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Full-Text Articles in Cardiovascular Diseases

Shortness Of Breath In A 39 Year Old: A Rare Case Of Heart Failure, Mohammed Rashik, Olufunmilola Adeleye, Jason Thompson, Tasaduq Mir Jan 2025

Shortness Of Breath In A 39 Year Old: A Rare Case Of Heart Failure, Mohammed Rashik, Olufunmilola Adeleye, Jason Thompson, Tasaduq Mir

North Texas Research Forum 2025

Currently, 2.6% of Americans suffer from heart failure. Common causes include coronary artery disease, chronic hypertension, arrhythmia, and myocardial infarction, often managed in clinical and hospital settings. A rare cause, however, is infiltrative cardiomyopathy, affecting just 0.04% of the U.S. population. This condition, often caused by amyloid buildup or sarcoidosis, is challenging to diagnose and typically requires a heart transplant due to its rapid progression. Thorough investigations into heart failure causes are crucial to identify this rare condition. A 39-year-old male with no significant medical history presented to the University of North Texas Health Science Center (UNTHSC) Family Medicine clinic …


Hearts Hidden Message: Right Ventricular Thrombus Reveals Esophageal Adenocarcinoma, Devika Adusumilli, Seline Haci, Jafri Imran, Arman Vaghefi, Mehdi Khalafi, Ikponmwosa Iyamu, Sarvanan Balamuthusamy Jan 2025

Hearts Hidden Message: Right Ventricular Thrombus Reveals Esophageal Adenocarcinoma, Devika Adusumilli, Seline Haci, Jafri Imran, Arman Vaghefi, Mehdi Khalafi, Ikponmwosa Iyamu, Sarvanan Balamuthusamy

North Texas Research Forum 2025

Introduction Right ventricular thrombi are uncommon, usually found with concurrent pulmonary emboli and associated with significant mortality. They often originate from deep vein thrombi but may also be due to primary intracardiac processes . A right ventricular thrombus can be an unexpected marker for underlying malignancies, including esophageal cancer. This occurs due to the hypercoagulable state often induced by malignancy. Here we report a presentation where the identification of a right ventricular thrombus led to the diagnosis of esophageal cancer. Case Presentation Our patient is a 57-year old male with no past medical history who experienced an episode of dizziness …


Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr Jan 2025

Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr

North Texas Research Forum 2025

Background Patients with massive/sub-massive pulmonary embolism (PE) and right ventricular strain have a significant risk of hemodynamic collapse. VA ECMO support provides an excellent salvage option for patients with acute/unstable pulmonary embolism with obstructive cardiogenic shock undergoing mechanical thrombectomy. Using VA-ECMO for a “protective PE” procedure allows control of hemodynamics and enables interventionalists to perform the thrombectomy in a more controlled environment. Here, we present our experience. Methods A retrospective data analysis on consecutive VA ECMO patients with cardiogenic shock secondary to pulmonary embolism was abstracted from August 2022 to June 2024. Results Patient characteristics and outcomes are described in …


Coexisting Type A And B Aortic Dissection With Extension To Carotid Arteries Resulting In Acute Ischemic Stroke, Dung Nguyen, Jilpa Shah, Amnah Andrabi Jan 2025

Coexisting Type A And B Aortic Dissection With Extension To Carotid Arteries Resulting In Acute Ischemic Stroke, Dung Nguyen, Jilpa Shah, Amnah Andrabi

North Texas Research Forum 2025

Coexisting Type A and B aortic dissection with extension to carotid arteries resulting in acute ischemic stroke Abstract Background: Acute aortic dissection (AAD) is a rare cause of ischemic stroke. Additionally, it is even rarer to have a combined type A and type B aortic dissection. ADD is a high-mortality disease that can lead to immediate decompensation and can be masked by stroke-like symptoms, which can result in delayed or missed diagnosis. We report a patient with acute ischemic stroke (AIS) with subsequent combined type A and type B aortic dissection. Case Report: A 47-year-old man was admitted to the …


Out Of Left Field Lv Thrombus: Incidental Finding In Patient Presenting With Abdominal Pain, Chak Lam Yeung, Shivani Gandi, Shakir Al-Ezzi, Nicole Huang, Adhikari Pragyan Jan 2025

Out Of Left Field Lv Thrombus: Incidental Finding In Patient Presenting With Abdominal Pain, Chak Lam Yeung, Shivani Gandi, Shakir Al-Ezzi, Nicole Huang, Adhikari Pragyan

North Texas Research Forum 2025

Introduction: Left Ventricular thrombus (LVT) is one of the most feared complications post myocardial infarction due to the high incidence of embolization. LVT typically form after myocardial infarction and the presence of low ejection fraction (EF), both of which contribute to Virchow’s triad for thrombus formation. LVT are less common in the absence of these risk factors or pre-existing cardiovascular disease. This case report explores the incidental discovery of LVT in a patient, without any known cardiovascular disease, who presented for treatment of acute pancreatitis. Case Presentation: 42-year-old male with past medical history of alcohol use disorder and recurrent pancreatitis …


Cannabis Induced 2nd Degree Av Block, Shivani Gandhi, Vineeth Lekkala, Muhammad Suleman, Anvitha Manduva Jan 2025

Cannabis Induced 2nd Degree Av Block, Shivani Gandhi, Vineeth Lekkala, Muhammad Suleman, Anvitha Manduva

North Texas Research Forum 2025

Cannabis use, both medical and non-medical, has seen a marked increase following the growing trend of legalization. While the immediate effects of cannabis on mental and physiological states are well-documented, its potential impact on the cardiovascular system remains an area of growing concern. Cannabis-induced arrhythmias, particularly atrioventricular (AV) block, are rare but potentially life-threatening events that can present in young, otherwise healthy individuals (Heckle et al., 2018). This case highlights the importance of recognizing cannabis as a potential contributing factor in the development of AV block.


A Case Of Severe Synodic Stenosis In A Patient With Granalomatosis With Polyangitis Requiring Tracheostomy, Yousuf Sherwani, Mohan Sengodan Jan 2025

A Case Of Severe Synodic Stenosis In A Patient With Granalomatosis With Polyangitis Requiring Tracheostomy, Yousuf Sherwani, Mohan Sengodan

North Texas Research Forum 2025

Granulomatosis with polyangiitis (GPA) is characterized by vasculitis of small and medium sized blood vessels and granulomatous lesions of the upper respiratory tract. A rare condition associated with GPA, subglottic stenosis, presents in about 20% of cases on inpatient GPA. Symptoms such as stridor, hoarseness, dyspnea and dysphagia are hall marks of subglottic stenosis. Here we present the case of a male patient with life threatening subglottic stenosis that required tracheostomy.


Humoral Influences On The Heart: A Case Of Overt Hypothyroidism And Dilated Cardiomyopathy With Acute Heart Failure, Shana-Kay Lambert-Johnson, Rui Zhang, Brian Yu, Tasaduq Mir Jan 2025

Humoral Influences On The Heart: A Case Of Overt Hypothyroidism And Dilated Cardiomyopathy With Acute Heart Failure, Shana-Kay Lambert-Johnson, Rui Zhang, Brian Yu, Tasaduq Mir

North Texas Research Forum 2025

BACKGROUND/INTRODUCTION: Dilated cardiomyopathy (DCM) affects approximately 7 in 100,000 adults annually, with a mortality rate of 50%. It is typically idiopathic, progressive, and irreversible. However, in the context of hypothyroidism, DCM can be reversible. Hypothyroid-induced DCM with coexisting systolic dysfunction is a rare occurrence. This case report presents an exceptional instance of this phenomenon, highlighting the critical role of thyroid hormone replacement in improving patient outcomes. CASE PRESENTATION: A 48-year-old female with a medical history of hypothyroidism (post-thyroidectomy) was transferred for higher-level care due to new-onset heart failure. Over the past five months, she experienced worsening dyspnea on exertion, fatigue, …


Culture Negative Endocarditis Masquerading As Idiopathic Leukocytoclastic Vasculitis, Sania Moonnumackel, Manish Pandey, Randy Nguyen, Reuben Abreu, Seline Haci, Neelima Paladugu, Machaiah Madhrira Jan 2025

Culture Negative Endocarditis Masquerading As Idiopathic Leukocytoclastic Vasculitis, Sania Moonnumackel, Manish Pandey, Randy Nguyen, Reuben Abreu, Seline Haci, Neelima Paladugu, Machaiah Madhrira

North Texas Research Forum 2025

Background: Infective endocarditis (IE) is a challenging disease to diagnose often presenting with heterogeneous features. Blood cultures are the gold standard for diagnosing endocarditis, but it is important to know that up to 20 % of cases of infective endocarditis have negative blood cultures. Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis and is idiopathic in 50% of cases. LCV is a rare but possible presentation of Infective endocarditis. Hence IE should be part of the differential diagnosis when LCV is diagnosed. Case summary: A 53-year-old male patient presenting right lower extremity pain and vesiculobullous lesions over bilateral upper and …


Case Report: Left Internal Mammary Artery (Lima)/Coronary Steal Syndrome (Css) In Severe Coronary Artery Disease And End-Stage Renal Disease, Fahed Alsayed, Muhannad Badran, Sara Khasawneh, Mohan Sengodan Jan 2025

Case Report: Left Internal Mammary Artery (Lima)/Coronary Steal Syndrome (Css) In Severe Coronary Artery Disease And End-Stage Renal Disease, Fahed Alsayed, Muhannad Badran, Sara Khasawneh, Mohan Sengodan

North Texas Research Forum 2025

Background: LIMA/coronary steal syndrome is a rare but significant complication in patients with severe coronary artery disease (CAD) who have undergone coronary artery bypass grafting (CABG) and concurrently have high-flow arteriovenous (AV) fistulas for hemodialysis. The left internal mammary artery (LIMA) is a preferred conduit for CABG due to its long-term patency and ability to sustain myocardial perfusion. However, in patients with end-stage renal disease (ESRD) requiring hemodialysis, excessive AV fistula flow can divert blood away from the LIMA graft, leading to myocardial ischemia despite graft patency. Early recognition and appropriate intervention are essential to prevent further deterioration of cardiac …


A Match Made In Heaven: The Heart And The Kidney, A Case Report On Uremic Pericardial Effusion With Complete Resolution Post Transplant, Sania Moonnumackel, Victor Delprincipe, Vivek Bhupathi, Srinivasan Rajaganapathy, Anand Karthik, Machaiah Madhrira Jan 2025

A Match Made In Heaven: The Heart And The Kidney, A Case Report On Uremic Pericardial Effusion With Complete Resolution Post Transplant, Sania Moonnumackel, Victor Delprincipe, Vivek Bhupathi, Srinivasan Rajaganapathy, Anand Karthik, Machaiah Madhrira

North Texas Research Forum 2025

Introduction: Pericardial effusion resulting from uremic pericarditis is a complication associated with chronic kidney disease (CKD). In patients with advanced CKD or End Stage renal disease (ESRD) renal transplant is the definitive treatment to improve long term outcomes. However, the presence of a large pericardial effusion poses a risk of hemodynamic compromise during transplant surgery. Options of stabilizing the patient with aggressive dialysis, pericardiocentesis or pericardial window can be considered. Here we present a case of a patient with advanced CKD who underwent pre-emptive kidney transplant and in three months had complete resolution of a large pericardial effusion noted pre-operatively. …


Streamlining Bubble Study Requests In Echo Orders: A Qi Initiative, Vineeth Lekkala, Sharvani Raguthu, Taher Yusufali, Mahmood Ahmad, Mohan Sengodan Jan 2025

Streamlining Bubble Study Requests In Echo Orders: A Qi Initiative, Vineeth Lekkala, Sharvani Raguthu, Taher Yusufali, Mahmood Ahmad, Mohan Sengodan

North Texas Research Forum 2025

Introduction: This quality improvement project centers around the implementation of a dedicated mechanism for ordering bubble studies in echocardiograms at Medical City North Hills Hospital. Drawing inspiration from successful implementations observed at Medical City Denton Hospital, the project aims to address existing challenges, standardize practices, and improve overall efficiency in the echocardiogram ordering workflow. Background: The echocardiogram ordering process at Medical City North Hills Hospital currently faces challenges, specifically the absence of a dedicated mechanism for ordering bubble studies. This deficiency introduces the risk of oversights, particularly in cases of syncope and stroke, thereby compromising diagnostic precision. Acknowledging these challenges, …


Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan Jan 2025

Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan

North Texas Research Forum 2025

INTRODUCTION: When deciding between VA ECMO (veno-arterial ECMO) and VV ECMO (veno-venous ECMO), the primary consideration is the underlying pathology affecting the patient’s heart and lungs. VA ECMO provides support for both the cardiovascular and respiratory systems, making it suitable for patients experiencing cardiogenic shock or combined cardiac and respiratory failure. In contrast, VV ECMO is used exclusively for respiratory failure, offering support to patients with severe lung dysfunction but intact cardiac function. CASE PRESENTATION: 41 year old male with no known past medical history presented s/p cardiac arrest secondary to aspiration pneumonia due to alcohol and opioid intoxication. Chest …


Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr Jan 2025

Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr

North Texas Research Forum 2025

BACKGROUND: Management of VA ECMO has substantially evolved over the years. Much literature has been published regarding indications, management, and outcomes; however, limited evidence exists detailing strategies to manage, progress, and wean patients from VA ECMO. We present our experience using a VA ECMO expected progression patient management guideline. METHODS: The VA ECMO Expected Progression Patient Management Guideline, approved on June 1, 2021, consists of six goal-oriented stages with suggestive interventions for managing cardiogenic shock patients undergoing VA ECMO therapy. Patient characteristics and outcomes were collected retrospectively and compared between March 2019 to May 2021 (VA Non-Expected Progression group) and …


Optimization Of Venous Thromboembolism (Vte) Prophylaxis In Pregnancy And The Postpartum Period, Sereena Jivraj, Isabella Sciacca, Sherrie Dixon, Timothy Kremer Jan 2025

Optimization Of Venous Thromboembolism (Vte) Prophylaxis In Pregnancy And The Postpartum Period, Sereena Jivraj, Isabella Sciacca, Sherrie Dixon, Timothy Kremer

North Texas Research Forum 2025

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolisms (PE) continues to be a leading cause of maternal mortality (MM) in the United States. VTE accounts for roughly 9-10% of all maternal deaths. Other countries have adopted anticoagulation protocols to reduce MM rates, but the US has yet to follow suit. The American College of Obstetricians and Gynecologists (ACOG), the American College of Chest Physicians (CHEST), and the Royal College of Obstetricians and Gynaecologists (RCOG) all vary in their guidelines for thromboembolism prophylaxis. Patients who deliver by Cesarean section (C-section) have higher incidences of MM due …


A Unique Case Of Small Bowel Arteriovenous Malformations In The Setting Of Immune Thrombocytopenic Purpura, Austin Moore, Evan Chen, Hassan Ahmed Jan 2025

A Unique Case Of Small Bowel Arteriovenous Malformations In The Setting Of Immune Thrombocytopenic Purpura, Austin Moore, Evan Chen, Hassan Ahmed

North Texas Research Forum 2025

Arteriovenous malformations (AVM) are a common cause of gastrointestinal (GI) bleeding and often require intervention for definitive treatment. The diagnosis and management of this disease process becomes complicated when combined with an immunologic coagulation disorder. There is very limited literature describing management techniques for patients with these coinciding diseases. This unique case describes a 65-year-old male with a history of AVMs of the small bowel as well as immune thrombocytopenic purpura (ITP). Previously he had undergone multiple medical interventions for management of his ITP, including steroids and intravenous immunoglobulin therapy. He had also undergone multiple imaging and endoscopic interventions to …


When The Chest And Heart Connect: A Rare Case Presentation Of Left Ventricular Pseudoaneurysm, Victor Delprincipe, Aditya Sharma, Wendy Phillips, Malik Amir, Sanjeev Nair Jan 2025

When The Chest And Heart Connect: A Rare Case Presentation Of Left Ventricular Pseudoaneurysm, Victor Delprincipe, Aditya Sharma, Wendy Phillips, Malik Amir, Sanjeev Nair

North Texas Research Forum 2025

We present a rare case of left ventricular pseudoaneurysm (LVPA) resulting from a prior cavity that persisted after surgical treatment of empyema via video-assisted thoracoscopic surgery (VATS) that ultimately lead to chronic inflammation of pericardium, resulting in obtuse marginal artery occlusion causing pseudoaneurysm. Computed tomography angiography (CTA) of the chest suggested that this cavity may have intermittently formed a fistula with the left ventricle, contributing to blood loss and progressive pseudoaneurysm formation. The case highlights the complex interplay between thoracic structures and cardiac pathology in the development of LVPA, with diagnostic and therapeutic challenges addressed.


A Rare Case Of Right Sided May-Thurner Syndrome Diagnosis And Treatment, Sania Moonnumackel, Akhil Gade, Anand Karthik, Machaiah Madhrira Jan 2025

A Rare Case Of Right Sided May-Thurner Syndrome Diagnosis And Treatment, Sania Moonnumackel, Akhil Gade, Anand Karthik, Machaiah Madhrira

North Texas Research Forum 2025

Introduction: May-Thurner Syndrome (MTS) is a phenomenon commonly described as acquired stenosis of the left common iliac vein secondary to compression by the right common iliac artery. Right sided MTS is a rare syndrome that can happen due to a left sided inferior vena cava (IVC) and abdominal aorta with a high bifurcation which results in the right common iliac vein being compressed by the left internal iliac artery. It is a rare presentation of this condition which can commonly be missed and management guidelines are less defined compared to classic MTS. Case Report: A 63-year- old female with past …


A Vaping Nightmare: Sudden Death Provoked By Vaping In The Setting Of Pectus Excavatum, Anoop Gala, Nga Van, Grace Rustom, Danielle Ford, Phuc Nguyen Jan 2025

A Vaping Nightmare: Sudden Death Provoked By Vaping In The Setting Of Pectus Excavatum, Anoop Gala, Nga Van, Grace Rustom, Danielle Ford, Phuc Nguyen

North Texas Research Forum 2025

Pectus excavatum (PE), characterized by an inward depression of the sternum, is the most common congenital chest wall abnormality. It has been rarely linked to cardiac abnormalities, such as arrhythmias and sudden cardiac arrest (SCA). In addition, emerging research suggests that vaping is a cardiovascular risk factor that has the potential to destabilize cardiac rhythm and promote arrhythmias. There is a lack of FDA oversight and long-term research on the effects of vaping. The rising popularity of vaping among youth, coupled with misconceptions about its safety, underscores the urgent need to understand the potential interactions vaping has in precipitating fatal …


Bradycardia In A Renal Transplant Patient Receiving Rabbit Antithymocyte Globulin, John Mathew, Victor Delprincipe, Seline Haci, Karthik Anand, Rangina Farhad Jan 2025

Bradycardia In A Renal Transplant Patient Receiving Rabbit Antithymocyte Globulin, John Mathew, Victor Delprincipe, Seline Haci, Karthik Anand, Rangina Farhad

North Texas Research Forum 2025

Rabbit antithymocyte globulin (rATG) is widely used for induction and treatment of acute T-cell mediated rejection in renal transplant patients. Bradycardia is reported as a rare side effect of this medication (citation). With the increasing number of transplanted kidneys in today's world, there is greater need to understand the adverse effects of these drugs in transplant recipients.. Here we report a case of symptomatic bradycardia in a renal transplant patient receiving rATG for acute T-cell mediated rejection.