Medical Specialties Commons^™

Effective Thrombectomy For Biventricular Thrombosis With An Endoscope Via The Aortic And Tricuspid Heart Valves, Yuki Endo, Yoshiei Shimamura, Chizuo Kikuchi, Hiroshi Niinami

The Texas Heart Institute Journal

The simultaneous formation of thrombi in the left and right ventricles is extremely rare, and this condition's clinical characteristics and prognosis remain unknown. Therefore, treatment methods are still controversial. This case highlights the potential for endoscopic thrombectomy as a viable option for the treatment of giant floating biventricular thrombi in a patient with restricted cardiac function. This approach via the aortic and tricuspid heart valves allowed for effective and complete removal of the thrombi, thereby preventing further embolic complications.

Lyme Carditis And Inflammation-Driven Plaque Erosion Presenting As Sudden Cardiac Arrest, Marco Kaldas, Moneal Shah, Diana Pashaieva, Georgios Lygouris, Anita Radhakrishnan

The Texas Heart Institute Journal

Lyme carditis represents a rare cardiac complication of Borrelia burgdorferi infection, often causing conduction disturbances but rarely causing malignant arrhythmias. Inflammatory acute coronary syndrome, driven by immune-mediated plaque erosion rather than rupture, represents a nontraditional ischemic mechanism. This case highlights their overlap. The case of a previously healthy man with Lyme disease who experienced cardiac arrest because of ventricular tachycardia is reported. Imaging showed myocardial inflammation together with coronary plaque erosion instead of plaque rupture. The patient underwent advanced diagnostic testing and received multidisciplinary medical care, which led to complete cardiac recovery and implantable cardioverter-defibrillator placement.

Early Structural Valve Deterioration And Cusp Tear Leading To Acute Heart Failure In A Second-Generation Trifecta Glide Technology Heart Valve, Akiyoshi Yamamoto, Kenji Kuwaki, Hidekazu Furuya, Yasunori Cho

The Texas Heart Institute Journal

This report highlights a case of early structural valve deterioration with a cusp tear in a second-generation Abbott Trifecta Glide Technology bioprosthetic heart valve. A 70-year-old man had undergone aortic valve replacement with a Trifecta Glide Technology valve 30 months earlier for severe bicuspid aortic valve stenosis. He suddenly developed acute heart failure with dyspnea resulting from severe aortic valve regurgitation, with a cusp tear in the Trifecta Glide Technology valve, as demonstrated by transthoracic echocardiography. The patient was successfully treated with urgent repeat aortic valve replacement.

Midterm Outcomes Of Pediatric Mitral Valvuloplasty For Moderate To Severe Mitral Valve Regurgitation And Associated Risk Factors For Postoperative Deterioration, Hongyuan Fu, Aijun Liu, Ming Yang, Zeyu Liu, Junwu Su

The Texas Heart Institute Journal

BACKGROUND: Mitral valvuloplasty is considered the best treatment for pediatric mitral valve regurgitation. The objective of this analysis was to identify risk factors for postoperative mitral valve regurgitation progression and evaluate valvuloplasty effectiveness.

METHODS: This retrospective, single-center study investigated the clinical efficacy of mitral valvuloplasty and identified factors that affect prognosis. Pediatric patients with moderate or severe mitral valve regurgitation who had undergone mitral valvuloplasty between September 2016 and August 2023 were included. Kaplan-Meier survival analysis was used to assess freedom from both mitral valve deterioration and cardiovascular death. Univariate and multivariate Cox regression analyses were performed to identify potential …

Accidental Left Ventricular Placement Of A Leadless Micra Pacemaker Through A Patent Foramen Ovale, Hamza Alkowatli, Mahmoud Kutmah, Adnan Shaik, Osama Hallak

The Texas Heart Institute Journal

The Micra device is a leadless pacemaker implanted in the right ventricle via a femoral vein transcatheter approach. There are several indications for and advantages to using a leadless pacemaker, and the device's role in the field of cardiology will probably continue to increase. This article presents the case of a rare complication probably due to inadvertent placement of the device in the left ventricle across an undiagnosed patent foramen ovale.

Shaping The Future Of "Cardio-Kidney-Metabolic" Health: Insights From The Texas Heart Institute's 2024 Cardiometabolic Syndrome Conference, Arjun Raghuram, Keri Sprung, Stephanie Coulter, Joseph G Rogers

The Texas Heart Institute Journal

At the Texas Heart Institute's 2024 Cardiometabolic Syndrome Conference, held on August 23, 2024, experts from diverse academic fields spoke about novel initiatives for addressing the worsening projections for cardiometabolic syndrome. Four major areas in which innovation is ongoing were highlighted: technology, policy, population health, and lifestyle and behavioral modification. This article presents a brief contextualization, summary, and analysis of the novel initiatives being implemented in each of these 4 areas to address cardiometabolic syndrome. Despite alarming projections, cardiometabolic syndrome presents a unique opportunity for innovators to drive change through collaborative, multidisciplinary efforts.

Sequelae And Surgical Management Of Giant Cardiac Myxoma, Norvin Hernandez, Michael Dileo, Christopher K Wong, Mahboob Alam

The Texas Heart Institute Journal

Cardiac myxomas are a rare phenomenon within the general population, and although there are reports of them, giant myxomas are not common in the medical literature. This report presents a case of a giant left atrial cardiac myxoma in a 57-year-old female patient who was largely asymptomatic until she presented with a diffuse thromboembolic stroke. This case report highlights the importance of surgical management of cardiac myxomas and discusses the difference in open vs minimally invasive surgical resection of giant cardiac myxomas.

Robot-Assisted Surgical Treatment Of Caseoma, Nancy Wang, Abdussalam Elsenousi, Kenneth K Liao

The Texas Heart Institute Journal

This report reviews 5 cases of mitral annular caseoma. Four patients presented with fatigue, stroke, or mitral stenosis. Robot-assisted resection of caseoma with or without mitral valve replacement was successfully performed in all patients with good outcomes. These cases demonstrate the safety and efficacy of robotic surgery in treating caseoma.

Navigating The Complexities Of Mitral Valve Clipping: Early Severe Mitral Valve Stenosis After Mitral Valve Clipping, Wassim Abouzeid, Ahmad Haddad, Chrystina Kiwan, Ahsan Khan, Addi Suleiman

The Texas Heart Institute Journal

This case study explores the journey of an 80-year-old male patient with a history of hypertension, diabetes, coronary artery disease after coronary artery bypass grafting, atrial fibrillation, and heart failure. Nine months before he presented to the emergency department, he had undergone mitral valve clipping for severe mitral valve regurgitation. Despite initial improvement, the patient experienced return of symptoms, including dyspnea at rest and lower limb edema. The results of this case-discovery of the need for mitral valve replacement-provides insights into the management of complications from mitral valve clipping and emphasizes that management requires a nuanced, meticulous approach.

Atrial Fibrillation Burden And Clinical Outcomes In Dual-Chamber Pacemaker Recipients, Ka Ho Oscar Chiu, Shou Yan Kam, Ka Chun Kevin Lee, To Shing Wong, Jacky Kit Chan, Yuk-Kong Lau, Kwok-Lun Lee, Wai-Ling Jessica Poon

Journal of the Hong Kong College of Cardiology

Background

Pacemaker-detected atrial fibrillation (PDAF) and its burden are associated with adverse clinical outcomes, but consensus is lacking on its definition and local clinical outcomes are unclear. We evaluated PDAF, its burden and relationship with major adverse cardiovascular and cerebrovascular events (MACCE).

Methods

This retrospective study recruited adult patients receiving dual-chamber pacemakers from 2014 to 2022. The presence of PDAF of 5 minutes, PDAF burden (defined by the longest episode) and time to new-onset PDAF were measured and analysed. High PDAF burden was defined as PDAF lasting 24 hours.

Results

A total of 275 patients were analysed and followed for …

Daily Weights, Better Outcomes: The Positive Impact Of Daily Weight Tracking In Hospitalized Patients On The Telemetry Floor, Sophia Zia, David Ortega, Lailany Agront-Davo, Merid Moqattash, William Lopez, Sirin Khajaviyan, Yagmur Beaman, Michael Craig

South Atlantic Division GME Research Day 2025

No abstract provided.

Assessing The Role Of Negative Troponin Tests In Discharge Decisions And Long-Term Outcomes For Ed Chest Pain Patients, Rajiv Shah, Nicholas Pennington, Julia Iman, Dominic Juarez, Akriti Arora, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Pediatric Carotid Artery Dissection Following Blunt Cerebrovascular Injury, Eric Friedman, Iren Shabanova, Arpit Arora

South Atlantic Division GME Research Day 2025

No abstract provided.

Endovascular Management Of High-Grade Inferior Mesenteric Artery Stenosis Via Left Radial Approach, Julia Iman, John Mcgue

South Atlantic Division GME Research Day 2025

No abstract provided.

Severe Mitral Bioprothesis Stenosis, A Clinical Dilemma Solved By The Sapien 3 Valve, Haris Ahmed, Natalia C. Badillo-Velez, Awad Hammad, Andrea Deneen, Youssef Al Saghir

South Atlantic Division GME Research Day 2025

No abstract provided.

Baroreceptor Activating Therapy And Subcutaneous Implantable Cardioverter-Defibrillators: An Electrical Mismatch?, Eboselumen Aigbe, Gunjan Mundhra, Munachiso Egbo, Yuhning Linda Hu

South Atlantic Division GME Research Day 2025

No abstract provided.

Acute Ischemic Stroke In The Setting Of Lambl’S Excrescenses, Natalia C. Badillo, Jay Heckert, Yoan Rodriguez, Ashu Dhanjal

South Atlantic Division GME Research Day 2025

No abstract provided.

When Innocent Becomes Malignant... Unmasking Stemi Through Pvcs, Sharul Saxena, Jomel Jacinto, Yuhning Linda Hu

South Atlantic Division GME Research Day 2025

No abstract provided.

High Rates Of Avoidable Computed Tomography Angiography For Pulmonary Embolism Exclusion, Kalyan Mantha, Angelo Kantrales, Kerolos Abadeer, Pranav Bommineni, Nicholas Prewitt, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

No Patient Left Behind: Improving Transition Of Care In Coronary Artery Disease And Heart Failure Patients, Rebecca Schuyler, Gunjan Mundhra, Mubbasher Syed

South Atlantic Division GME Research Day 2025

No abstract provided.

Surgical Outcomes Of Median Arcuate Ligament Release, Savannah Yeh, Alina Chen, Yasmeen Dhindsa, Peter Lawrence, Karen Woo

South Atlantic Division GME Research Day 2025

No abstract provided.

Case Report Of Tricyclic Antidepressant Toxicity With Prolonged Qt/Qtc And Widened Qrs On Ekg, Alexandra Doan, Joshua Wilkes, Jonathan Leggett, Jarratt Lark

South Atlantic Division GME Research Day 2025

No abstract provided.

Bloodstream To Heart Valve: A Case Of Pseudomonas Endocarditis, Jacob Keesee, Brenden Pearce, Mohammed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Shake It Off: Common Angina Medication Ranolazine And Its Rare Reversible Myoclonus Side Effect, Minh Nguyen, Sheharyar Abbasi, Dustin Rizzieri, Robert Sherertz

South Atlantic Division GME Research Day 2025

No abstract provided.

Viral Vengeance: A Case Of Hiv Induced Myocarditis, Jacob Keesee, Brenden Pearce, Mohammed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Left Atrial Appendage Morphology Related To Cva Risk In Patients With Atrial Fibrillation, Lincoln Smith, John-Michael Benson, Jacob Michael Keesee

South Atlantic Division GME Research Day 2025

No abstract provided.

Endocarditis Causing Complete Heart Block And Cardiogenic Shock, Ish Patel, Jacob M. Keesee, Brenden Pearce, Sarah Barnhardt, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Treatment Of Myocardial Infiltration Of Hodgkins Lymphoma: A Catch-22, Jennifer Priessnitz, Erin Biringen, Fadi Khoury, Christina Bergin

Department of Medicine Faculty Publications

Background: Cardiac sequelae in Hodgkin Lymphoma (HL) can manifest as involvement of the heart and pericardium. Direct cardiac involvement is rare, and myocardial infiltration is distinctly unusual.¹ When it does occur, it is often a late manifestation of lymphoma, with a median onset of 20 months after initial diagnosis, and it is usually associated with advanced-stage disease.²

Case: A 34-year-old male was diagnosed with classic HL by lymph node biopsy. During his hospitalization, the patient remained in sinus tachycardia with heart rate up to 150 with no dysrhythmias. Transthoracic echocardiogram (TTE) revealed a reduced ejection fraction (EF) of 36% concerning …

Association Between Neighborhood-Level Social Vulnerability And Hypertension Outcomes, John E. Brush Jr., Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Iris J. Lundy, Jordan R. Asher, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, Yuan Lu

Department of Medicine Faculty Publications

Background

Neighborhood-level social vulnerability is associated with hypertension prevalence and severity and with cardiovascular complications in conditions other than hypertension, but its association with cardiovascular complications in patients with hypertension is understudied.

Objectives

The aim of the study was to examine how the neighborhood-level social vulnerability index (SVI) influences cardiovascular outcomes in a large, diverse cohort of patients with hypertension.

Methods

We used electronic health data to examine the association between census tract-level rankings for the SVI with a composite endpoint of incident myocardial infarction, congestive heart failure, or stroke.

Results

In a longitudinal cohort of 330,972 patients with hypertension …

Diagnosis And Management Of Cardiometabolic Disease After Spinal Cord Injury: Identifying Gaps In Physician Training And Practices, Chinenye Christa Nnoromele, Du Pham, Felicia Skelton, Ryan Solinsky

Faculty, Staff and Students Publications

CONTEXT: Cardiometabolic disease (CMD) frequently occurs in individuals with spinal cord injury (SCI), with growing awareness surrounding the expansive scope of this problem. As CMD has significant morbidity and mortality, early guidelines-based screening and management have been established. However, the extent to which these guidelines have been adopted are unclear.

OBJECTIVE: Describe physicians' screening and management pattern for CMD in patients with SCI, as compared to SCI-specific CMD screening guidelines, and elucidate variables linked to screening and management patterns.

METHODS: SCI medicine-boarded physicians were surveyed on screening timing for CMD following acute SCI, along with their practice pattern and comfort …