Cardiology Commons^™

Features On Cardiac Magnetic Resonance Imaging And Accuracy Of Echocardiographic Findings For Diagnosing Constrictive Pericarditis, Salik Ur Rehman Iqbal, Fateh Ali Tipoo Sultan

Section of Cardiology

Constrictive pericarditis is a rare disease with a difficult diagnosis. Cardiac magnetic resonance (CMR) imaging data of Aga Khan University Hospital from January 2011 to March 2020 was retrospectively reviewed and patients with the diagnosis of constrictive pericarditis were included. A total of 22 patients were included with the mean age of 46±16 years and majority 17(77%) were male. The most common findings on transthoracic echo were significant respiratory variation in mitral and tricuspid inflow velocities in 20(91%), and septal annular e'>9 in 10 (86%). The most common finding on CMR was respiratory septal shift in 22(100%), followed by …

Clinical Outcomes Of Physiologically-Guided Revascularisation, Nasir Rahman, Ghufran Adnan, Awais Farhad, Jamshed Ali, Ihsan Ullah

Section of Cardiology

Objective: To assess the clinical outcomes of revascularisation based on fractional flow reserve (FFR) and/or instantaneous wave-free ratio (iFR).
Study design: Descriptive study.
Place and duration of study: Department of Medicine, The Aga Khan University Hospital, Karachi from January 2012 to January 2020.
Methodology: A cohort of patients having moderate to severe coronary stenosis, undergoing coronary revascularisation based on invasive physiological assessment (FFR or iFR) were assessed. The participants were divided into the revascularisation-deferred group and the revascularization-performed group, based on the physiological results. Cox-proportional hazard model building was done, using a stepwise approach by assessing all plausible interactions and …

Covid-19 Bbibp-Corv Vaccine And Transient Heart Block - A Phenomenon By Chance Or A Possible Correlation - A Case Report, Pirbhat Shams, Jamshed Ali, Sheema Saadia, Aamir Hameed Khan, Fateh Ali Tipoo Sultan, Javed Tai

Section of Cardiology

Importance: Bradyarrhythmia during COVID19 illness carries prognostic significance. Electrophysiological side effects of COVID19 vaccine remain largely unknown. It is imperative to report nature of cardiovascular side effects of the vaccine.
Case presentation: An 80 years-old-man presented with complains of dizziness, trepidation and shortness of breath following his first shot of COVID-19 BBIBP-CorV (Sino-pharm). ECG on arrival showed 2:1 atrioventricular block with an underlying old left bundle branch block. The AV block changed into Mobitz type-I over the course of next 2 days and into a sinus 1:1 conduction on fourth day of presentation. However, our patient underwent permanent pacemaker implantation …

Direct Oral Anticoagulants For Stroke Prevention In Patients With Atrial Fibrillation And Bioprosthetic Heart Valves, Vardhmaan Jain, Kirtipa Bhatia, Devika Aggarwal, Agam Bansal, Bharat Narasimhan, Michael J. Hendrickson, Sameer Arora, Michael J. Ricciardi, Arman Qamar

Articles

No abstract provided.

Surgical Treatment Of Valvular Heart Disease In Nigeria: A 6-Year Experience, Ikechukwu A Nwafor, John C Eze, Maureen N Nwafor

The Texas Heart Institute Journal

Surgical treatment of valvular heart disease in Nigeria, the most populous country in sub-Saharan Africa, is adversely affected by socioeconomic factors such as poverty and ignorance. To evaluate our experience in this context, we identified all patients who underwent surgery for acquired or congenital valvular heart disease at our Nigerian center from February 2013 through January 2019. We collected data from their medical records, including patient age and sex, pathophysiologic causes and types of valvular disease, surgical treatment, and outcomes. Ninety-three patients (43 males [46.2%]; mean age, 38.9 ± 10.0 yr [range, 11–80 yr]) underwent surgical treatment of a total …

Atypical St-Segment-Elevation Myocardial Infarction Presentation In Patients With Covid-19 At A High-Volume Center In New York City, Miguel A Alvarez Villela, Ahmad Alkhalil, Michael A Weinreich, Jonathan Koslowsky, Shunsuke Aoi, M Azeem Latib

The Texas Heart Institute Journal

Atypical presentations of ST-segment-elevation myocardial infarction (STEMI) have been reported in patients who have COVID-19. We have seen this occurrence in our center in Bronx, New York, where multitudes of patients sought treatment for the coronavirus. We studied the prevalence of atypical STEMI findings among patients with COVID-19 who presented during the first 2 months of the pandemic.

Consistent with previous reports, 4 of our 10 patients with COVID-19 and STEMI had no identifiable culprit coronary lesion; rather, they often had diffuse ST-segment elevations on surface electrocardiograms along with higher levels of D-dimer and inflammatory markers. In contrast, 32 of …

Novel Pharmacomechanical Thrombolysis For Treating Intermediate-Risk Acute Pulmonary Embolism: The Bashir Endovascular Catheter, Maninder Singh, Austin Quimby, Vladimir Lakhter, Mohamad Al-Otaibi, Parth M Rali, Riyaz Bashir

The Texas Heart Institute Journal

No abstract provided.

Large-Bore Aspiration Thrombectomy: Catalyst For A Revolution In Treating Pulmonary Embolism, Thomas M Tu

The Texas Heart Institute Journal

No abstract provided.

Left Ventricular Ballooning Patterns In Recurrent Takotsubo Cardiomyopathy: A Systematic Review And Meta-Analysis Of Reported Cases, Ravi Korabathina, Jamie Porcadas, Kevin E Kip, Puja R Korabathina, Andrew D Rosenthal, Peter Wassmer

The Texas Heart Institute Journal

Recurrent takotsubo cardiomyopathy (TTC) and the clinical profiles and outcomes of patients have not been fully evaluated, nor has the effect of left ventricular ballooning pattern. After searching the medical literature for reports of patients with recurrent TTC, we identified 84 articles with 101 case descriptions. We divided the cases into those with only apical left ventricular ballooning patterns at recurrence (typical, n=60), and those with at least one midventricular or basal ballooning pattern (atypical, n=41). We then compared their clinical profiles and outcomes.

The groups were similar in terms of baseline demographic characteristics, presence and types of triggers, use …

Endovascular Treatment Of Acquired Atheromatous Postsubclavian Aortic Coarctation, Bhushan S Sonawane, Sreeja Pavithran, Kothandam Sivakumar

The Texas Heart Institute Journal

Coral reef aorta is a rare calcifying obstructive disease that involves the thoracoabdominal aorta. Similar presentations in the postsubclavian aorta may result in acquired atheromatous aortic coarctation leading to systemic hypertension and heart failure. The associated calcification makes surgical anatomic or extraanatomic bypass and thromboendarterectomy challenging. Extensive circumferential calcification often precludes endovascular intervention. We present the case of a 25-year-old man with an acquired atheromatous coarctation of the postsubclavian aorta who underwent successful endovascular treatment with use of a balloon-expandable covered stent.

Patient Characteristics And Outcomes Of Type 2 Myocardial Infarction During Heart Failure Hospitalizations In The United States, Salik Nazir, Abdul Mannan Khan Minhas, Ishan S Kamat, Robert W Ariss, George V Moukarbel, Juan Carlos Plana Gomez, Savitri Fedson, Ajith Nair, Biykem Bozkurt, Hani Jneid

Faculty, Staff and Students Publications

BACKGROUND: Type 2 myocardial infarction (MI) is increasingly diagnosed in patients with heart failure (HF). A paucity of data exists pertinent to the contemporary prevalence and impact of type 2 MI in patients with HF. We studied the patient profiles and the prognostic impact of type 2 MI on outcomes of HF hospitalizations.

METHODS: The Nationwide Readmission Database 2018 was queried for patients with HF hospitalizations with and without type 2 MI. Baseline characteristics, inpatient outcomes, and 30-day all-cause readmissions between both cohorts were compared.

RESULTS: Of 1,072,674 primary HF hospitalizations included in the study, 28,813 (2.7%) had type 2 …

A Rare Presentation Of An Acute Type A Aortic Dissection Obscured Due To The Simultaneous Presence Of Acute Pancreatitis, Amrin M. Kharawala, Nirav Brahmbhatt, Huzefa Bhopalwala, Nakeya Dewaswala, Adnan Bhopalwala, Waqas Ghumman, Robert Dean Chait

HCA Healthcare Journal of Medicine

Introduction

Acute pancreatitis (AP) and acute aortic dissection (AAD) are medical emergencies that must be promptly recognized to avoid the development of life-threatening complications. Both of these diseases can present with chest or epigastric pain which can radiate to the back, thus, early suspicion based on clinical presentation and risk factors is essential. We present the case of a 56-year-old patient initially diagnosed with AP who was later found to have an AAD.

Clinical Findings

A 56-year-old man with a history of alcohol abuse presented with 1 day of diffuse abdominal pain, nausea and vomiting. His lipase was 3,909 U/L …

Underlying Coronary Microvascular Disease May Lead To Underestimation Of Global Longitudinal Strain Differences, Neelesh Gupta, Mohammed Elkhazendar, Rajeev Gupta

Journal of the Saudi Heart Association

No abstract provided.

Prenatal Delineation Of Coronary Anatomy In Dextro-Transposition Of Great Arteries, Geetha Haligheri, Chandrakant Patel, Rukmini Komarlu

Manuscripts, Articles, Book Chapters and Other Papers

Background: Dextro-transposition of the great arteries (D-TGA) is the second-most common cyanotic congenital heart disease with variable coronary artery anatomy. The arterial switch procedure has revolutionized outcomes for this defect, with coronary anatomy being a key determinant of both short- and long-term outcomes following surgical repair. The assessment of coronary anatomy is usually undertaken in the postnatal period by transthoracic echocardiography, with assessment prenatally not being well studied. We sought to assess the feasibility of delineating the coronary arteries on fetal echocardiograms in a small cohort of patients followed prenatally. Methods: This was a retrospective review of fetuses with D-TGA …

Radiolucent Mechanical Valve: Chest Radiography Conundrum, Mohamad S. Alabdaljabar, Genya Turgul, Adelaide M. Arruda-Olson, Jeffrey B. Geske

Journal of the Saudi Heart Association

No abstract provided.

Diagnostic Accuracy Of Dobutamine Stress Echocardiography For Detection Of Cardiac Allograft Vasculopathy In Orthotopic Heart Transplant Patients, Mohammed Mahmoodurrahman, Josef Marek, Talal Al Otaibi, Vera Maria Cury Salemi, Najmeddine Echahidi, Jehad Al Buraiki, Bahaa M. Fadel, Dania Mohty

Journal of the Saudi Heart Association

Objective Cardiac allograft vasculopathy is one of the leading causes of late graft failure and subsequent death in orthotopic heart transplant. Although invasive coronary angiography is the gold standard modality for detection of cardiac allograft vasculopathy, dobutamine stress echocardiography has been recently frequently used as an alternative. Our aim was to evaluate the diagnostic performance of dobutamine stress echocardiography for detection of cardiac allograft vasculopathy in transplant patients. Methods A retrospective analysis was conducted using a total of 150 dobutamine stress echocardiographic exams that were performed on 99 patients in our institution, with paired coronary angiogram and no acute rejection, …

Should Covid Vaccination Be Required In Heart Transplantation & Left Ventricular Assist Device Implantation?, Mustafa M. Ahmed, Manjula G. Ananthram, Susan M. Joseph

The VAD Journal

This letter to the editor does not have an abstract.

Complications After Surgical Repair Of Congenital Heart Disease In Infants. An Experience From Tertiary Care Center, Farrukh Javed, Nabil Abdulrahman Aleysae, Abdulmajid Yahya Al-Mahbosh, Amal Ali Zubani, Ali Mohammed Atash, Hanan Bin Salem, Mohamed Abdallah, Omaima Alkhatib, Ashraf Abu-Adas, Maymoona Abdelmouz Hrays, Nawal Ali Alqarni, Alla Felemban, Saad Abdullah Alsaedi, Ahmed Abdullah Jamjoom

Journal of the Saudi Heart Association

Objectives. This study aimed to describe the incidence and spectrum of postoperative complications in infants who underwent their first cardiac surgery for the repair of congenital heart diseases. Methods. This is a single-center retrospective study. Data of infants admitted to King Faisal Specialist Hospital & Research Center; Jeddah; Saudi Arabia, from January 2015 to December 2019 who underwent the first cardiac procedure for congenital heart disease at an age of less than 3 months, were analyzed. The primary outcome is the prevalence and spectrum of postoperative complications during hospitalization. Data were analyzed by using descriptive and analytical statistics using SAS …

Simultaneous Bicarotid And Microscope-Assisted Coronary Revascularization As An Individual Surgical Strategy, Andrey N. Semchenko

Journal of the Saudi Heart Association

A 59-year-old man presented with complaints of giddiness caused by changes in body position, an unsteady gait, daily episodes of vision loss, breathlessness, and chest pain flowing minor physical exertion. Computed tomography revealed an occlusion of the right common carotid artery, a critical stenosis of the left common carotid artery, and a significant stenosis of the left internal carotid artery. A coronarography detected a stenosis of the left main trunk and a triple coronary artery obstructive disease. A simultaneous aortic-bicarotid bifurcation prosthesis and coronary artery bypass grafting were performed. The patient showed a satisfactory postoperative outcome.

Health Care Policy And Congenital Heart Disease: 2020 Focus On Our 2030 Future, Devyani Chowdhury, Jonathan N Johnson, Carissa M Baker-Smith, Robert D B Jaquiss, Arjun K Mahendran, Valerie Curren, Aarti Bhat, Angira Patel, Audrey C Marshall, Stephanie Fuller, Bradley S Marino, Christina M Fink, Keila N Lopez, Lowell H Frank, Mishaal Ather, Natalie Torentinos, Olivia Kranz, Vivian Thorne, Ryan R Davies, Stuart Berger, Christopher Snyder, Arwa Saidi, Kenneth Shaffer

Division of Cardiology Faculty Papers

The congenital heart care community faces a myriad of public health issues that act as barriers toward optimum patient outcomes. In this article, we attempt to define advocacy and policy initiatives meant to spotlight and potentially address these challenges. Issues are organized into the following 3 key facets of our community: patient population, health care delivery, and workforce. We discuss the social determinants of health and health care disparities that affect patients in the community that require the attention of policy makers. Furthermore, we highlight the many needs of the growing adults with congenital heart disease and those with comorbidities, …