Medical Specialties Commons^™

Hypertensive Disorders Of Pregnancy, Covid And Readmission Status, Margaret Luebke, Ross Bindler, Trisha Saul, Linda Trinh

Publications 2026-present

No abstract provided.

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

Evaluating Low Molecular Weight Heparin For Venous Thromboembolism Treatment In Extreme Body Weights, Natalie Tran, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber

All Poster Presentations

No abstract provided.

Contextual Variability In Under-Diagnosed Cardiometabolic Disease And Cognitive Vulnerability Among Populations At High Risk For Alzheimer's Disease And Related Dementias, Nwanyieze Jiakponnah, Joseph Curran, Tamlyn Watermeyer, Jasmit Shah, Litha Musili, Stanely Onyango, Benard Aliwa, Zul Merali, Karen Blackmon, Chinedu Momoh

Brain and Mind Institute

Underdiagnosis of cardiometabolic risk factors (CMRFs) may represent an unrecognised biological pathway contributing to dementia risk; yet remains poorly characterised in African and African diaspora populations. We quantified the prevalence and determinants of underdiagnosed hypertension and abnormal glycaemia across four cohorts comprising up to 7000 adults aged ≥40 years from Nigeria, Kenya, and The United States: Indianapolis, and North Texas. Underdiagnosis was defined as absence of self-reported diagnosis despite elevated systolic blood pressure ( ≥130 mmHg) or fasting blood glucose ( ≥100 mg/dL). Cohort-stratified analyses examined demographic, socioeconomic, cognitive, Alzheimer’s genetic, and blood-based biomarker correlates. Underdiagnosis was pervasive in African …

Quality Improvement: Referral Algorithm For Team-Based Care Of Blood Pressure Control, Hai-Yen Tang, Elise Gibson

All Podium Presentations

No abstract provided.

Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery At Swedish Cherry Hill, Jacinta Smith

All Podium Presentations

No abstract provided.

Sex-Based Disparities In Health Care Access And Utilization Among Patients With Atrial Fibrillation, Ji Mei May Wong, Peter R. Kowey

Department of Medicine Faculty Papers

IMPORTANCE: Females with atrial fibrillation (AF) experience a higher risk of stroke, myocardial infarction, and mortality than males with AF. Theories suggest that sex-based differences in hormonal, structural, and electrophysiologic factors are associated with this imbalance; we hypothesized that sex-based differences in health care access and utilization (HCAU) are also underlying factors.

OBJECTIVE: To determine whether sex-based disparities in HCAU barriers exist among individuals with AF.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data on patients with AF in the All of Us Research Program Registered Tier dataset (version 8), which contains integrated data from the electronic health record …

Practice Patterns In Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study., Britney Reed, Poonam Puranik, Andrew Rodenbarger, Mira Trivedi, Dilachew A. Adebo, Gary Beasley, Louis Bezold, M Jay Campbell, Michael R. Carr, Joshua Daily, Mark Debrunner, Erica Del Grippo, Carlen G. Fifer, Timothy M. Hoffman, Susan R. Hupp, Joshua D. Kurtz, Gira Morchi, Carl Owada, Renuka Peterson, Michael D. Puchalski, Ryan Romans, Arwa Saidi, Rajesh U. Shenoy, Anoop K. Singh, Robert D. Tunks, Thomas M. Yohannan, Carolyn M. Wilhelm, Jyoti K. Patel

Manuscripts, Articles, Book Chapters and Other Papers

Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction. All 47 responding centers (response rate 38%) conduct presurgical conferences, mostly on a weekly basis (92%) lasting 60-120 min (79%). The conferences are solely virtual (19%) or hybrid (81%). High-volume centers (> 300 surgical cases/year) are more likely to hold multiple conferences (13/20 vs 7/27, p <  0.01) and less likely to designate a moderator (11/20 vs 22/26, p = 0.027). Categorical pediatric cardiology fellows at 33 centers present clinical data (97%), echocardiograms (85%), catheterizations (82%), and cross-sectional imaging (39%), typically beginning in their first year. Most centers report that minor (98%) or major changes (51%) are made to patient management at least "sometimes." Responders rate conferences as very important (median 10/10 on a 10-point Likert scale, IQR 9-10), but satisfaction is more modest (median 7/10, IQR 7-9). Only 17% of centers have a formal QI process. Comments from 42 centers reveal positive themes of collaboration (68%) but also concerns about lengthy (30%) or inefficient (36%) discussion. Conclusions: This survey highlights common practices for pediatric cardiothoracic presurgical conferences. Conferences are collaborative and seen as highly impactful. However, satisfaction varies, and QI efforts are infrequent. These findings highlight opportunities for process improvement and standardization.

A 2-Year Randomized Trial Of Pitavastatin Calcium Vs Placebo To Treat Combined Dyslipidemia In Adolescents With Overweight And Obesity., Brian W. Mccrindle, Silva Arslanian, Michele Mietus-Snyder, Elaine M. Urbina, Adam L. Ware, Jessica E. Teng, Felicia Trachtenberg, Mark W. Russell, Amy S. Shah, Mark Cartoski, Julie A. Brothers, Christine San Giovanni, Justin P. Zachariah, Sandra Pena, William T. Mahle, Amy L. Peterson, Sheela N. Magge, Geetha Raghuveer, Binu Sharma, Valiantsina Kazlova, Craig A. Sponseller, D'Andrea Freemon, Mario Stylianou, Sarah D. De Ferranti, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Combined dyslipidemia of overweight/obesity (CDO) is prevalent in youth and is associated with an increased risk of early cardiovascular disease.

OBJECTIVE: We sought to determine the impact and safety of statin therapy for CDO in adolescents.

METHODS: A double-blind, randomized trial was performed across 18 North American sites. Participants aged 10 to 19 years with body mass index ≥85th percentile and CDO defined as non-high-density lipoprotein cholesterol (non-HDL-C) ≥120 mg/dL (3.10 mmol/L) and either low HDL-C or high triglyceride:HDL-C ratio were randomized centrally to receive either pitavastatin calcium 4 mg/d or placebo for 2 years. The primary outcome was …

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 …

When Qtc Shrinks After Rhythm Conversion, Mohammed Hussein Kamareddine, Alyssa Zakala, Farid Farkouh, Ibrahim Alameh, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: An 83-year-old man with a history of atrial fibrillation on amiodarone therapy was admitted for direct-current cardioversion because of recurrent atrial fibrillation with a ventricular rate of approximately 105 beats per minute. Cardioversion successfully restored sinus rhythm. Postcardioversion 12-lead electrocardiography revealed an unexpectedly short QTc of 344 ms despite chronic treatment with a QT-prolonging agent. This finding was attributed to QT hysteresis, reflecting delayed adaptation of ventricular repolarization to the abrupt reduction in heart rate after rhythm conversion.

TAKE-HOME MESSAGE: QT hysteresis can result in transient QTc shortening and has important implications for interpretation of QT intervals during …

Pr Interval Alternans And The Mystery Of Inverse Decremental Conduction, Alyssa Zakala, Mohammed Hussein Kamareddine, Farah Olleik, Ali Keramati, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: A 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation.

TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the …

A Reappraisal On The Use Of Mechanical Circulatory Support In Acute Coronary Syndrome And High-Risk Percutaneous Coronary Intervention—Lessons From Stemi-Dtu And Chip-Bcis3, Marwan F. Jumean, Mir Babar Basir, Biswajit Kar

Journal of Shock and Hemodynamics

None.

Comments On The Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience, Marwan Shawki, Ali H. Al-Fiadh

Journal of the Saudi Heart Association

No abstract for this article type.

Comment On “Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience”, Michael Gomes

Journal of the Saudi Heart Association

No Abstract for this article type.

Advancing Lipid Management: Saudi Heart Association Position Statement On Pcsk9-Targeted Therapies In The Primary And Secondary Prevention Of Cardiovascular Disease, Waleed Alhabeeb, Hussein Alamri, Hussein Elbadawi, Yazed S. Alruthia, Waleed Alharbi, Owayed Alshammeri, Adel Tash, Shadi Almoziny, Naji Kholaif, Hussain Halawani, Fadia Almahdi, Wael Yar, Khalid F Alhabib

Journal of the Saudi Heart Association

Background: Despite robust evidence for low-density lipoprotein cholesterol (LDL-C) reduction in atherosclerotic cardiovascular disease (ASCVD) prevention, attainment of guideline-recommended targets remains suboptimal in Saudi Arabia, especially among high- and very high-risk patients. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9)-targeted therapies, which include monoclonal antibodies (evolocumab, alirocumab) and small interfering RNA (inclisiran), offer potent LDL-C lowering that can help address this gap.

Methods: The Saudi Heart Association (SHA) convened a multidisciplinary panel to review evidence from randomized controlled trials, real-world studies, and economic analyses on PCSK9-targeted therapies. Recommendations were developed through expert consensus, contextualized to the Saudi healthcare environment.

Results and conclusions: …

Clinical Outcomes Between Transradial And Transfemoral Primary Percutaneous Coronary Intervention In St-Segment Elevation Myocardial Infarction Patients In Chonburi Hospital: A Retrospective Study, Artit Torpongpun, Pornchai Ngamjanyaporn, Woravit Tantisiriwat, Chanadda Rutnuntamongkon, Gahn Nakornchai, Paramaporn Suttirut

Chulalongkorn Medical Journal

Background: According to recent global data, transradial primary PCI in ST-elevation myocardial infarction (STEMI) patients has demonstrated better procedural outcomes compared to transfemoral PCI.

Objective: To compare the clinical outcomes between transradial and transfemoral primary PCI in STEMI patients at Chonburi Hospital.

Methods: Patients diagnosed with STEMI who underwent PCI at Chonburi Hospital between October 1, 2016, and September 30, 2023, were enrolled. Clinical data were obtained through a retrospective review of medical records and the Chonburi Hospital STEMI registry database.

Results:A total of 913 patients were eligible for statistical analysis, with 532 and 381 patients undergoing PCI via …

Value Of The Non-Enhanced Cardiac Computed Tomography Scan Analysis In Determination Of The Appropriate Coronary Ct Angiography Scan Protocol Improving Image Quality While Minimizing Radiation, Osama A Smettei, Sawsan A Sayed, . Fatin M Ahmed, Tawfeeq H Alharbi, Mohammed Saied, Rami M Abazid

Journal of the Saudi Heart Association

Objective: Coronary computed tomography angiography (CCTA) is a cornerstone in the assessment of coronary artery disease. Despite technological advancements, balancing radiation does with diagnostic image quality remains a challenge. This study evaluates whether assessing preliminary non-enhanced CT scans allows for the optimization of CCTA gating protocols to enhance image quality and minimize radiation exposure.

Methods: We prospectively analyzed 150 patients undergoing CCTA on a 256-slice scanner. Non-enhanced scans were used to identify motion artifacts or anatomical challenges. Based on these findings, a specific gating protocol (prospective, prospective with padding, or retrospective) was selected. This cohort was compared to a …

Quantifying Patient Positioning Errors And Radiation Dose Variation In Cardiac Computed Tomography Angiography, Yasser H. Hadi, Hassan B. Hawsawi, Niamh Moore, Helle Precht, Andrew England, Mark Mcentee

Journal of the Saudi Heart Association

Objectives: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring. Methods: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Isolated Giant Aneurysm Of The Acute Marginal Branch Of Right Coronaryartery Presenting As Nstemi: Successful Direct Surgical Repair Preserving The Native Flow, Sai Kumari Ms., Anbarasu Mohanraj Dr, Saranya Damodaran Ms

Journal Of Indian Physician Associates

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter^1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch …

Endo-Epicardial Ventricular Tachycardia Ablation In Arrhythmogenic Right Ventricular Cardiomyopathy- A Case Report, Selva Maheswari M Dr, Sharon Jabamalar Dr, Usnish Adhikari Dr, Deep Chandh Raja S Dr

Journal Of Indian Physician Associates

ABSTRACT:

Background

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare genetic disorder marked by progressive fibrofatty replacement of the right ventricle, causing life-threatening ventricular arrhythmias and sudden cardiac death (SCD). It is predominantly seen in young adults. As the substrate often involves both RV endocardium & epicardium, conventional ablation is often not successful. One of the effective therapies is combined endo- epicardial ablation, which gives good arrhythmia control and reduction of AICD (Automated Implantable Cardioverter Defibrillator) shock. Here we present two such cases.

Methods

Two patients presented with history of recurrent ventricular tachycardia (VT) which were reverted with DC (Direct …

Morphological Assessment Of Stage Hh38 Of The Japanese Quail (Coturnix Japonica) Heart By Micro-Sonogram, Jaden Roe, Ashlyn Benavides, Michael B. Filla, Douglas C. Bittel, Whitney Shae, Geetha Haligheri, James E. O'Brien, Nataliya Kibiryeva

Manuscripts, Articles, Book Chapters and Other Papers

A challenge of studying mammalian cardiac embryogenesis is the limited ability to perform experimental manipulations in animal models. The avian embryo is widely accepted as a model for mammalian heart developmental studies. In this study, we establish the methodology and protocols for studying the Japanese quail (Coturnix japonica) heart at embryonic day 10 (HH38) using the FUJIFILM VisualSonics Vevo 3100 ultrasound system equipped with a MX550D small animal cardiology transducer. These protocols were designed to measure right ventricular wall thickness, pulmonary artery diameter, and the outflow velocities of the right ventricular outflow tract (RVOT) and the pulmonary artery …

Interventional Approach To Intermediate-High-Risk Pe: Catheter-Directed Mechanical Thrombectomy, Shreya Agarwal, Kirill Ruban, Ishan Kirti, Karina Ruban, Fadi Saab, Sujata Kambhatla, Pranay Gupta

Conference Presentation Abstracts

Acute pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. The clinical outcomes are largely determined by thrombus burden and its hemodynamic impact on the right ventricle (RV). Over the past decade, catheter-directed mechanical thrombectomy has emerged as a promising alternative for systemic thrombolysis for PE management, particularly in patients at high risk for major bleeding. This approach provides rapid mechanical debulking of thrombus without exposure to thrombolytics and has been associated with significant improvements in RV function and pulmonary artery pressures. We present a case of extensive bilateral PE successfully treated with mechanical thrombectomy, highlighting the …

Right Ventricular Involvement In Stress Cardiomyopathy: A Case Of Biventricular Takotsubo With Cardiogenic Shock, Ahmad Muhammad, Yazan Alkehef, Theodore Schreiber

Conference Presentation Abstracts

Introduction Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular (LV) dysfunction following a stressor in the absence of obstructive coronary artery disease. We present a case of a less common variant with right ventricular involvement. Hospital course A 45-year-old woman with sickle cell disease and asthma presented with nausea, vomiting, abdominal pain, and fevers, one week after the death of her father. Examination revealed an irregular tachycardia. Labs demonstrated leukocytosis, elevated lactate, and markedly increased troponin. Chest imaging showed bilateral basilar opacities. ECG demonstrated atrial flutter with rapid ventricular response. She developed progressive respiratory failure requiring intubation. Repeat ECG …

Risk-Stratified Transitional Care And Cardiovascular Hospitalizations By Sex: A Secondary Analysis Of A Randomized Clinical Trial., Douglas S Lee, Chang Nancy Wang, Peter C Austin, Sharon E Straus, Michael E Farkouh, Alice Chong, Monica Taljaard, Stephanie Poon, Stuart Smith, Robert S Mckelvie, Robert M Iwanochko, Andrea Macdougall, Esam Elbarasi, Peter M Cram, Jiming Fang, Clare L Atzema, Jacob A Udell, Paula A Rochon, Michael J Schull, Susanna Mak, Heather J Ross

Heart and Vascular Articles

IMPORTANCE: Female patients with heart failure (HF) are older and more often present with preserved left ventricular ejection fraction (LVEF), whereas male patients present with more ischemic disease. Despite these differences, an emergency department-based acute HF strategy may be equally applicable to both sexes.

OBJECTIVE: To determine whether the strategy for acute HF management in the Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial differed by sex.

DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of the multicenter COACH stepped-wedge, cluster-randomized clinical trial included 10 acute care hospitals in Ontario, Canada. Data were collected from January …

Evaluation Of The Effectiveness Of Antihypertensive Therapy Chosen Through Maternal Hemodynamic Profile Analysis, Margaret Weimer

Poster Presentations

In treatment of emergent hypertension, the American College of Obstetricians and Gynecologists (ACOG) recommends both oral labetalol and nifedipine, with no preference shown between the two. These medications have different mechanisms of action. Studies have suggested that consideration of hemodynamic profile may be an effective way to determine medication, but have not considered the Rule of 55, a simple calculation to predict hemodynamic profile.

Goals: 1. Determine if tailoring the antihypertensive to patient’s hemodynamic profile is associated with better control of blood pressure. 2. Determine if the Rule of 55 is an accurate method to determine hemodynamic profile.

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

No abstract provided.

Spontaneous Coronary Artery Dissection In Postpartum: A Hidden Cause Of Maternal Myocardial Infarction, Riya Chhabra, Brian Renard

Conference Presentation Abstracts

Spontaneous coronary artery dissection (SCAD) is a tear in the coronary artery lining which decreases blood flow to the heart. SCAD is the leading cause of myocardial infarction in young to middle aged women, especially during and after pregnancy. While SCAD is often managed conservatively, patients are prone to complications like cardiomyopathy. This case underscores the importance of considering SCAD as a differential for postpartum women with chest pain. Furthermore, this case highlights the diagnosis and management of an atypical stress-induced cardiomyopathy with global hypokinesis following postpartum SCAD. A 37-year-old female postpartum for five weeks presented to our hospital with …