Cardiovascular Diseases Commons^™

The Importance Of Serial 12-Lead Ecgs In The Prehospital Setting: A Case Of Transient St Elevation Myocardial Infarction (Tstemi), Zachary J. Blickley Nrp, Fp-C, Matthew E. Kent Nrp, Fp-C, Benjamin J. Lawner Do, Emt-P

Tower Health Research Day

No abstract provided.

Cardiotoxicity Induced By Capecitabine And Oxaliplatin In Gastric Cancer Treatment: A Rare Case Of Cardiac Arrest And Cardiogenic Shock., Muhammad Umer Riaz Gondal, Jared Segal, John Lemoine, Zainab Kiyani, Devi Parvathy Jyothi Ramachandran Nair, Brian Mccauley

Tower Health Research Day

No abstract provided.

Reactive Oxygen Species In Acute Coronary Syndrome, Fernando Cisneros, Alex Zuo

Research Symposium

Background: Reactive oxygen species (ROS) have diverse functions in biomedicine, providing roles in cellular metabolism and signaling while posing a threat to cellular components through oxidative damage. This poster explores the significance of ROS in various cardiovascular diseases, specifically hypertension, atherosclerosis, and myocardial infarction, all of which are associated with acute coronary syndrome which are the conditions and symptoms caused by ischemia. We have studied over 30 most recent or related literature to the topic and determine important roles of ROS in cardiovascular disease. Correlations have linked ROS culprits, particularly upregulation of NADPH oxidase (NOX) 2 and NOX 4, with …

Interplay Of Periodontal Bacterial Metabolites In The Progression Of Coronary Artery Disease: A System Biological Approach, Janakiraman V

Annual Research Symposium

Purpose:

The purpose of this study is to investigate the intricate relationship between periodontal disease (PD) and coronary artery disease (CAD), as evidenced by epidemiological associations. Metalloproteinase inhibitor (TIMP1) plays a pivotal role in cellular signaling, differentiation, cell death, and migration by binding to target metalloproteinases, forming complexes with other molecules (collagenases) to inactivate them. However, the expression of TIMP1 is reduced in both PD and CAD, leading to an upregulation of other metalloproteinases. This research explores the hypothesis that metabolites released from (Porphyromonas gingivalis), a prevalent bacterium in atherosclerotic patients, may inhibit TIMP1, thereby influencing CAD progression. …

It Takes A Big Heart To Shape Atrophic Hepatocytes: Hypoxic Hepatitis Secondary To Congestive Heart Failure, Lina Pedraza Sanchez, Jose Rivera, Cynthia Rivas, Grigoriy Rapoport, Michelle Lopez

Research Colloquium

Introduction: Hypoxic hepatitis (HH) also known as ischemic hepatitis is the result of a hypoperfusion state during diffuse hepatic injury¹. The incidence of HH is 2:1000 of patients within any hospital care level. 94% of HH are related to chronic heart failure (HF). In this setting, hepatic dysfunction occurs as a result of passive venous congestion². The most common predisposing factors are acute heart failure and shock states, however, more than half of the cases are not related to any hemodynamic change, thus, underrecognized.

Case description: A 77-year-old woman is admitted to the hospital for acute …

A Case Of Device Lead Induced Severe Tricuspid Regurgitation And Right-Sided Heart Failure, Nina Shyama Appareddy, Michaela Iglesia, Ayman Khaddam, Henry Kwang, Eduardo D. Flores

Research Colloquium

Background: Interference of device leads with closure of the tricuspid leaflets can cause severe tricuspid regurgitation (TR) and right-sided heart failure, as can heart failure with reduced LV function (HfrEF), and left sided valve disease.

Case Presentation: A 78-year-old male with history of coronary artery disease s/p remote coronary bypass, ischemic cardiomyopathy with left ventricular ejection fraction 35-40%, and inducible ventricular tachycardia status post defibrillator presented with worsening dyspnea on exertion, easy fatigue, lower extremity pitting edema, anasarca, abdominal bloating and new systolic murmurs at the right upper and left lower sternal borders. An Echocardiogram demonstrated severe aortic stenosis with …

Fat Distribution And Differential Effects On Metabolic Liver Fat Infiltration In Young Mexicans In Reynosa, Mexico: A Collaborative Study Across The U.S.-Mexico Border, Esperanza Milagros Garcia-Oropesa, Adriana Leticia Perales-Torres, Estrella Martinez-Lopez, Claudia Munguia-Cisneros, Edna Nava-Gonzalez, Monserrat Perez-Navarro, Marisol Rosas-Diaz, Neyla Baltazar, Alvaro Diaz-Badillo, Octelina Castillo-Ruiz, Joselin Hernandez-Ruiz, Srinivas Mummidi, Laura Yanneth Ramirez-Quintanilla, Carlos Ramirez-Pfeiffer, Juan Carlos Lopez-Alvarenga

Research Symposium

Introduction: Metabolic-associated fatty liver disease (MAFLD) is a descriptive term for NAFLD (Non-alcoholic) physiopathology associated with obesity. The age of onset linked to body fat distribution is poorly studied. Therefore, we aimed to assess the body fat effect on liver fat infiltration and stiffness (LSt) mediated by insulin resistance (IR).

Methods: After obtaining informed consent, five hundred freshmen from two universities in Reynosa, Mexico (UMAN & UAT) were enrolled in the study. They completed a questionnaire focused on familial cardiometabolic risk and provided anthropometric measurements. In a subset of N=200, we obtained blood samples for biochemical measurements, body fat percentage …

Variant Of Fii Gene Plays A Critical Role In Coagulation Potential In Mexican-Americans, Hoang Anh T. Nguyen, Shuchita Vijay Jhaveri, Marcio A. Almeida, Vincent P. Diego, Satish Kumar, Juan M. Peralta, Joanne E. Curran, Bernadette W. Luu, Donna M. Lehman, Ralph A. Defronzo, Laura Almasy, Sarah Williams-Blangero, Ravi Duggirala, John Blangero, Tom Howard

Research Symposium

Background: Disruption in the balance between coagulation and bleeding can result in varying phenotypes such as hypercoagulability and can lead to the development of cardiovascular disease. In our study utilizing extended families of Mexican-Americans from South Texas, we performed a search for protein-altering variants influencing coagulation potential.

Methods: Mexican-Americans in the study were genotyped using Illumina-(human)-exome-24 chip to screen for protein-altering variants. Variants were analyzed for their association with FII activity, aPTT, and PT. Linear-mixed-model analysis was performed to estimate trait heritabilities and to interrogate single nucleotide variations (SNV) for evidence of genetic association. To control for multiple testing, associations …

Characterization Of Epithelial Growth Factor Transcripts Identified In Crotalus Atrox Venom, Ivan Lopez, Ying Jia

Research Symposium

Epithelial Growth Factor (EGF) is the primary source in regeneration and stimulation of essential fibroblasts cells commonly found in epithelium. Studies have shown that snake venom components are becoming a growing factor in treating illnesses such as cancer, muscular dystrophy, chronic pain, blood pressure, blood clotting, etc. EGF in human cells contains a promising quaternary structure that can bind to snake venom metalloproteinases, proposing a means of activating biochemical responses through protein-protein interactions to regulate unwanted cellular functions. This supports promising research in achieving a greater understanding of regulation along cellular pathways through ligands, increasing the likelihood of targeting unwanted …

Recognizing Fatal Electrocardiography Rhythm Changes In A Patient With Severe Hyperkalemia And Prevention Of Cardiac Arrest With Medical Management In Small Hospitals, Semenawit B. Burka, Eduardo Flores, Johnathan Gyebi-Agyepong

Research Symposium

Background: Hyperkalemia is one of the most potentially lethal electrolyte disorders. Severe hyperkalemia is defined as a serum potassium level of >6.5 mEq/L. The risk of arrhythmias increases with potassium values >6.5 mEq/L. Small elevation above this value can cause peaked T waves to quickly progress to ventricular fibrillation or asystole. The longer the patient has elevated potassium concentrations, the greater the risk of sudden deterioration. Therefore, recognizing ECG changes and acting quickly to decrease potassium concentration is important to prevent hyperkalemic cardiac arrest.

Case Presentation: A 26-Year-old man with a history of congenital hypoaldosteronism presented to the emergency department …

Taking The Load Off: Device Lead-Induced Severe Tricuspid Regurgitation And Right-Sided Heart Failure Treated With Transcatheter Aortic Valve Implantation (Tavi), Nina Shyama Appareddy, Michaela Iglesia, Ayman Khaddam, Henry Kwang, Eduardo Flores

Research Symposium

Background: Interference of device leads with closure of the tricuspid leaflets can cause severe tricuspid regurgitation (TR) and right-sided heart failure, as can heart failure with reduced ejection fraction (HFrEF) and left sided valve disease. We report a case treated with transcatheter aortic valve implantation (TAVI) with improved TR.

Case: A 78-year-old male with coronary artery disease status post remote myocardial infarction and coronary bypass, HFrEF with left ventricular ejection fraction 35-40%, and inducible ventricular tachycardia status post AICD placement presented with worsening dyspnea on exertion, easy fatigue, lower extremity edema, anasarca and abdominal bloating. Transthoracic echocardiography demonstrated severe aortic …

Subtotal Iliac Vein Occlusion Secondary To May-Thurner Syndrome, Nina Shyama Appareddy, Jose Ramos, Usman Sheriff

Research Symposium

Background: May Thurner Syndrome (MTS), an anatomical variant present in over 20% of the population, can present with iliofemoral deep venous thrombosis (DVT) caused by compression of the common iliac vein by the adjacent iliac artery.

Case: An 86 year old male with coronary artery disease presented with left lower extremity swelling. Ultrasound revealed acute iliofemoral region DVT. This clot, extending from the groin to the ankle, placed him at high risk for pulmonary embolism and post-thrombotic syndrome.

Decision-making: Patient was placed on heparin drip. Venogram performed at 48 hours showed extensive clot in the superficial femoral, common femoral and …

Socio-Contextual Factors Predicting Pericardial Effusion And Mortality In Patients With Confirmed Sars-Cov2 In A South Texas Hospital. A Preliminary Analysis, Nina Shyama Appareddy, Cesar Peralta, Juan Carlos Alvarenga, Charles Mild

Research Symposium

Introduction: Few pericardial effusion (PEf) cases have been reported in the literature amongst adult hospitalized patients with SARS-CoV2. The goal of our study is to determine the frequency and risk factors of PEf amongst adult hospitalized patients with SARS-CoV2 and its effect on mortality.

Methods: This preliminary analysis included 48 consecutive patients with confirmed SARS-CoV2 admitted from 08/01-08/31/2021. Socio-demographic data and risk factors for coronary artery disease were recorded. Echocardiography was reviewed for evidence of PEf. A comparison of patients with effusion, no effusion, and no echo was performed with chi-square, t-test, ANOVA, and probability of death using logistic regression …

Using Cartesian Coordinate Systems To Create, Classify, And Retrieve Biomedical Time-Series: Applications To 24-Hour Ambulatory Blood Pressure Monitoring, Antonio Garcia, Gladys E. Maestre, John Blangero, Jesus D. Melgarejo, Julio Facelli

Research Symposium

Background: Ambulatory Blood Pressure Measurement (ABPM) allows physicians to monitor blood pressure variability under everyday living conditions and predicts clinical outcomes better than conventional blood-pressure measurement. ABPM can demonstrate mean arterial pressure (MAP) behavior over 24 hours relevant to clinical practice, such as nocturnal hypertension or increased blood pressure variability. We hypothesized that individuals with the same cardiovascular health status would have the same MAP signal (MAPs) waveform.

Methods: This study reutilizes a data subset from the IDACO Consortium to create 24-hour MAPs. We assigned all the MAPs to data matrix X, performed principal components analysis (PCA) to X, and …

Prevalência De Hipertensão Nos Trabalhadores Da Saúde De Um Hospital Universitário, Francielle Lopes Dos Reis, Luciana Pereira Silva, Maria Carlota Borba Brum, Sheila De Castro Cardoso Toniasso, Camila Pereira Baldin, Robson Martins Pereira, Maria Da Graça Rocha Penha, Celia Mariana Barboza Souza, Julio Cesar Ferreira Bertoloto, Vitória Sparrenberger Santos, Rebeca Mendonça Quinhones, Daniela Boeira, Carolina Esteves Lock

AMNET XX Conferencia Internacional

Introdução: A Hipertensão Arterial Sistêmica (HAS) é descrita como uma doença prevenível considerada um grave problema de Saúde Pública no Brasil. Conforme o Sistema de Informação sobre Mortalidade (SIM), de 2010 a 2020, foram registradas 551.262 mortes por doenças hipertensivas. O monitoramento preventivo, conforme previsto na NR-7 do Ministério da Saúde, preconizado no Programa de Controle Médico e Saúde Ocupacional (PCMSO), estabelece o diagnóstico precoce dos agravos à saúde dos trabalhadores, para que sejam realizadas ações estratégicas preventivas, que apontam com a melhoria do estilo de vida

Objetivo: Verificar a prevalência de hipertensão entre trabalhadores da saúde em um hospital …

Cicatrização De Lesão Infecciosa Em Paciente Com Doença Crônica Na Atenção Primária: Estudo De Caso, Elisiane De Oliveira Machado, Claudia Luciani Tappes, Suimara Dos Santos, Simone Thais Vizini, Fabio Silva Da Rosa, Djulia Andriele Wachter, Miguel Lucas Silva Da Paixão, Gabriel F. Goncalves, Maicon Daniel Chassot, Juciane Furlan Inchauspe, Michelle Dornelles Santarém

AMNET XX Conferencia Internacional

Introdução: Doenças crônicas não transmissíveis (DCNT) dificultam a cicatrização de feridas. A Hipertensão Arterial Sistêmica (HAS), por exemplo, causa alterações microvasculares que geram hipóxia tecidual, inibindo a atividade fagocitária e possibilitando infecções por menor atividade leucocitária. É necessário, portanto, uma abordagem eficaz para a cicatrização destas lesões, prevenindo agravos de saúde. Objetivo: Relatar o caso de cicatrização de uma lesão infecciosa em um paciente com DCNT. Metodologia: Estudo de caso sobre paciente feminina, 64 anos, com HAS, que após cirurgia no joelho, apresentou deiscência e infecção local na ferida operatória, iniciando o tratamento da lesão com a Unidade Básica de …

A Young Infant With Large Anomalous Systemic Artery To Supply Left Lower Lobe Of The Lung With Normal Intracardiac Anatomy, Ghita Benjelloun,, Jie Sun

St. Chris Research Day

No abstract provided.

Association Between Remote Monitoring And Interstage Morbidity And Mortality In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal

Research Days

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation.

Objectives/Goal: We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period.

Methods/Design: Using the CHAMP database, we identified 610 infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with …

Mixed Beri’S: High Output Heart Failure From Severe Anemia And Thiamine Deficiency, Rohan Umrani, Hiral Amin, Ashley Pinckney, Charles Yang, Daniel Tran

Rowan-Virtua Research Day

Background: Severe anemia and thiamine deficiency can independently result in high output heart failure (HOHF) through different mechanisms. Data on the threshold and timeframe at which these etiologies may precipitate HOHF is unclear.

Case: A 63-year-old male with alcohol use disorder consuming 18 drinks/week presented with progressive shortness of breath and lower extremity edema for a few months. Physical exam revealed tachycardia, anasarca, jugular venous distension, Lancisi’s sign, and a midsystolic murmur. Echocardiogram demonstrated EF of 30-35%, dilated left ventricle, and cardiac index of 4.2L/min/m2.

Decision-Making: Heart failure can independently precipitate anemia while severe alcoholism can induce myelosuppression and promote …

Comorbidities, Behaviors, And Socioeconomic Factors And Mortality From Diseases Of The Heart In New Jersey, Matthew Guariglia, Stephen Poos, Ahmed Gawash, David Lo, Aayush Visaria

Rowan-Virtua Research Day

Mortality from diseases of the heart claimed the lives of 186,074 New Jerseyans from 2010 to 2019. This study aims to establish correlations between each of health-related risk factors and death from heart disease in each of six New Jersey counties. Each of the counties ranked by age-adjusted mortality per 100,000 from diseases of the heart. The six counties were divided by the least (Hunterdon, Somerset, Bergen) and greatest (Cape May, Salem, and Cumberland) mortality rates from heart disease. Additionally, this data was broken down into three main categories that include comorbidities, socioeconomic status, and behavior patterns. Each main category …

Is There A Role For Plant-Based “Meat” In Cardiovascular Disease Prevention?, Aziza Jadallah, Usmaan Al-Shehab, Adam Friedman

Rowan-Virtua Research Day

Diet is an established risk factor for cardiovascular disease. The American Heart Association recommends following a whole-food, minimally processed diet emphasizing fruit and vegetables to reduce cardiovascular mortality. Recently, processed plant-based meat substitutes, such as Beyond Meat® and Impossible™ foods have become easily accessible to consumers and are advertised as a healthful addition to a plant-based diet. However, these products are highly processed and contain high amounts of saturated fat and sodium. The purpose of this research is to investigate the effect of processed plant-based meat diets on adverse cardiovascular events compared to animal-based meat diets and minimally processed healthful …

A Rare Case Of Left Main Vasospasm Resulting In Sudden Cardiac Death, Trinava Roy, Anjeli Patel, Tania Maheshwari, Vasu Palli

Rowan-Virtua Research Day

Background: Coronary artery vasospasm (CAV) is transient spasm of a coronary artery that can lead to cardiac ischemia. We present a case with left main (LM) CAV identified on electrocardiogram (ECG) and cardiac catheterization resulting in appropriate therapy.

Case: A 52 year old female with months of spontaneously resolving episodic neck pain, flushing, and diaphoresis presented to the emergency department after a resuscitated cardiac arrest. Initial ECG was without evidence of ischemia, however high-sensitivity troponin (522) was elevated. Telemetry monitoring and ECG showed transient ST elevations in V1 and diffuse ST depressions with left bundle branch block. LV Function was …

Dislodged Endovascular Heat-Induced Thrombus Resulting In Pulmonary Embolus Following Post-Operative Ultrasound Compression, Danielle Park, Aghilas Belkadi, Luke Perry, Michael Kachmar, Holly Graves

Rowan-Virtua Research Day

Introduction: Venous insufficiency and consequent varicose veins are common problems faced by many patients. Fortunately, there are many treatment options available including a minimally invasive method known as radiofrequency ablation (RFA). RFA is not without complications; amongst those are endovascular heat induced thrombosis (EHIT). This rare complication is typically managed conservatively; however, in rare occasions, the thrombus can detach and embolize causing further issues for patients.

Case Description: A 48-year-old male underwent an uneventful RFA procedure for a CEAP 4a venous insufficiency. On the post-operative ultrasound venous duplex evaluation, the patient was found to have EHIT type 2 in the …

The Angiovac® Device Limits Lethal Complications Of Sepsis And Severe Infective Endocarditis With A Large Tricuspid Valve Vegetation: A Case Report, Dua Xiao, Raeann Dalton, Adam Fineman, Michael Benz, Antonios Tsompanidis

Rowan-Virtua Research Day

Introduction: Infectious endocarditis of the tricuspid valve is a common complication of intravenous drug use. Endocarditis caused by viridans streptococci can lead to heart valve vegetations which may be life threatening due to the potential for embolism and obstruction. Management of large valvular vegetations is often difficult due to the risks involved with open heart surgery, especially in patients with comorbid conditions. The AngioVac® device has been shown in rare cases to be effective at debulking vegetations without the need for invasive surgery.

Case Presentation: We present a patient with a history of intravenous heroin use disorder, hepatitis C, spinal …

Importance Of Serial Ekgs In The Emergency Room Setting, Swet Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Chest pain is one of the most common chief complaints that presents to the emergency department. More than 8 million patients with chest related complaints present each year with about 10% of all ED visits comprise of cardiovascular emergencies. Immediate evaluation is the standard of care to differentiate between life threatening conditions and non-life threatening ones with the use of 12-lead electrocardiograph (EKG) and bedside monitors. The 12 lead EKG remains gold standard for initial screening and evaluating patients with chest pain and angina equivalents. The test is fairly inexpensive and noninvasive with providing vital information about cardiac rhythm. The …

New Onset Lichen Planus And Back Pain Leading To Discovery Of A Peri Aortic Abscess, Monica Diep, Wayne Tamaska, Philip Carhart, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Back pain is a common chief complaint in the emergency department. With the differential ranging from musculoskeletal pain to cauda equina, there are a plethora of diagnoses. Differentiating between benign back pain and back pain that warrants further evaluation and even possible emergent surgical intervention is often a challenge in the acute setting. In this case report, a strange combination of all new symptoms including lichen planus, fevers, chills and atraumatic back pain lead to the eerie and very unexpected diagnosis of a peri-aortic abscess.

Effects Of Attention-Deficit/Hyperactivity Disorder On Patients Undergoing Percutaneous Coronary Intervention Procedure: Insights From The National Inpatient Sample, Rafail Beshai, Keri Anacker, Keith Anacker, Tony Elias, Veyola Rezkalla, Maziyar Daneshvar, Howard Weinberg

Rowan-Virtua Research Day

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that can affect children and adults and is characterized by deficits in attention, self-regulation, and executive functioning. Symptoms can seriously affect daily functioning and may present as hyperactivity, inattentive behaviors, or a combination of both. There are data to suggest patients with ADHD suffer from increased rates of cardiovascular disease, however not much is known specifically regarding the relationship between ADHD and undergoing Percutaneous Coronary Intervention. We sought to examine this relationship in greater detail by perusing the national inpatient sample database to describe in-hospital trends and outcomes among these …

Inflammatory Marker Levels Among Patients Diagnosed With Autism Spectrum Disorder And Congenital Heart Defects, Patrick Pearce, Venkateswar Venkataraman, Andrea Iannuzzelli, Jennifer Lecomte

Rowan-Virtua Research Day

Autism Spectrum Disorder (ASD) and congenital heart defects (CHD) are conditions that both confer an immense increase in standard of care, and utilization of medical resources addressing comorbidities. One shared symptom that has been consistently cited is inflammation. This review sought to explore the levels of Tumor Necrosis Factor-𝞪 (TNF-𝞪) and Interleukin-6 (IL-6) between patients diagnosed as having either ASD or CHD. By compiling published data containing the mean values of these two inflammatory markers within these populations, it was shown that while both have significantly elevated levels compared to a phenotypically normal demographic, there is no significant difference between …

Comparison Of Clinical And Radiographic Efficacy Of Particles Versus Nbca/Onyx In Middle Meningeal Artery Embolization For Chronic Subdural Hematoma, Jane Khalife, Mohamed Salem, Victoria Wong, Allen Karimov, Brian Jankowitz, Jan Karl Burkhardt, Hamza Shaikh, Daniel Tonetti, Pratit Patel, Tudor Jovin, Ajith Thomas

Rowan-Virtua Research Day

Different embolic materials are utilized in MMA embolization of chronic subdural hematoma per operators’ discretion. We aim to compare the clinical and radiographic efficacy of different embolic materials in a pooled retrospective cohort of two US centers.

Spontaneous Iliac Arteriovenous Fistula, High-Output Heart Failure, And Cardiac Arrest, J. Maxwell Piraneo, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

High-output heart failure is a potentially life-threatening condition that can lead to cardiac arrest. The most common causes of this condition are obesity, liver disease, arteriovenous shunts, lung disease, and myeloproliferative disorders, however the exact prevalence remains uncertain [1]. Here we describe an unusual case of cardiac arrest as a consequence of high-output heart failure, secondary to rupture of an iliac artery aneurysm into the common iliac vein, with arteriovenous (AV) fistula formation.