Cardiology Commons^™

Caseous Mitral Valve Calcification And Concurrent Hypertrophic Obstructive Cardiomyopathy: A Rare Cause Of Stroke, Waqas Ullah, Donald C. Haas, Talal Almas, Aws- Al-Mukhtar, Asad Inayat

Division of Cardiology Faculty Papers

No abstract provided.

Reorganising For Covid-19 Pandemic: A Review Of Structural Modifications By The Department Of Internal Medicine In Low To Middle-Income Countries, Shakeel Ur Rehman, Muhammad Arslan Ahmed, Ghufran Adnan, Maria Ali Khan

Department of Medicine

Scientists classified the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a novel coronavirus on January 7, 2020. The World Health Organization (WHO) acknowledged the SARS-CoV-2 outburst a public health emergency of international concern on January 30, 2020. Since its origin, this virus has disrupted the best healthcare systems, economies, and strained financial resources; and for underdeveloped countries' healthcare systems, the virus has become a crisis. To tackle the potential hazards from this virus, our Department restructured the services that not only helped us to cope with the pandemic, but also provided an example to copy for other contemporary institutes. …

Healthcare Utilisation And Expenditure Patterns For Cardio-Metabolic Diseases In South Asian Cities: The Carrs Study, Priti Gupta, Kalpana Singh, Roopa Shivashankar, Kavita Singh, Ajay Vamadevan, V Mohan, Muhammad Masood Kadir, Nikhil Tandon, K M. Narayan, Dorairaj Prabhakaran, Mohammed K. Ali

Community Health Sciences

Objective: To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia.
Design: Cross-sectional surveys.
Setting: We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan).
Participants: We used data from non-pregnant adults (≥20 years) from the aforementioned cities that responded to a cost-of-illness questionnaire. We estimated health …

When Myocardial Infarction Is Choosing Young Victims, Cristina Nedelcu, Mihaela Ionescu, Paris Ionescu, Vitalie Morosanu, Gabriel Smarandache, Dumitru Cristinel Badiu, Florentina Gherghiceanu, Vlad Denis Constantin, Emanuele Maria Merlo, Daniel Niţă

Journal of Mind and Medical Sciences

We present the case of a 31-year-old patient, without cardiovascular risk factors, without significant pathological or family history of cardiovascular disease, who was diagnosed with severe coronary artery disease, left main bifurcation localization, which required surgical coronary revascularization. The angiographic and intraoperative aspect excluded the most common causes of non-atherosclerotic causes of coronary lesions. Vasculitis was another possible etiology but was also excluded based on the normal clinical examination, negative inflammation markers, lack of diffuse vascular impairment, TPHA and negative VDRL. Prolonged mental stress can lead to accelerated progression of atherosclerosis by inducing endothelial dysfunction, our patient describing a “burnout …

Intestinal Microbiota – A Possible Contributor To Cardiovascular Diseases?, Roua Iorga, Ovidiu Gabriel Bratu, Nicolae Bacalbasa, Mihnea-Alexandru Gaman, Camelia Cristina Diaconu

Journal of Mind and Medical Sciences

The intestinal microbiota represents an interesting and emergent field of research, with already known implications in metabolic and immunological functions. Recently, there is increasing evidence that specific gut microbial populations are associated with cardiovascular diseases. Numerous completed and ongoing studies aim to evaluate the potential of intestinal microbiota assessment to improve the prevention, diagnosis, and therapeutic arsenal of cardiovascular diseases, considering dysbiosis as a cardiovascular risk factor. There is strong evidence for a correlation between intestinal flora imbalance and metabolic changes secondary to bacterial metabolites. In this minireview, we discuss recent data about the connections between intestinal microbiota and cardiovascular …

Diagnosis And Management Of Pericardial Effusion, Maria Manea, Ovidiu Gabriel Bratu, Nicolae Bacalbasa, Camelia Cristina Diaconu

Journal of Mind and Medical Sciences

Pericardial effusion is a common pathology in clinical practice. The etiology of pericardial effusion is diverse, from infectious diseases, malignancies, autoimmune diseases, chronic renal failure, to drug-related or after an invasive cardiac intervention. Clinical presentation of pericardial effusion is variable, depending on the volume of the fluid and the rate of accumulation. Clinical manifestations are dramatic if the pericardial fluid accumulates rapidly. Classical symptoms in pericardial effusion include pleuritic chest pain associated with dyspnea. In case of cardiac tamponade, orthopnea, jugular venous distension, pulsus paradoxus, hypotension, and shock appear. Transthoracic echocardiography is the gold standard investigation for the diagnosis of …

Covid 19 Myocarditis: Myth Or Reality?, Lamyae Sasbou Md

Journal of the Saudi Heart Association

COVID 19 so far is not a known cardiotropic virus, and the term “myocarditis” should be exclusively used after EMB or autopsy proven diagnosis.

We report a case of 26-year-old man admitted for COVID 19 infection and symptoms leading to a myocarditis. We describe the workup that led to the potential diagnosis.

Diagnostic Accuracy Of Global Longitudinal Strain For Detecting Significant Coronary Artery Disease In Diabetic Patients Without Regional Wall Motion Abnormality, Oumaima Alaika, Souad Jamai, Nawal Doghmi, Mohamed Cherti

Journal of the Saudi Heart Association

Objectives:

Speckle-tracking imaging is a novel method for assessing left ventricular (LV) function and ischemic changes. The aim of this prospective study was to assess the diagnostic accuracy of global longitudinal strain (GLS) and regional longitudinal strain (RLS) parameters at rest in comparison to stress echocardiography findings for detecting significant coronary artery disease (CAD) in patients with diabetes mellitus (DM).

Methods:

We prospectively studied echocardiographic characteristics at rest with Speckle tracking echocardiography (2D STE) measures ; then stress echocardiography and coronary angiography data in 34 diabetic patients without regional wall motion abnormality (RWMA) at rest. Patients were grouped according to …

Non-Traditional Risk Factors And The Risk Of Myocardial Infarction In The Young In The Us Population-Based Cohort, Chayakrit Krittanawong, Yiming Liu, Dhruv Mahtta, Bharat Narasimhan, Zhen Wang, Hani Jneid, Jacqueline E. Tamis-Holland, Alam Mahboob, Usman Baber, Salim S. Virani

Office of the Provost

Although most prevalent in elderly, myocardial infarction (MI) also affects younger adults. We sought to investigate baseline characteristics in young patients (<55 >years) with MI using the National Inpatient Sample (NIS) database between 2004 and 2015. Multivariable logistic regression models were used to assess factors associated with acute myocardial infarction (AMI) in young patients. After multivariable analyses adjusted for age, sex, race, family history of atherosclerosis, body mass index (BMI), diabetes, hypertension, hyperlipidemia, chronic kidney disease, and current cigarette smoking; novel risk factors such as human immunodeficiency virus (HIV), systemic lupus erythematosus (SLE), and obstructive sleep apnea (OSA) were associated …

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3.26 …

Unusual Case Of Pump Thrombosis In Lvad Patient With Covid-19 — Diagnostic Challenges, William H. Frick Md, Ryan D. Mallory, Maya Guglin, Eve Anderson, Erin N. Lushin, Rey P. Vivo, Kashif Saleem, Roopa A. Rao

The VAD Journal

We present the first reported case of left ventricular assist device (LVAD) pump thrombosis in the setting of the coronavirus pandemic. We describe the clinical features of the case which helped to differentiate coronavirus disease 19 (COVID-19) from LVAD pump thrombosis. The patient is 56-year-old female supported by destination LVAD therapy. She was originally implanted with a HeartMate II device in 2015 and underwent two pump exchanges in 2017 and 2019 for pump thrombosis, despite medication adherence. Shortly after routine lab work revealed near doubling of her lactate dehydrogenase (LDH) levels, she tested positive for COVID-19. She then developed power …

Cardiac Magnetic Resonance Evaluation Of Cardiac Masses In Patients With Suspicion Of Cardiac Masses On Echo Or Computed Tomography, Fateh Ali Tipoo Sultan, Syed Waqar Ahmed

Section of Cardiology

Objectives: In recent years, cardiac magnetic resonance (CMR) imaging has emerged as an important tool in the identification and characterization of cardiac masses. No imaging data on cardiac masses are available from Pakistan. We aimed to review the clinical presentation, CMR findings, and outcome of patients referred for CMR due to suspicion of cardiac masses on echocardiogram or computed tomography (CT).
Material and methods: We reviewed all the patients referred for CMR at Aga Khan University Hospital, Karachi, from January 2011 to March 2020, with the suspicion of cardiac mass on echocardiogram and/or CT. Only those with the confirmed diagnosis …

Increased Epicardial Adipose Tissue Is Associated With The Extent Of Aortic Dissection, Ahmet S. Yõlmaz

Journal of the Saudi Heart Association

Background: Epicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection.

Methods: We retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of …

Subaortic Membrane And Patent Ductus Arteriosus In Rare Association-Case Series, Hussain Moafa, Mohammed Alnasef, Obayda M. Diraneyya, Fahad Alhabshan

Journal of the Saudi Heart Association

Background: The combination of subaortic membrane (SAM) and patent ductus arteriosus is very rare. Subaortic stenosis is the second most common form of left ventricular outflow tract (LVOT) obstruction after valvular aortic stenosis. We are reporting the largest case series of SAM and PDA. Methods: We included all patients that were diagnosed with the combination of SAM and PDA at our cardiac center. We have reviewed patients echocardiographic studies, cardiac catheterizations, surgical notes and all the outpatients notes. Results: We have a total of 7 patients. The age at presentation was in the early childhood with 3 patients diagnosed in …

Stroke In Young Adults: Current Trends, Opportunities For Prevention And Pathways Forward, Tamer Yahya, Mohammad Hashim Jilani, Safi U. Khan, Reed Mszar, Syed Zawahir Hassan, Michael J. Blaha, Ron Blankstein, Salim S. Virani, Michelle C. Johansen

Office of the Provost

Cardiovascular disease remains a major contributor to morbidity and mortality in the US and elsewhere, and stroke is a leading cause of disability worldwide. Despite recent success in diminishing stroke incidence in the general US population, in parallel there is now a concerning propensity for strokes to happen at younger ages. Specifically, the incidence of stroke for US adults 20-44 years of age increased from 17 per 100,000 US adults in 1993 to 28 per 100,000 in 2015. Occurrence of strokes in young adults is particularly problematic as these patients are often affected by physical disability, depression, cognitive impairment and …

Does Preoperative Dipyridamole-Thallium Scanning Reduce 90-Day Cardiac Complications And 1-Year Mortality In Patients With Femoral Neck Fractures Undergoing Hemiarthroplasty?, Chin-Yi Liao, Timothy L. Tan, Yu-Der Lu, Cheng-Ta Wu, Mel S Lee, Feng-Chih Kuo

Rothman Institute Papers

BACKGROUND: This study aimed to evaluate the effect of dipyridamole-thallium scanning (DTS) on the rates of 90-day cardiac complications and 1-year mortality in patients with a femoral neck fracture treated with hemiarthroplasty.

METHODS: Between 2008 and 2015, 844 consecutive patients who underwent cemented or cementless hemiarthroplasty were identified from the database of a single level-one medical center. One-hundred and thirteen patients (13%) underwent DTS prior to surgery, and 731 patients (87%) did not. Patient characteristics, comorbidities, surgical variables, and length of the delay until surgery were recorded. A propensity score-matched cohort was utilized to reduce recruitment bias in a 1:3 …

Ultra Long Stent In An Aberrant Right Coronary Artery, Desabandhu Vinayakumar, Jomy Vadasseril Jose

Journal of the Saudi Heart Association

The prevalence of anomalous origin of right coronary artery from the left sinus is about 0.92%. A percutaneous coronary intervention (PCI) in such a vessel is challenging especially when maneuvering long stents. We report a case of 75- year old female patient with recent acute coronary syndrome. The angiogram showed significant lesions in the left anterior descending coronary artery and the left circumflex coronary artery with an aberrant RCA originating from the left sinus close to the origin of LMCA with multiple tight lesions. The aberrant RCA was stented with a 50 mm long stent. To the best of our …

Accidental Snapping Of Right Ventricular Pacing Lead With Micra, Vivek Singh Guleria, Prafull Sharma, Prashant Bharadwaj

Journal of the Saudi Heart Association

Leadless pacemaker implantation rates are increasing worldwide. These pacemakers have to be deployed , captured and redeployed in order to achieve optimal electric parameters. Various complications occur during this procedure. We herein report a unique case, where right ventricular(RV) pacing lead of the patient was accidentally snapped during MICRA deployment in a elderly male with pocket site infection.

Effect Of Coronary Artery Bifurcation Angle On Atherosclerotic Lesion Localization Distance To The Bifurcation Site, Murat Ziyrek, Ahmet Lütfü Sertdemir, Mustafa Duran

Journal of the Saudi Heart Association

Objectives: Although percutaneous coronary interventions become a common treatment modality for coronary artery diseases, lesion localization make these procedures more complex. As the lesion localizes near to the bifurcation site, more complex PCI procedures, overqualified equipments are needed and complication risk increases. Previous studies have demonstrated the strong correlation between wide angulation and significant coronary stenosis. However, a paucity of data exists about the association between bifurcation angle and lesion localization distance. In this study we analysed the effect of coronary bifurcation angle and left main coronary artery length on the atherosclerotic lesion localization.

Methods: Patients, who underwent coronary angiography …

Outcomes Of Cancer Patients Undergoing Transcatheter Aortic Valve Replacement., Vardhmaan Jain, Anas M Saad, Mohamed M Gad, Agam Bansal, Omar Abdelfattah, Medhat Farwati, Keerat R. Ahuja, James Yun, Amar Krishnaswamy, Samir R Kapadia

Reading Hospital Cardiovascular Medicine Fellowship

No abstract provided.