Medical Specialties Commons^™

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.

The Infected Diabetic Foot: Risk Factors For Re-Infection After Treatment For Diabetic Foot Osteomyelitis, Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Matthew Sideman, Michael C Siah, Arthur N Tarricone

Center on Aging Staff Publications

Our objective was to evaluate risk factors for re-infection in patients after treatment for diabetic foot osteomyelitis (OM). We used pooled patient level data from two RTCs that evaluated patients with diabetic foot infections. We evaluated 171 patients with OM. OM was confirmed with bone culture or histopathology. Data from the 12-month follow-up were used to determine clinical outcomes. Re-infection occurred in 47 (27.5%) patients. Risk factors for re-infection were Toe Brachial Index < 0.40 (25.7% vs. 9.8%, p = 0.02), skin perfusion pressure < 40 mmHg (6.3% vs. 5.9%, p = 0.04), wound healing (55.3% vs. 75.0%, p = 0.01), time to heal (156.0, 69.5-365 vs. 91.5, 38.8-365, p = 0.001), and history of MI (14.9% vs. 3.2%, p = 0.005). During 12-month follow-up, patients with re-infections were 198.8 times more likely to require a foot related hospitalisation (81.8% vs. 0.0%, p = 0.001), 10.4 times more likely have an all-cause hospitalisation (70.2% vs. 18.5%, p = 0.001) and 9.4 times more likely to need an amputation (36.2% vs. 5.6%, p = 0.001). Patients with re-infection had a significantly longer median length of hospitalisation (20.0, 13.5-34.5 vs. 14.0, 10.0-22.0, p = 0.003) and median length of antibiotic duration (55.0, 35.0-87.0 vs. 46.0, 22.8-68.0, p = 0.03). Patients with re-infection are less likely to heal and have more foot-related hospitalizations and amputations.

Risk And Prognosis Of Hepatocellular Carcinoma In Mexican Americans With Type 2 Diabetes Mellitus, Rikita I Hatia, Lu-Yu Hwang, Ruosha Li, Catherine Troisi, Prasun K Jalal, Christopher I Amos, Henry F Gomez, Yun Shin Chun, Asif Rashid, Ahmed O Kaseb, Paul A Scheet, Manal M Hassan

Faculty, Staff and Student Publications

INTRODUCTION: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

METHODS: A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the …

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 …

Emcreg-International Multidisciplinary Consensus Panel On Management Of Hyperkalemia In Chronic Kidney Disease And Heart Failure, Natalie Kreitzer, Nancy M. Albert, Alpesh N. Amin, Craig J. Beavers, Richard C. Becker, Gregg Fonarow, W. Brian Gibler, Katherine W. Kwon, Robert J. Mentz, Biff F. Palmer, Charles V. Pollack, Iliana L. Piña

Division of Cardiology Faculty Papers

BACKGROUND: Hyperkalemia, generally defined as serum potassium levels greater than 5.0 mEq/L, poses significant clinical risks, including cardiac toxicity and muscle weakness. Its prevalence and severity increase in patients with chronic kidney disease (CKD), diabetes mellitus, and heart failure (HF), particularly when compounded by medications like angiotensin converting inhibitors, angiotensin receptor blockers, and potassium sparing diuretics. Hyperkalemia arises from disruptions in potassium regulation involving intake, excretion, and intracellular-extracellular distribution. In CKD and acute kidney injury, these regulatory mechanisms are impaired, leading to heightened risk. The management of chronic hyperkalemia presents a challenge due to the necessity of balancing effective cardiovascular …

Fabrication Of Palladium Decorated Zinc Oxide Nanostructures For Non-Enzymatic Glucose Sensing, Reagan Aviha, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

The growing global burden of diabetes necessitates the development of glucose sensors that are not only reliable and sensitive but also cost-effective and amenable to point-of-care use. In this work, we report a non-enzymatic electrochemical glucose sensor based on laser-induced graphene (LIG), functionalized with zinc oxide (ZnO) and palladium (Pd) nanostructures. The ZnO nanostructures were systematically optimized on the LIG surface by varying electrochemical deposition parameters, including applied potential, temperature, and deposition time, to enhance the electrocatalytic oxidation of glucose in alkaline medium. Subsequent modification with Pd nanostructures further improved the electrocatalytic activity and sensitivity of the sensor. The performance …

Diagnostic Dilemma: Appendiceal Endometriosis Mimicking Acute Appendicitis In A Pregnant Patient, Samantha Perez, Abigail Haythron, Trey Doss, Keisha Reddick

South Atlantic Division GME Research Day 2025

No abstract provided.

Incontinentia Pigmenti Diagnosed In Newborn Nursery, Virginia Ramsey Aldrich, Andrea Heuser

South Atlantic Division GME Research Day 2025

No abstract provided.

Autoimmune Pancreatitis Not Otherwise Specified (Aip-Nos): The Importance Of Gastroenterology Consultation When Clinical Findings Are Concerning For Pancreatic Cancer, Cooper Alden Josephs, Daniel Mullady, Nicholas Fuerstenau, Steve Xie, Taylor Templeton-Jager

South Atlantic Division GME Research Day 2025

No abstract provided.

Cryptogenic Fusobacterium Liver Abscesses In Two Healthy, Young Adult Males, Cooper Alden Josephs, Anna Bryce Tucker, James Everhart, Nick Fuerstenau, Taylor Templeton-Jager

South Atlantic Division GME Research Day 2025

No abstract provided.

Surgical Treatment For Severe Penile Calciphylaxis: Case Report And Systematic Review, Kenley Tyler, Peter L. Miller, Kenneth Carney

South Atlantic Division GME Research Day 2025

No abstract provided.

Traumatic Dislocation Of The Testis, Blake Chandler, Emily Clifton, Christopher Hulsey

South Atlantic Division GME Research Day 2025

No abstract provided.

Maternal Postpartum Depression, The Family Unit, And Childhood Development, Sara Kate Wiggins, Alexandria Bailey, Peyton Dekle, Joshua Ferrell

South Atlantic Division GME Research Day 2025

No abstract provided.

Metastatic Squamous Cell Carcinoma In A Nonsmoker Presenting With Pathological Humeral Fracture, Nicholas Fuerstenau, Grant Cookson, Smit Jani

South Atlantic Division GME Research Day 2025

No abstract provided.

E. Coli Sepsis And Cholangitis In A Patient With Sickle-Cell Disease: A Case Report, Madeline Pham, Kristen Stovall, Marvin Sineath Jr.

South Atlantic Division GME Research Day 2025

No abstract provided.

Diagnosis Of Hibernoma: A Case Report Of A Benign Adipose Tumor With Radiological And Histopathological Features, Pavan Patel, Himani Patel, Patrick Mullinix

South Atlantic Division GME Research Day 2025

No abstract provided.

Atypical Presentation Of Ocular Myasthenia Gravis In A 26 Year Old Female, Laura Henein, Shahla Delawalla, Ebere Obasi, Gina Brock, Shameka Jones

South Atlantic Division GME Research Day 2025

No abstract provided.

Clinical Presentation And Management Of Littoral Cell Angioma: A Case Report, Rebecca Ashton Taylor, Steven Carpenter

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of A Cough Unveiling Pulmonary Amyloidosis, Conner Dalton, Timothy Kocher, Chase Tenewitz, Benjamin Goldsmith

South Atlantic Division GME Research Day 2025

No abstract provided.

Anaphylaxis Vs. Sepsis: A Case Of Distributive Shock After Receiving Hemodialysis, William Downs, Benjamin H. Bridges, Trey Embrey, Logan Reid, Meghan Rosenquist

South Atlantic Division GME Research Day 2025

No abstract provided.

Atypical Pityriasis Rosea – A Case Report, Benjamin H. Bridges, Madeline Pham, Meghan Rosenquist

South Atlantic Division GME Research Day 2025

No abstract provided.

Volvulus Of A Wandering Spleen: A Case Report, Curtis Bethel, Allison Thompson

South Atlantic Division GME Research Day 2025

No abstract provided.

Meniscal Allograft Transplantation Provides Long-Term Chondroprotection After Meniscectomy, Melanie Valencia

South Atlantic Division GME Research Day 2025

No abstract provided.