Cardiology Commons^™

Implementing Bedside Handoff In The Cvpacu In The Cardiovascular Short Stay Unit, Alyssa Ruud

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Improving Nursing Documentation Compliance For Acute Heart Failure Patients, Amy Nunez, Kassidi Wedemeyer

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

A Rare Case Of Hydroxychloroquine-Induced Cardiogenic Shock, Nikhil Erabelli, Pranayvir Lotey, Alice J. Chu, Marwan F. Jumean

Journal of Shock and Hemodynamics

Cardiac complications are common in systemic lupus erythematosus (SLE), but drug-induced cardiomyopathy remains underdiagnosed. Hydroxychloroquine (HCQ) cardiotoxicity is rare, and the few reports of HCQ-associated cardiogenic shock have followed acute overdose rather than chronic therapeutic use. A 36-year-old woman with SLE on long-term HCQ and heart failure with mildly reduced ejection fraction (EF) presented with exertional dyspnea, lower extremity edema, and retrosternal chest pain. Echocardiography showed a new EF of 20% to 25%, and computed tomography demonstrated pulmonary edema. The patient’s lactate levels rose despite intravenous furosemide, consistent with Society for Cardiovascular Angiography and Interventions stage C cardiogenic shock. Right …

Saudi Heart Association Position Statement On The Management Of Uncontrolled And Resistant Hypertension, Waleed Alhabeeb, Ismail Raslan, Adel Tash, Bader Ali Almustafa, Badr Ali Alzahrani, Fadel A. Alrowaie, Faisal Alghamdi, Fawaz Almutari, Ibrahim Jelaidan, Maryam Alqaseer, Mohamed Alkharasani, Raed Aldahash, Salem Assiri, Suleiman M. Kharabsheh, Sultan Al Dalbhi, Wejdan Ibrahim Aburas

Journal of the Saudi Heart Association

Background: Despite advances in antihypertensive therapy, blood pressure control remains suboptimal globally and in Saudi Arabia, where uncontrolled hypertension continues to contribute significantly to disease burden. Resistant hypertension represents a high-risk phenotype associated with increased cardiovascular and renal morbidity.

Methods: This Saudi Heart Association position statement was developed by a multidisciplinary expert panel using a structured consensus approach and a comprehensive, non-systematic review of the literature. Evidence on epidemiology, pathophysiology, diagnosis, and management of uncontrolled and resistant hypertension was critically appraised to formulate clinically applicable recommendations.

Results and conclusions: Uncontrolled and resistant hypertension are driven by complex mechanisms including activation …

Comments On Prevalence Of Cerebrovascular Disease In Patients With Coronary Artery Disease After Pharmacological Stress Test, Xiaowei Wang, Jingwen Wei

Journal of the Saudi Heart Association

No abstract provided.

Reply To The Letter Comments On Prevalence Of Cerebrovascular Disease In Patients With Coronary Artery Disease After Pharmacological Stress Test., Muhammad S. Muhammad Hagrass, Haytham S. Ghareeb

Journal of the Saudi Heart Association

No abstract provided.

Reply To The Letter: Comments On “Intravenous Atropine In Reducing Reperfusion Arrhythmias, Conduction Abnormalities, And Hypotension In Inferior St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention”, Mohamed Ismail Rashed, Islam Mahmoud Bastawy, Ahmed Lotfy Mohamed, Mohamed Gamaleldin Elewa

Journal of the Saudi Heart Association

No abstract provided.

Comment On Intravenous Atropine In Reducing Reperfusion Arrhythmias, Conduction Abnormalities, And Hypotension In Inferior St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention, Azeen Qaisar

Journal of the Saudi Heart Association

No abstract provided.

Impact Of Neighborhood And Individual Social Drivers Of Health On Outcomes Following Congenital Heart Surgery., Andrew Well, Heather Van Diest, Brett R. Anderson, Wei Zhang, Kathleen Carberry, Alexandra Lamari-Fisher, Jeremy Affolter, Erin A Gottlieb, Jeffery P. Jacobs, Charles D. Fraser, Carlos M. Mery

Manuscripts, Articles, Book Chapters and Other Papers

Background Despite advances in congenital heart surgery (CHS) and improvements in outcomes, disparities continue to exist. Social Drivers of Health (SDoH) have been associated with many aspects of health and wellness including congenital heart disease. The goal was to evaluate the impact of individual and neighborhood-level SDoH on outcomes following CHS.

Methods Retrospective review of the Society of Thoracic Surgeons Congenital Heart Surgery Database from 2014 to 2022 linked via ZIP code with the Centers for Disease Control and Prevention Social Vulnerability Index (SVI). ZIP codes were ranked by their SVI score with the first quintile the least vulnerable and …

Association Between Echocardiographic Epicardial Adipose Tissue Thickness And Atrial Fibrillation In A Single-Centre Pakistani Cohort, Ateeb Mahmood Khan, Fateh Ali Tipoo Sultan, Aiman Sultan, Adeel Khoja

Journal of the Saudi Heart Association

Objectives: To assess the association between echocardiographic epicardial adipose tissue (EAT) thickness and atrial fibrillation (AF) in a single-centre Pakistani cohort of patients referred for transthoracic echocardiography (TTE).

Methods: Patients referred for TTE at Aga Khan University Hospital (AKUH), Karachi, were prospectively enrolled over a six-month period (1 September 2024 – 28 February 2025) using a convenience sampling approach; nearly all patients referred for TTE with AF during this period were captured, while patients in sinus rhythm were enrolled by convenience sampling alongside them, in order to ensure an adequate number of AF cases for comparison. EAT was measured in …

Cardiac Marker Levels In Patients With Sickle Cell Disease During Emergency Room Visits: A Retrospective Study, Adel F. Al-Marzouki, Osman Radhwi, Nadine Alharbi, Sondos Jar, Weam Bajunaid, Abdulaziz Alzahrani, Majed Alhuzali, Sultan Aljuaid, Naif Abdulaziz Meighrbl

Journal of the Saudi Heart Association

Background: Millions of people worldwide suffer from a genetic hemoglobinopathy known as sickle cell disease (SCD). It is a long-term condition marked by progressive multiorgan failure. Among SCD patients, cardiovascular complications are the main leading cause of death. Cardiovascular complications raise cardiac markers levels as well as sickle cell vaso-occlusive crisis (VOC). This makes it challenging to determine the source. This research aims to identify the association between cardiac markers and myocardial infarction in SCD patients at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia.

Material and Method: This retrospective study was conducted from June 2022 to March 2023. …

Recognizing Coronary Artery Disease In Women, Krista Ohmie Pa-C, Cck, Aacc

Lynchburg Journal of Medical Science

The purpose of this review is to identify sex-specific factors in the prevention, diagnosis, and treatment of cardiovascular disease in women as it continues to be the number one cause of their mortality. A search of the literature was conducted using PubMed as well as resources from the American College of Cardiology and the American Heart Association with multiple articles identified for use. The risk of cardiovascular disease in women is affected by traditional risk factors such as hypertension and diabetes, but is compounded by length of estrogen exposure, pregnancy, and higher rates of systemic inflammation. Systemic barriers such as …

Primary Treatment Of Congenital Aortic Stenosis In Infants: A Comparative Analysis Of Balloon Aortic Valvuloplasty And Surgical Aortic Commissurotomy, Kayumov Arabbek Ravshanovich, Sinelnikov Yuriy Semenovich, Amansakhatova Ekaterina Nazarovna, Nalimov Konstantin Aleksandrovich, Roseykin Evgeniy Vladimirovich, Manukian Serezha Nersesovich, Soynov Ilya Aleksandrovich

Journal of the Saudi Heart Association

Objective

To compare the efficacy and safety of balloon aortic valvuloplasty (BAV) and surgical aortic commissurotomy (SAC) as primary treatment strategies for congenital aortic stenosis in infants during the first year of life.

Methods

This retrospective two-center cohort study included 89 infants with congenital aortic stenosis treated between April 2015 and June 2025 at two tertiary centers. Patients were divided according to the initial intervention: BAV (n = 39) and SAC (n = 50). The primary endpoint was any repeat intervention on the aortic valve. Secondary endpoints included hospital and late mortality, recurrent hemodynamically significant aortic stenosis, and clinically significant …

Continuous Pacing During Lbbap With A Lumenless Lead: A Simplified, Zero-Cost Sliding-Contact Technique, Leonardo Marinaccio

Journal of the Saudi Heart Association

Left bundle branch pacing with lumenless leads usually requires disconnecting pacing cables during rotation, creating an electrical blind spot during septal advancement. We describe the "sliding-contact" technique, a zero-cost modification enabling continuous real-time monitoring. Retracting the rubber shroud of a standard sterile alligator pacing clip reduces jaw tension, allowing unrestricted lead pin rotation while preserving electrical continuity. In 42 consecutive cases, LBBAP was successfully performed without complications. Beat-to-beat feedback on QRS morphology, impedance, and injury current was maintained throughout rotation, improving procedural precision and safety without specialized equipment.

Inferior Vena Cava–Left Atrial Connection Hidden Beneath Large Secundum Defect. A Case Report, Alisia Yuana Putri, Muhammad Surya Tiyantara

Journal of the Saudi Heart Association

Inferior vena cava (IVC) drainage into left atrium is an exceptionally rare congenital anomaly and may remain unrecognized when associated with a large atrial septal defect (ASD). A 35-year-old-man presented with progressive exertional dyspnea and fatigue. Transthoracic echocardiography, transesophageal echocardiography, and cardiac catheterization demonstrated a large secundum ASD with severe septal malalignment, while systemic venous drainage was interpreted as normal. During surgical ASD repair, an unexpected IVC-to-left atrium connection was identified and redirected to right atrium. Careful assessment of IVC inflow is essential in patients with large malaligned ASD despite normal oxygen saturation.

Complete Atrioventricular Block Revealing Late-Onset Cardiac Fabry Disease: Diagnostic Role Of Native T1 Mapping, Nouhaila Bentama, Lamyae Bakamel, Jalal Tagueniti, Fatiha Ait Yahya, Brahim Meftout

Journal of the Saudi Heart Association

A 63-year-old man presented with symptomatic complete atrioventricular block requiring urgent pacemaker implantation. Evaluation revealed non-obstructive left ventricular hypertrophy with normal coronary arteries. Cardiac magnetic resonance showed diffusely reduced native T1 values and inferolateral late gadolinium enhancement, suggesting Fabry cardiomyopathy; amyloidosis was excluded by bone scintigraphy. Diagnosis was confirmed by markedly reduced alpha-galactosidase A activity, elevated lyso-Gb3, and a pathogenic hemizygous GLA variant (p.Asn215Ser). Enzyme replacement therapy with agalsidase beta was initiated, with early stabilization of myocardial deformation and septal thickness. This case highlights native T1 mapping as a key diagnostic biomarker in unexplained left ventricular hypertrophy.

Time-Varying Spatial Ventricular Gradient Orientation Is Associated With Anthracycline Heart Failure, Andrea N. Rosas Diaz, Hans F. Stabenau, Patricia Tung, Jason Nelson, Gabriel Pajares Hurtado, Sarah Warack, Sanam Alilou, Arunashis Sau, Daniel B. Kramer, Aarti Asnani, Jonathan W. Waks

Division of Cardiology Faculty Papers

BACKGROUND

Anthracycline use is limited by cardiotoxicity resulting in heart failure (HF). The spatial ventricular gradient(SVG) is a vectorcardiographic measurement of myocardial electrical heterogeneity associated with sudden death and incident HF. It is unclear if serial measurement of SVG after anthracycline initiation can help predict subsequent HF.

OBJECTIVES

The objective of the study was to determine if time-varying SVG measurements are associated with anthracycline HF.

METHODS

Retrospective, single-center study of adult patients with cancer treated with anthracyclines between 1992 to 2019. Standard 12-lead electrocardiograms obtained within 6 months before and up to 5 years after anthracycline initiation were analyzed. Patients …

Comment On “Advancing Lipid Management: Saudi Heart Association Position Statement On Pcsk9-Targeted Therapies In The Primary And Secondary Prevention Of Cardiovascular Disease”, Ali Faris Altebainawi

Journal of the Saudi Heart Association

No abstract provided.

Modified Frozen Elephant Trunk Repair For Aortic Coarctation With Segmental Post-Stenotic Aneurysms, Pham Quoc Dat, Ma Nguyen Thai Hoang, Dang Van Phuc, Ta Dinh Do, Ngo Phi Long

Journal of the Saudi Heart Association

Aortic coarctation can be complicated by descending thoracic aortic aneurysms in adults. A 31-year-old man presented with exertional chest pain radiating to the back. Preoperative evaluation showed a 27-mmHg arm-leg systolic pressure gradient, echocardiographic coarctation with a 10-mm narrowest diameter and 25-mmHg gradient, and computed tomography showing two segmental post-stenotic aneurysms, the largest measuring 62 mm. He underwent one-stage modified frozen elephant trunk repair using a Medtronic thoracic stent graft sutured to a surgical graft. The postoperative gradient decreased to 5 mmHg, with stable 9-month follow-up.

Recommendations For Preparticipation Cardiovascular Screening For Athletes In Saudi Arabia: A Consensus Statement From The National Heart Center, Saudi Heart Rhythm Society, And National Center For Sudden Death, Alwaleed Aljohar, Bandar S. Al-Ghamdi, Abdulrahman Y. Sabbagh, Fahad Almehmadi, Fayez Bokhari, Naeem Alshoaibi, Yahya Alhebaishi, Wael Alqarawi

Journal of the Saudi Heart Association

Vigorous sports participation provides substantial physical and psychological benefits but may be accompanied by a small risk of sudden cardiac arrest and death in individuals with previously unrecognized cardiovascular disease. Preparticipation cardiovascular screening aims to identify athletes at increased risk, facilitate appropriate evaluation and management, and promote safe participation in sport. Despite growing international experience, no national recommendations have previously existed for Saudi Arabia. Recognizing the rapid expansion of organized sports participation driven by Saudi Vision 2030, an expert panel convened to develop consensus recommendations for the implementation of a nationwide preparticipation cardiovascular screening program. A comprehensive review of contemporary …

Sex-Based Disparities In Artificial Intelligence For Cardiovascular Disease: A Scoping Review, Maurgan Lee, Tarek Atasi, Michael Mclellan, Yodit Beru, Jason Booza

Population, Patient, Physician and Professionalism Projects

No abstract provided.

Hubungan Kadar Fibroblast Growth Factor-23 Dalam Serum Dengan Hipertrofi Ventrikel Kiri Dan Fraksi Ejeksi Ventrikel Kiri Pada Pasien Hemodialisis Di Rumah Sakit Cipto Mangunkusumo, Ester Morina Silalahi Ester, Maruhum Bonar Marbun, Eka Ginanjar, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Fibroblast growth factor-23 (FGF-23) is a marker that indicates the process of bone mineral disorders in chronic kidney disease dialysis. An elevated FGF-23 causes a remodeling process that contributes to the development of left ventricle hypertrophy (LVH) and the still controversial direct decline of left ventricle ejection fraction (LVEF) among hemodialysis patients. This study aimed to seek out the connection between FGF-23 levels in serum with left ventricle hypertrophy and left ventricle ejection fraction among regular hemodialysis patients.

Methods. A cross-sectional study was conducted to 111 regular hemodialysis patients for twice a week in Cipto Mangunkusumo Hospital …

Reversible Microvascular Ischemia With St-Segment Elevation: An Underrecognized Manifestation Of Antibody-Mediated Rejection In Cardiac Allograft Recipients, Jonathan Ahn, Justin Daneshrad, Liset Stoletniy, Dmitry Abramov

The VAD Journal

Electrocardiographic manifestations of cardiac allograft rejection are often subtle, and stress-induced ST-segment elevation associated with antibody-mediated rejection (AMR) is rarely reported. We describe a 34-year-old heart transplant recipient with progressive exertional angina, nonobstructive coronary disease on angiography, and exercise-induced ST-segment elevation in lead augmented vector right, high-lateral leads I, and augmented voltage left, along with diffuse ST-segment depressions, hypotension, and transient ventricular tachycardia. Concurrent emergence of complement-binding donor-specific antibodies with high mean fluorescence intensity raised concern for AMR, prompting treatment with corticosteroids, plasma exchange, and intravenous immunoglobulin despite the absence of biopsy confirmation. After therapy, symptoms, exercise-induced ischemic electrocardiographic abnormalities, …

Wolff-Parkinson-White Pattern: Recognition Of Ventricular Pre-Excitation And Risk Stratification, Devi Parvathy Jyothi Ramachandran Nair, Badri Aryal

Transformative Medicine

Background: Wolff-Parkinson-White (WPW) pattern is characterized by ventricular pre-excitation through an accessory atrioventricular pathway. Although often asymptomatic, some pathways carry a risk of tachyarrhythmia and sudden cardiac death.

Case Description: A 45-year-old man with hypertension, polysubstance use, and bipolar disorder presented with altered mental status following suspected substance intoxication. His course was complicated by hypoxic respiratory failure requiring intubation and a large right basal ganglia hemorrhage requiring surgical evacuation. During hospitalization, an abnormal ECG prompted Cardiology consultation. The ECG demonstrated sinus rhythm with a short PR interval, delta wave, and widened QRS complex, consistent with ventricular pre-excitation. He had …

Is My Child's Heart Murmur Dangerous?, Bob Underwood, Mahmoud Jaara, Pezad Doctor

Pediatrics in Practice: A CME Podcast

Is my child's heart murmur dangerous or just harmless? Heart murmurs and when they matter — Pezad Doctor, MD, Pediatric Cardiology at Children's Mercy - Pediatrics in Practice - CME, and Mahmoud Jaara, MD, pediatric cardiology fellow at Children's Mercy - Pediatrics in Practice - CME, explain how to tell innocent murmurs (soft, systolic, short, position‑dependent) from concerning ones, which symptoms and family history raise concern, and what to expect at a cardiology visit (exam, oxygen saturation, pulses).

Click here to stream the podcast episode.

Automated Artificial Intelligence-Enabled Measurement Of Cardiac Structures On Point-Of-Care Ultrasonography: A Prospective Multicenter Validation Study, Sarah F. Mercaldo, Bernardo C. Bizzo, Tsion Sadore, Madeleine A. Halle, Ashley L. Macdonald, Isabella Newbury-Chaet, Eric L'Italien, Alex S. Schultz, Victor Tam, Sheila M. Hegde, Judy R. Mangion, Praveen Mehrotra, Qiong Zhao, Justina Wu, James M. Hillis

Division of Cardiology Faculty Papers

Introduction: Point-of-care ultrasonography (POCUS) enables clinicians to obtain critical diagnostic information at the bedside, especially in resource-limited settings. This information may include 2D cardiac quantitative data, although measuring the data manually can be time-consuming and subject to user experience. Artificial intelligence (AI) can potentially automate this quantification. This study assessed the interpretation of key cardiac measurements on POCUS images by an AI-enabled device (AISAP Cardio V1.0).

Methods: This retrospective diagnostic accuracy study included 200 POCUS cases from four hospitals (two in Israel and two in the United States). Each case was independently interpreted by three cardiologists and the device for …

Transportability Of An Artificial Intelligence Electrocardiography Model For Structural Heart Disease: External Validation And Recalibration Of Echonext-Mini In Mimic-Iv, Emmanuel Otabor, Abdulraheem Hassan, Ayoyimika Okunlola, Justin Lam, Laith Alomari, Michael Hamilton

Einstein Health Papers

AIMS: Structural heart disease is often underdiagnosed, and echocardiography is limited by access and referral thresholds. Artificial intelligence electrocardiography (AI-ECG) may identify echocardiographically defined structural heart disease. EchoNext-Mini is a released AI-ECG model, accompanied by a benchmark dataset, that detects a composite structural heart disease outcome and component conditions from 12-lead electrocardiogram waveforms together with age, sex, and electrocardiographic measurements. We assessed its transportability and recalibration.

METHODS AND RESULTS: We linked electrocardiograms from MIMIC-IV to subsequent transthoracic echocardiograms, including adults whose electrocardiogram preceded an eligible echocardiogram within one year, one per patient. Labels were mapped to structured echocardiographic fields using …

Evaluation Of Radial Artery Anatomy With Various Anatomical Variants In Patients Undergoing Transradial Q1 Catheterization, Nisarg Desai, Sharadkumar Jain, Kunal Parwani, Pooja Vyas, Yaqub Sidatar

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the incidence of radial artery anomalies in a large cohort of patients undergoing TRA and to evaluate their specific impact as predictors of procedural failure and access site complications.                                                                                  

  Methods: This prospective, observational, single-center study enrolled 1000 consecutive patients undergoing coronary angiography or intervention via TRA between 2022 and 2024. Radial artery anatomy was assessed using retrograde radial arteriography immediately following sheath insertion. Anatomical variants were categorized into high bifurcation (origin proximal to the cubital fossa), Radial artery loops (full 360-degree curvature), Tortuosity (curve of more than 45 degrees in the vessel), Narrow calliber, …

"Re-Evaluation Of Radial Artery Anatomy With Anatomical Variants In Patients Undergoing Transradial Catheterization, Eman Aslam, Eman Zahra, Maryam Amjad

Journal of the Saudi Heart Association

No abstract provided.

Strengthening The Evidence Base For Pediatric Cardiac Ct: Statistical And Technological Considerations, Faizan Faisal

Journal of the Saudi Heart Association

No abstract provided.