Cardiovascular Diseases Commons^™

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.

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.

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.

Contributions Of Pathobiological And Translational Science To Understanding And Managing Ischemic Heart Disease: Progress, Impediments, And Future Directions, L Maximilian Buja

The Texas Heart Institute Journal

Key pathobiological components of ischemic heart disease have been identified as follows: (1) In 1970 to 1973, myocardial infarct size was found to be the primary determinant of prognosis after acute myocardial infarction (AMI); (2) in 1973 to 1989, vulnerable coronary artery plaques were found to predispose individuals to coronary plaque disruption and thrombosis, causing major AMI; (3) in 1972, timely coronary reperfusion was demonstrated to limit the size of evolving AMI but with risk of reperfusion injury; and (4) in 1986, myocardial conditioning was found to be a clinically significant modulator capable of delaying AMI progression. Promising cardioprotective strategies …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Enhancing Health Literacy Using Video Education And The Teach-Back Method For Hypertension And Diabetes Mellitus Type 2, Shelly-Ann M. Malcolm-Padilla

Doctor of Nursing Practice Projects

Diabetes type 2 and hypertension are chronic illnesses that have both physical and psychological impacts on an individual. Primary care providers play an important role in the management of chronic illness, specifically type 2 diabetes and hypertension. Changing behavior with a commitment to compliance with the treatment plan and living a healthy lifestyle can decrease disease complications for both diabetes and hypertension. With the use of educational videos and the teach-back method to confirm understanding of disease management, the goal of this quality improvement project was to contribute to positive health and lifestyle change for patients, their caregivers, clinical staff, …

Pumping Iron, Straining Hearts: Androgen Building Cardiomyopathy In A Middle Aged Bodybuilding Enthusiast, Milan Terzic, Yash B. Patel

Graduate Medical Education Research Journal

A 46-year-old bodybuilder presenting with new onset dyspnea found to have a new onset non-ischemic cardiomyopathy (CM) attributed to exogenous trenbolone and testosterone use. Steroid cessation and guideline-directed heart failure therapy led to notable recovery in left ventricular function supported by global longitudinal strain, ejection fraction and symptomatology.

Anabolic steroid-induced CM involves multiple mechanisms including lipid disturbances, hypertrophy, reduced receptor sensitivity, and cell damage. This case emphasizes the importance of recognizing anabolic steroid misuse as a potential cause of non-ischemic cardiomyopathy in middle aged men. With prompt discontinuation of steroids, remained abstinence and early initiation of guideline-directed medical therapy, myocardial …

Acute Myocarditis Secondary To Human Metapneumovirus: A Case Series And Mini-Review, Hussam Al Hennawi, Aamna Khan, Alexander Shpilman, Jennifer A. Mazzoni

Abington Jefferson Health Papers

Among viral myocarditis, human metapneumovirus (hMPV) is a rare causative agent with associated cardiac complications. This report provides insight into the disease progression and sheds light on reported cases from the literature. We present the clinical courses of two patients, aged 68 and 58, who developed myocarditis secondary to hMPV infection. Despite the typical severity associated with viral myocarditis in older populations, both patients experienced significant improvement in their condition and ultimately survived. This report highlights the necessity of recognizing hMPV as a potential cause of myocarditis, particularly in older adults presenting with simultaneous respiratory and cardiac symptoms. The recovery …

Alcohol-Induced Gut Microbial Reorganization And Associated Overproduction Of Phenylacetylglutamine Promotes Cardiovascular Disease, Zhen Li, Min Gu, Aline Zaparte, Xiaoming Fu, Kala Mahen, Marko Mrdjen, Xinmin S. Li, Zhihong Yang, Jing Ma, Themis Thoudam, Kristina Chandler, Maggie Hesler, Laura Heathers, Kiersten Gorse, Thanh Trung Van, David Wong, Aaron M. Gibson, Zeneng Wang, Christopher M. Taylor, Pearl Quijada, Catherine A. Makarewich, Stanley L. Hazen, Suthat Liangpunsakul, J Mark Brown, David J. Lefer, David A. Welsh, Thomas E. Sharp

School of Medicine Faculty Publications

The mechanism(s) underlying gut microbial metabolite (GMM) contribution towards alcohol-mediated cardiovascular disease (CVD) is unknown. Herein we observe elevation in circulating phenylacetylglutamine (PAGln), a known CVD-associated GMM, in individuals living with alcohol use disorder. In a male murine binge-on-chronic alcohol model, we confirm gut microbial reorganization, elevation in PAGln levels, and the presence of cardiovascular pathophysiology. Fecal microbiota transplantation from pair-/alcohol-fed mice into naïve male mice demonstrates the transmissibility of PAGln production and the CVD phenotype. Independent of alcohol exposure, pharmacological-mediated increases in PAGln elicits direct cardiac and vascular dysfunction. PAGln induced hypercontractility and altered calcium cycling in isolated cardiomyocytes …

Prolonged Cardiopulmonary Bypass Time-Induced Endothelial Dysfunction Via Glypican-1 Shedding, Inflammation, And Matrix Metalloproteinase 9 In Patients Undergoing Cardiac Surgery, Shiyi Li, Katherine V Nordick, Iván Murrieta-Álvarez, Randall P Kirby, Rishav Bhattacharya, Ismael Garcia, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

Faculty, Staff and Students Publications

OBJECTIVES: A prolonged cardiopulmonary bypass (CPB) time of over 180 min is linked to poorer outcomes and higher mortality in cardiac surgery. This study examines how glypican-1 shedding, matrix metallopeptidase 9 (MMP9), and the pro-inflammatory cytokine IL-1β may contribute to endothelial dysfunction in patients undergoing on-pump surgery with an extended CPB.

METHODS: Fifty-one patients undergoing cardiac surgical procedures were divided into two groups based on the intraoperative CPB duration: (i) normal CPB (<180 >min,

RESULTS: Before surgery, the plasma levels of glypican-1, MMP9, and IL-1β were comparable between the normal CPB and the prolonged CPB groups. However, after the end …

Letter To "Early Do-Not-Attempt Resuscitation Orders And Neurological Outcomes In Older Out-Of-Hospital Cardiac Arrest Patient: A Multicenter Observational Study", Benjamin Tangkamolsuk, Quang La, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We enjoyed reading the article by Kohri et al., titled “Early do‐not‐attempt resuscitation orders and neurological outcomes in older out‐of‐hospital cardiac arrest patients: A multicenter observational study” and would like to offer additional commentary on the article. We hope these perspectives may provide insight into areas that may require further research and improvement.

Artificial Intelligence In Fetal And Pediatric Echocardiography, Alan Wang, Tam T Doan, Charitha Reddy, Pei-Ni Jone

Faculty, Staff and Students Publications

Echocardiography is the main modality in diagnosing acquired and congenital heart disease (CHD) in fetal and pediatric patients. However, operator variability, complex image interpretation, and lack of experienced sonographers and cardiologists in certain regions are the main limitations existing in fetal and pediatric echocardiography. Advances in artificial intelligence (AI), including machine learning (ML) and deep learning (DL), offer significant potential to overcome these challenges by automating image acquisition, image segmentation, CHD detection, and measurements. Despite these promising advancements, challenges such as small number of datasets, algorithm transparency, physician comfort with AI, and accessibility must be addressed to fully integrate AI …

Multiparametric Cardiovascular Magnetic Resonance Is Associated With Outcomes In Pediatric Heart Transplant Recipients, Andrew A Lawson, Kae Watanabe, Lindsay Griffin, Christina Laternser, Michael Markl, Cynthia K Rigsby, Joshua D Robinson, Nazia Husain

Faculty, Staff and Students Publications

BACKGROUND: Multiparametric cardiovascular magnetic resonance (CMR) has an emerging role in non-invasive surveillance of pediatric heart transplant recipients (PHTR). Higher myocardial T2, higher extracellular volume fraction (ECV), and late gadolinium enhancement (LGE) have been associated with adverse clinical outcomes in adult heart transplant recipients. The purpose of this study was to investigate the prognostic value of CMR-derived T1 and T2 mapping, ECV, and LGE for clinical outcomes in PHTR.

METHODS: We performed a single-center, retrospective chart review of consecutive, gadolinium-enhanced CMR studies in PHTR over a 7.5-year period, excluding follow-up studies. Standard CMR ventricular volume and function analysis, T1 mapping …

Improved Adherence To Lipid Screening In The Pediatric Cardiology Clinic: A Quality Improvement Project, Rachel Magnan, Thomas Murphy, Lauren Rosenthal, Aparna Prasad, Anjali Chelliah, Stuart Kaufman, Donna Timchak, Lindsey Mcphillips, Saira Siddiqui

Department of Pediatrics Faculty Papers

INTRODUCTION: Lipid screening identifies at-risk patients to facilitate cardiovascular risk reduction. National pediatric guidelines recommend universal lipid screening between 9-11 and 17-21 years of age. We aimed to improve adherence to lipid screening for all age-appropriate outpatient pediatric cardiology visits from a baseline of 35% to 90% between November 2021 and July 2023.

METHODS: All outpatient visits for patients 9-11 and 17-21 years were included. Chart review and an Epic electronic health record report identified patients screened, lipid test results, and need for further testing. A P-chart was generated. After establishing a baseline for 8 weeks, interventions, including an Epic …

Importance Of The Hemoglobin Glycation Index For Risk Of Cardiovascular And Microvascular Complications And Mortality In Individuals With Type 2 Diabetes (Endocrinol Metab 2024;39:732-47, Claudia Regina Lopes Cardoso Et Al.), Stuart A. Chalew

School of Medicine Faculty Publications

No abstract provided.

Measurement Of Breast Artery Calcification Using An Artificial Intelligence Detection Model And Its Association With Major Adverse Cardiovascular Events, Suzanne Rose, Josette Hartnett, Zachary Estep, Daniyal Ameen, Shweta Karki, Edward Schuster, Rebecca Newman, David Hsi

Department of Medicine Faculty Papers

Breast artery calcification (BAC) obtained from standard mammographic images is currently under evaluation to stratify risk of major adverse cardiovascular events in women. Measuring BAC using artificial intelligence (AI) technology, we aimed to determine the relationship between BAC and coronary artery calcification (CAC) severity with Major Adverse Cardiac Events (MACE). This retrospective study included women who underwent chest computed tomography (CT) within one year of mammography. T-test assessed the associations between MACE and variables of interest (BAC versus MACE, CAC versus MACE). Risk differences were calculated to capture the difference in observed risk and reference groups. Chi-square tests and/or Fisher's …

Uncontrolled Hypertension Or A Bad Medication Interaction? The Importance Of Reviewing Over-The-Counter Medications During Medication Reconciliation, Shefali Amin Do, Caitlyn R. Moss Md

Transformative Medicine

Introduction: In the management of chronic conditions, review of the complete medication list for potential drug-drug interactions is crucial. This case involves a patient taking activated charcoal for unclear reasons, leading to misdiagnosed uncontrolled hypertension.

Case Description: We present the case of an elderly male with uncontrolled hypertension who had been placed on multiple chronic antihypertensives for years. On further review, he was found to be taking activated charcoal twice daily thereby inactivating his five oral antihypertensive medications and making his blood pressure difficult to control. Discontinuation of the activated charcoal led to significant improvement in his blood …

A Case Of Isolated Sma Dissection With Failed Initial Conservative Management, Salma Emara, Madison Kropp, Masoud Akbari, Kristin Cook

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Isolated superior mesenteric dissection (ISMAD) is an uncommon condition, often diagnosed incidentally for presentations of acute abdominal pain. Early identification and treatment are crucial as complications such as bowel ischemia or vessel rupture can occur. There remain no established treatment guidelines, making surgical and endovascular indications controversial. A 60-year-old male presented with acute abdominal pain, and was diagnosed with ISMAD via computed tomography imaging. He was initially managed conservatively which progressed to worsening abdominal pain, hypertensive crisis, and hemoperitoneum on follow-up computed tomography angiography (CTA). A mesenteric angiogram revealed a pseudoaneurysm in the superior mesenteric artery (SMA) which was subsequently …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …

Food Security And Its Impact On Hypertension In Urban Communities, Lauren M. Nobriga

Master's Projects and Capstones

The Quality Improvement Team proposed an intervention to increase enrollment in the Food Security Program, a six-month initiative that provides vouchers redeemable for fruits and vegetables. Long-term impacts of this Program include an improved food economy and enhanced patient disease management autonomy. This project aimed to increase the percentage of eligible adult medicine clinic patients enrolled in the Food Security Program by 25%, or 11 patients per month, based on the mean enrollment for the first four months of the Program (May to August) of nine patients. The intervention was based on bi-monthly performance reports, making the goal include enrolling …