Medical Specialties Commons^™

Incidental Left Ventricular Fibroma Detected During Pre-Participation Screening In A Young Athlete, Alya J. Al Hashmi, Meetha S. Al Ameri, Asna Ayoob, Hafsa Maryam, Fiza Halima

Journal of the Saudi Heart Association

Primary cardiac fibromas are rare benign tumors that may carry arrhythmic risk. We report a case of cardiac fibroma that was incidentally detected in an 18-year-old athlete with echocardiography and MRI during routine pre-championship screening. Following multidisciplinary heart team discussion and shared decision-making, surgical excision was performed due to potential arrhythmic risk in the setting of high-intensity athletic activity.

Socioeconomic Disparities In Readmission Outcomes And Cardiac Procedures Among Atrial Fibrillation Hospitalizations, Muhammad U. Almani, Muhammad Yousuf, Noor Fatima, Muhammad Q. Ullah, Muhammed Arshad

Einstein Health Papers

Introduction: Atrial fibrillation (AF) remains one of the leading dysrhythmias incurring hospitalization. We set out to determine the impact of socioeconomic status (SES) on in-hospital cardiac procedures and the readmission outcomes in patients with AF. Methods: The National Readmission Database (NRD) was searched for adults with a primary diagnosis of AF between 2010 and 2019. We determined unplanned AF-specific readmission within 30 days. Median neighborhood household income was assessed by patient zip code as quartiles: low income (Q1), middle income (Q2), upper-middle income (Q3), and high income (Q4). Differences in in-hospital cardiac procedures during the index hospitalization and probability of …

Influenza B Viral Infection Complicated By Acute Fulminant Myocarditis Requiring Mechanical Support: A Case Report., Tareef Hesham Kannout, Muhammad Azam Shah, Fahmi Abdullah Alkaf, Faisal A. Alghamdi, Mohammed Alreshidan

Journal of the Saudi Heart Association

Acute fulminant myocarditis represents a severe complication of myocarditis, necessitating early suspicion and intervention for improved patient outcomes. Influenza B-induced myocarditis remains a relatively rare entity. A young lady presented to the emergency department with symptoms of heart failure and cardiogenic shock, requiring inotropes without significant improvement. For the continued deterioration of her hemodynamics, she underwent mechanical circulatory support, including Extracorporeal Membrane Oxygenation (ECMO) and Intra-aortic balloon pump (IABP).  The follow-up investigations showed positive influenza B. She was treated with antiviral therapy and steroids, resulting in gradual improvement in hemodynamics and left ventricular ejection fraction

A Hemorheological Perspective On Coronary Microvascular Dysfunction: Association Of Erythrocyte Parameters With Angiography-Derived Coronary Microcirculatory Resistance, Abdulrahman Alqazzaz, Yanfeng Lu, Jasmine Bao, Gary S. Mintz, Jiahao Feng, Yong Zhang, Shanshan Gao, Qiang Song, Feifei Ning, Hytham H. Al-Samawi, Mohsen Al-Manj, Mohammed Al-Asadi, Xin Huang, Ning Guo

Student Papers, Posters & Projects

BACKGROUND: Coronary microvascular dysfunction (CMD) contributes to myocardial ischemia in patients both without obstructive coronary artery disease (e.g., MINOCA/INOCA) and in those with co-existing epicardial stenosis. While its etiology includes structural and functional causes. hematologic parameters have been linked to cardiovascular outcomes. However, the relationship between red blood cell (RBC) markers and microvascular resistance remains poorly characterized. We aim to evaluate whether RBC parameters are correlated with the angiography-derived index of microcirculatory resistance (angio-IMR).

METHODS: This retrospective study evaluated the association between red blood cell (RBC) parameters and angio-IMR in patients with intermediate coronary artery disease (30%-70% stenosis). Data were …

Atrial Fibrillation In Athletes: Mechanisms, Management, And Future Directions, Ibrahim Alameh, Ghina Al Fout, Michael D. Ezekowitz, Mohammed Kamareddine

Department of Medicine Faculty Papers

BACKGROUND: High-volume endurance training may shift exercise from cardioprotective to arrhythmogenic, increasing the risk of atrial fibrillation (AF) in healthy athletes.

CASE SUMMARY: A 38-year-old marathon runner with a 15-year history of high-intensity endurance training presented with episodic palpitations and reduced athletic performance. Electrocardiogram showed paroxysmal AF; echocardiography revealed mild left atrial enlargement without structural heart disease. Symptoms worsened during the recovery phase after runs, suggesting vagally mediated AF. After unsuccessful flecainide therapy, he underwent pulmonary vein isolation. Twelve months later, he remained free of recurrent AF on Holter monitoring and successfully resumed endurance training following an 8-week recovery period. …

Visual-Physiological Concordance And Target Vessel Outcomes: A Μqfr-Based Real-World Cohort Study, Yanfeng Lu, Abdulrahman Alqazzaz, Jasmine Bao, Gary S Mintz, Jiahao Feng, Yong Zhang, Shanshan Gao, Qiang Song, Feifei Ning, Wangge Ma, Haoyu Wu, Yuejiao Wei, Jiaying Li, Ning Guo, Xin Huang

Student Papers, Posters & Projects

BACKGROUND AND OBJECTIVES: Quantitative flow ratio (QFR) offers a non-interventional alternative for evaluating ischemia, yet its concordance with real-world treatment and clinical outcomes remains unclear. This study aimed to assess the alignment between Murray law-based QFR (μQFR) physiological assessment and treatment strategies, evaluate the association between treatment concordance and clinical outcomes, and explore factors influencing concordance.

METHODS: In this retrospective cohort, 242 patients with angiographically intermediate coronary stenosis and μQFR values adjacent to the grey-zone (low: 0.70-0.74; high: 0.86-0.90) were included. Treatment concordance was defined as PCI for low μQFR and medication for high μQFR. The primary endpoint was target …

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

Student Works

1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …

2. Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery, Jacinta Smith

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Improving Door To Ekg Time In The Emergency Department, Juleene J Mcgowan

Providence Nursing Research Conference 2023 – Present

References:

Yiadom, M. Y., Gong, W., Patterson, B., et al. 2022.

Fallacy of Median Door-to-ECG Time: Hidden Opportunities for STEMI Screening Involvement.

Journal of American Heart Association. Https://doi.org/10.11161/JAHA.121.024067

Yiadom, M. Y., Gong W., Bloos S., et al. 2024.

Shorter Door-to-ECG Time is Associated with Improved Mortality in STEMI Patients.

Journal of Clinical Medicine. 2024, 13, 2650. https://doi.org/10.3390/jcm13092650

Resuscitating Rapid Response And Code Blue Education, Danielle Fogel

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Hypertensive Disorders Of Pregnancy: Clinical Features And Characteristics Associated With Postpartum Readmissions, Nicole Evaro

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Acls Escape Room: A Gamified Learning Experience, Elizabeth Senecal

Providence Nursing Research Conference 2023 – Present

No abstract provided.

The Effect Of Transcranial Near-Infrared Laser Therapy On Chronic Ischemic Stroke Patients: A Randomized, Single-Blind, Sham-Controlled Trial, Merna Hassan, Osama Al Balah, Ahmed Hegazy, El Sayed Satour

Journal of the Saudi Heart Association

Background: Transcranial photobiomodulation (TPBM) using near-infrared (NIR) light is a novel, non-invasive neuromodulation strategy with potential to enhance neurorecovery. While preclinical studies are promising, clinical evidence in chronic stroke remains limited and inconsistent.

Objective: To evaluate the efficacy and safety of 980 nm transcranial NIR laser therapy as an adjunct to standard rehabilitation in improving neurological function in patients with chronic ischemic stroke.

Methods: In this randomized, single-blind, sham-controlled trial, 40 chronic ischemic stroke patients (>6 months post-onset, NIHSS 7-22) were allocated to active treatment (n=20) or sham control (n=20). The active group received 980 nm laser therapy (6W, …

Retrocardiac Innominate Vein: A Rare Vascular Anomaly Associated With Congenital Heart Disease, Ali Alakhfash, Osama Alrusaini, Fahad Alhabshan, Khaled Alhawri, Abdulrahman Almesned

Journal of the Saudi Heart Association

Atrial septal defects are common congenital heart anomalies and may coexist with rare systemic venous abnormalities. We describe a one-year-old female with a large secundum atrial septal defect and an unusual retrocardiac innominate vein. Transthoracic echocardiography suggested a persistent left superior vena cava, but the innominate vein was absent from its usual location and the coronary sinus was not dilated. Cardiac CT angiography demonstrated a retrocardiac innominate vein draining into the azygos system and subsequently to the right atrium. Surgical atrial septal defect closure was successful. Recognition of this anomaly is essential for accurate diagnosis and procedural planning.

Clinical And Economic Impact Of Vascular Access Teams Utilizing An Ic-Ecg-Based Tip Confirmation System For Peripherally Inserted Central Catheters., Gustavo Rc De Freitas, Sanjay A Patel, Shigeki Fujitani, Yusuke Terasaka, Angel A Sarabia Collazo, Andrew Barton, Leanne Ruegg, Amanda Griffin, Matthew O'Brien, Idal Beer

Heart and Vascular Articles

INTRODUCTION: Peripherally inserted central catheters (PICCs) are commonly used in clinical practice. Historical PICC placement methods (e.g. fluoroscopy-guided placement or blind insertion with confirmatory chest X-ray) have many limitations and are associated with longer wait times, treatment delays, and potential risks to patient safety. One such way of addressing some of these issues is the use of dedicated systems that integrate ultrasound vessel selection and PICC insertion, magnetic catheter tip navigation, and intracavitary electrocardiogram-based tip confirmation (IC-ECG). The uptake of these systems has been slow in some parts of the world. This narrative review aims to assess the clinical and …

Role Of Continuous Positive Airway Pressure In The Prevention Of Cardiovascular Events In Patients With Obstructive Sleep Apnea: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials, Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Ahmad Alilo, Maryam Altaher, Mohamed Almuzainy, Sami Alsalem, Mohamed Dawdi

Journal of the Saudi Heart Association

Background: Obstructive sleep apnea (OSA) is prevalent among patients with cardiovascular disease and is associated with increased risk of major adverse cardiovascular events (MACE). Continuous positive airway pressure (CPAP) is the standard treatment for OSA, but its impact on cardiovascular outcomes remains uncertain, particularly in randomized controlled trials (RCTs).

Objectives: To evaluate the effect of CPAP therapy on cardiovascular outcomes in patients with OSA, and to explore the influence of adherence on treatment efficacy.

Methods: We conducted a systematic review and meta-analysis of RCTs comparing CPAP with placebo or usual care in adults with OSA. Databases including PubMed, Scopus, Ovid, …

A Case Report Of A Double Descending Dorsal Aorta In A Complex Congenital Heart Disease., Anhar Ali Baeshen, Mohammad Amin Ghulam Rasol, Riad Abouzahr, Zaheer Ahmad Ahmad

Journal of the Saudi Heart Association

Double dorsal aorta is an extremely rare congenital embryological vascular anomaly caused by incomplete regression and fusion of the paired dorsal aortae and may be associated with complex congenital heart disease. We report a 9-year-old girl with complex congenital heart disease who underwent single-ventricle palliation, including a bidirectional Glenn at 10 months of age. During pre-Fontan cardiac catheterization a double descending dorsal aorta was incidentally discovered and later confirmed by CT angiography. Although patient was asymptomatic, recognizing this anomaly is crucial for surgical planning and catheter-based interventions, highlighting the importance of detailed preoperative imaging in single-ventricle patients.

Association Between Functional Status And Cardiac Function In Chronic Heart Failure: Insights From The C-Mic Ii Trial., Marat Fudim, Tamara Kovacevic-Preradovic, Marija Zdravkovic, Sasko Jovev, Nermir Granov, Tanja Popov, Igor Rudez, Petar Vukovic, Velibor Ristic, Annette Holtdirk, Muhammad Shahzeb Khan, Faouzi Kallel, Miodrag Peric, Javed Butler, Stefan D. Anker, Dragana Kosevic, J. Eduardo Rame

Department of Medicine Faculty Papers

INTRODUCTION: Relationship between changes in cardiac function, functional capacity, and patient-reported health status in heart failure (HF) remains incompletely defined, which may help inform endpoint selection and clarify how distinct clinical domains reflect treatment response.

METHODS: This post hoc analysis of the randomized cardiac microcurrent (C-MIC) II trial, which evaluated the efficacy and safety of C-MIC therapy in patients with chronic HF with reduced ejection fraction on optimal guideline-directed medical therapy, included 65 ambulatory patients with non-ischaemic dilated cardiomyopathy, New York Heart Association (NYHA) Class III-IV symptoms, and baseline left ventricular ejection fraction (LVEF) 25-35%. Correlations between changes in Kansas …

Comparison Of Integrated 3d Electroanatomic Mapping And Conventional Mapping Systems For Pentaspline Pulsed Field Ablation Of Atrial Fibrillation., Auroa Badin, Andrea K Robinson, Allyson Farrah, Saanvi Billakanty, David M Nemer, Ankur N Shah, Jaret D Tyler, Eugene Y Fu, Nagesh Chopra, Anish K Amin

Heart and Vascular Articles

INTRODUCTION: Pulsed field ablation (PFA) is an established therapy for atrial fibrillation (AF), yet optimal mapping strategies during pentaspline PFA remain uncertain. We compared procedural characteristics and material costs of an integrated 3D electroanatomic mapping (EAM) platform with conventional mapping systems.

METHODS AND RESULTS: In a multicenter observational study of 448 consecutive AF ablations done using pentaspline catheter (62 integrated mapping; 386 conventional mapping) performed between February 2024 and August 2025, baseline characteristics were similar between groups. Compared with conventional mapping, the integrated platform was associated with shorter total procedure time (49 ± 16 vs. 66 ± 26 min, p …

Hyperacute Effects Of Non-Code Dose Bolus Epinephrine In Paediatric Cardiac Intensive Care Patients: Insights From High-Fidelity Physiologic Data., Wesam Sourour, Michael Evans, Kevin Le, Saul Flores, Juan S. Farias, Rohit Seth Loomba

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Non-code dose boluses of epinephrine are utilised in critically ill paediatric patients during periods of hemodynamic deterioration, often with the hopes of preventing a cardiac arrest. Data regarding the physiologic effects of these administrations are limited. The primary aim of this study was to use high-fidelity physiologic data to characterise the effects of intravenous non-code dose bolus epinephrine.

METHODS: Paediatric patients in the cardiac ICU who received non-code dose bolus epinephrine were identified. Those who received fluid boluses or chest compressions within 2 minutes of bolus epinephrine were excluded. Autoregressive integrated moving average analyses with exogenous variables were conducted …

Reply To The Letter-To-Editor On Article "Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography", Osama Elshaer

Journal of the Saudi Heart Association

No abstract provided.

Impella 5.5 Versus Heartmate 3 In Left Ventricular Unloading, Hannah Frederick, Douglas Tran, Erik Sorenson, H. Todd Massey, Albert Hicks, Manjula Ananthram, Bartley P. Griffith, Aakash Shah

The VAD Journal

The Impella 5.5 (Abiomed) is increasingly used as a bridge to durable left ventricular assist device (LVAD) implantation in advanced heart failure, yet most studies focus on survival and transition success rather than left ventricular (LV) unloading or valvular effects. This study addresses this gap by comparing Impella 5.5 and HeartMate 3 (HM3, Abbott) in terms of unloading and cardiac support at similar flow rates. We conducted a retrospective study of nine patients who received Impella 5.5 before HM3 implantation. The primary outcome was the degree of LV unloading, as assessed by changes in left ventricular end-diastolic diameter (LVEDD). There …

Safety And Feasibility During Early Implementation Of Robotic-Assisted Percutaneous Coronary Intervention, Dung Thuong Ho, Manh Cuong Nguyen, Tran Tran Nguyen, Long Tran, Huy Nguyen, Dil Mai, Tuong Mien Ngo, Duc Chinh Nguyen, Chi Cuong Tran, Khiem D. Ngo

School of Medicine Publications

Background: Robotic-assisted Percutaneous Coronary Intervention (R-PCI) is an advanced technique offering potential advantages for both patients and interventional cardiology practices. In 2023, Can Tho S.I.S General Hospital implemented its first robotic system for PCI procedures. This study aimed to evaluate the safety and clinical outcomes during the early learning curve of R-PCI.

Methods: This prospective study included all patients undergoing R-PCI with the CorPath GRX Vascular Robotic System at Can Tho S.I.S General Hospital from April to September 2023. Baseline patient characteristics, procedural details, and six-month follow-up data were collected. Primary outcomes included Clinical Success, defined as < 30% residual diameter stenosis in the target vessel without major adverse cardiovascular events (MACE) during hospitalization (e.g., death, myocardial infarction, target-vessel revascularization, stroke), and robotic success, defined as achieving clinical success with partial manual support or no manual support.

Results: Thirty-one patients …

Plasma Ca125 Levels As A Predictor Of Major Adverse Cardiac Events In Patients With Acute Coronary Syndrome: A Six-Month Follow-Up Study, Nazlı Dilek Çolak, Turgut Karabağ, Onuralp Çalışkan, Songül Tezcan

Journal of the Saudi Heart Association

Objectives: Carbohydrate antigen 125 (CA125) is associated with different cardiovascular conditions. This study aimed to determine CA125 levels in patients with acute coronary syndrome (ACS) and the potential relationship between major adverse cardiac events (MACE) in the short-term following.

Methods: This prospective cohort study was conducted in a coronary care unit between May and November 2022. Plasma CA125 levels were measured only once upon hospital admission. Patients were followed for six months. All-cause mortality, recurrent acute coronary syndrome, requirement for revascularization, decompensated heart failure, cardiogenic pulmonary edema, atrial fibrillation, and stroke were recorded as MACE.

Results: A total of 127 …

“From Compression To Closure: Efficacy And Safety Of Vascular Closure Devices (Vcd) Versus Manual Compression: A Comparative Analysis Of Hemostatic Strategies Of Obtura, Angioseal, And Proglide Vcd“, Praveen Shukla, Kumar Himanshu, Ali Mohammed, Mukesh Jitendra Jha, Santosh Kumar Sinha, Puneet Aggarwal, Mohammad Mahmodullah Razi, Mohit Sachan, Awadhesh Kumar Sharma, Umeshwar Pandey, Neeraj Prakash, Rakesh Kumar Verma

Journal of the Saudi Heart Association

Objective: Use of vascular closure devices (VCDs) for femoral artery puncture site hemostasis has increased but their safety and efficacy have remained unclear. This study was designed to compare safety and efficacy of Obtura, Angioseal, and Proglide VCD to manual compression (MC) and also between for femoral artery haemostasis.

Methods:This was prospective, randomized controlled study where patients were randomly assigned on 1:1:1:1 basis. Primary endpoints were time to hemostasis (TTH) and ambulation time (AT) while secondary endpoints were deployment success, device related adverse events and technical success rate. ANOVA and Tukey HSD was conducted to draw significant difference between …

Cancer Treatment Induced Skeletal Muscle Loss As A Predictor Of Late Cardiotoxicity In Aya: A Pilot Study, Savannah V. Rauschendorfer, Efstratios Koutroumpakis, Behrang Amini, Juhee Song, Michelle Hildebrandt, Anita Deswal Md Mph, J. Andrew Livingston, Michael Roth, Eugenie S. Kleinerman Md

Cancer Survivorship Research Retreat

No abstract provided.

Racing Against Time: Simultaneous Anterior And Inferior St-Elevation Myocardial Infarction Managed With The Nano-Crush Bifurcation Stenting Technique, Selim Süleyman Sert, Fatih Aksoy

Journal of the Saudi Heart Association

We present a rare case of simultaneous anterior and inferior ST-elevation myocardial infarction caused by the acute occlusion of both the right coronary artery and the left anterior descending artery. The culprit LAD lesion involved a true bifurcation, which was successfully treated using the nano-crush stenting technique, achieving complete reperfusion. This case highlights the feasibility of complex bifurcation intervention in a hemodynamically unstable patient with double-vessel STEMI. It underscores the importance of rapid diagnosis, aggressive revascularization, and appropriate stenting strategy in managing multivessel acute myocardial infarction.

Six-Year Outcomes After Transcatheter Vs Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, Steven J Yakubov, G Michael Deeb, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: The Evolut Low Risk trial enrolled patients with severe aortic stenosis at low surgical risk. Annual follow-up is planned for 10 years, evaluating the composite of all-cause mortality or disabling stroke and key secondary endpoints.

OBJECTIVES: Our prespecified objective was to report the 6-year clinical outcomes of transcatheter aortic valve replacement (TAVR) vs surgery from the Evolut Low Risk trial. Given an increase in reintervention rates at 6 years, we performed additional analyses in available 7-year data.

METHODS: Low-risk patients with severe symptomatic aortic stenosis were randomized to TAVR or surgery from 2016-2019. Prespecified analyses at 6 years included …

Postdilation Of Evolut Transcatheter Heart Valves: Insights From Bench Testing., Ole De Backer, Ryan Stublaski, Hatem Tadros, Arif Khokhar, Gintautas Bieliauskas, Steven J Yakubov, Michael Deeb, Kendra J Grubb, John K Forrest, Michael J Reardon

Heart and Vascular Articles

No abstract provided.

Ruptured Sinus Of Valsalva Aneurysm In A Patient With Mixed Connective Tissue Disease: Case Report, Kenzo Adhi Wiranata, Pramadya Vardhani Mustafiza, Enrico Ananda Budiono

Journal of the Saudi Heart Association

Sinus of Valsalva aneurysm is a rare cardiac anomaly, affecting approximately 0.09% of the population. Its rupture represents a life-threatening event that can rapidly lead to heart failure. We report a 32-year-old woman with mixed connective tissue disease presenting with right-sided heart failure. Echocardiography demonstrated a ruptured right coronary cusp sinus of valsalva aneurysm into the right ventricle with moderate aortic regurgitation. Surgical repair was successfully performed, and histopathology supported an autoimmune-mediated etiology. To our knowledge, this is the first reported case of ruptured sinus of valsalva aneurysm occurring in a patient with autoimmune mixed connective tissue disease.