heart. Normal physiologic fluid can consist of approximately 15-50mL in an otherwise healthy adult . Larger amounts of fluid can be detected on radiographs, but are able to be seen on ultrasound when just exceeding physiologic conditions . Here we report a case of persistent hypotension assessed by point of care ultrasound (POCUS) in order to lead to a diagnosis.

Stroke Mimics And Stroke Chameleons: Leveraging The False Positive/False Negative Diagnostic Schema In Resident Teaching, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Stroke mimics and stroke chameleons contribute significantly to diagnostic uncertainty in Emergency Medicine. Traditional teaching often relies on enumerating examples, yet residents struggle to internalize these distinctions.

Objective

To present a conceptual teaching framework that maps stroke mimics to false positives and stroke chameleons to false negatives, leveraging pre-existing diagnostic schemas.

Methods

Using representative cases—including hypoglycemic hemiparesis and spinal epidural lipomatosis presenting as stroke mimic—we developed an explanation for residents involving framing mimics as false positives and chameleons as false negatives.

Results

Framing mimics as false positives and chameleons as false negatives activates existing learner schemas related to sensitivity …

Developing A Computational Pipeline For Biomarker Discovery In Ischemic Reperfusion Injury, Surabhi Panda, Kaitlyn Insana, Dimitri Pestov

Rowan-Virtua Research Day

Background: Ischemia-reperfusion injury (IRI) contributes significantly to tissue damage in cardiovascular disease. During IRI, stressed and dying cells release ribosomal RNA, which exhibits distinct fragmentation patterns that may serve as potential diagnostic biomarkers. Although these patterns have been observed using low-resolution biochemical techniques, there is currently no standardized computational approach to quantify and visualize RNA fragmentation for clinical interpretation.

Hypothesis: A computational pipeline can be developed to visualize and analyze ribosomal RNA fragmentation patterns, enabling identification of distinct fragmentation hotspots associated with ischemic conditions and potential biomarker discovery.

Methods: RNA fragmentation datasets generated from ribosomal RNA experiments in a Saccharomyces …

Acute Coronary Syndrome Presenting As Pericarditis, Oliwia A. Dalek, Zamin Kazmi, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 71-year-old male with a past medical history of myocardial infarction (MI) who initially presented to the emergency department (ED) with a chief complaint of chest pain and shortness of breath.  After consultation with Cardiology in the ED, the presumed diagnosis was pericarditis, and heparin drip was not initiated.  The patient subsequently developed a complete heart block indicating an atrioventricular (AV) nodal knock out, likely due to an ischemic event.  This case highlights the importance of identifying acute coronary syndrome (ACS) as early as possible in order to intervene and achieve the best possible outcomes …