Cardiology Commons^™

Lightning Assocated With More Visits To The Ed For Chest Pain, Bailee Lichter, Benjamin Aaker

Scholarship Pathways Program

This study investigates the potential association between lightning events,used as a proxy for thunder, and increased emergency department (ED) visits for chest pain and myocardial infarction (MI). Electronic medical records from Avera McKennan Hospital were analyzed for chest pain and MI diagnoses between June 1 and July 31, 2021. Lightning data within a 100-mile radius were obtained from Vaisala and cross-referenced with patient presentation times. Statistical analysis revealed a significant increase in chest pain-related ED visits within 0.5 hours and between 2.5 to 5.5 hours following lightning strikes, with p-values ranging from 0.018 to 0.047. Although a trend toward increased …

Spectrum Of Coronary Artery Involvement With Multisystem Inflammatory Syndrome In Children Versus Kawasaki Disease., Simon Lee, Ashraf S. Harahsheh, Geetha Raghuveer, Michael A. Portman, Arash A. Sabati, Michael Khoury, Nagib Dahdah, Marianna Fabi, Supriya S. Jain, Audrey Dionne, Kyle Runeckles, Frederic Dallaire, Nadine F. Choueiter, Tyler H. Harris, Matthew D. Elias, Anji T. Yetman, Balasubramanian Sundaram, Luis M. Garrido-Garcia, Nilanjana Misra, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There is significant overlap in clinical features between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD). We sought to compare the prevalence, severity, and associated factors for coronary artery (CA) involvement.

METHODS AND RESULTS: From January 1, 2020 through January 31, 2023, 1191 patients with MIS-C and 554 patients contemporaneously diagnosed with KD were enrolled into the International Kawasaki Disease Registry. Demographic and clinical features, laboratory values, maximum Z score in any CA branch +2.5 or greater) were determined separately for each diagnosis using multivariable logistic regression analyses. The prevalence of CA aneurysms was lower for MIS-C …

Response To The Letter Titled: “Platelet-To-White Blood Cell Ratio As A Prognostic Biomarker For Spontaneous Reperfusion After Primary Percutaneous Coronary Intervention” By Hinpetch Daungsupawong, Gökhan Alıcı, Tayfur Erdoğdu, Arafat Yıldırım, Özge Ö. Abacıoğlu, Ömer Genç, Ceyhun Yücel, Örsan D. Urgun, Abdullah Yıldırım, Şerafettin Demir

Journal of the Saudi Heart Association

No abstract for this article type.

Platelet-To-White Blood Cell Ratio And Prognostic Biomarker For Spontaneous Reperfusion After Primary Percutaneous Coronary Intervention, Hinpetch Daungsupawong, Viroj Wiwanitkit

Journal of the Saudi Heart Association

No abstract for this article type.

Intractable Hiccups As The Presenting Symptom Of Relapsed Salmonella Bacteremia Complicated By Salmonella Endocarditis, Sahej Arora, Tripti Jain, Hafsa Jawaid, Nada Hafez, Binita Neupane

Advances in Clinical Medical Research and Healthcare Delivery

Salmonella infections are generally acute diarrheal illnesses that uncommonly spread to deeper or endovascular tissues, with key symptoms being nausea, vomiting, diarrhea, abdominal pain and fever. We present a case of a 76-year male who presented chiefly with recurrent intractable hiccups after finishing two weeks of oral ciprofloxacin for a previous episode of Salmonella bacteremia. He was ultimately found to have an aortic root vegetation on transesophageal echocardiogram and focal adenomyomatosis on gallbladder ultrasound. He underwent cholecystectomy, aortic valve replacement and six weeks of antibiotic therapy with resolution of his hiccups. Our case demonstrates an atypical symptom of intractable hiccups …

Normothermic Regional Perfusion In Donation After Circulatory Death: The Essential Role Of The Certified Clinical Perfusionist. A Scoping Review., Robert A. Perdue

Student Works

Background: Donation after Circulatory Death (DCD) was the original mode of transplantation (e.g., first lung transplant in 1963 and first heart transplant in 1967) (1,2) but was largely abandoned post-1968 following the Harvard brain-death criteria (3). Recently, Normothermic Regional Perfusion (NRP) has renewed interest in DCD by mitigating warm ischemic injury. However, Certified Clinical Perfusionists (CCPs), who manage the extracorporeal circuits essential for NRP, remain largely overlooked or underrepresented in protocols and literature, even though they are, according to the American Board of Cardiovascular Perfusion (ABCP), the only professionals “formally educated and trained in adult and pediatric extracorporeal technology” (4). …

A Storm Within: Anti-Nmda Receptor Encephalitis Mimicking Anxiety In A Young Woman, Izma Khaliq, Omar Sami Abdelhai, Angela Ishaq, Emmanuel Meram, Anointing Onuoha, Ahmed Jabri, William Dillon

Conference Presentation Abstracts

Case Description: A 21-year-old female with a history of asthma presented to the emergency department (ED) with restlessness, anxiety, and loss of appetite shortly after returning from a trip to France, where she and her boyfriend ended their relationship. Her initial evaluation, including unremarkable laboratory results, led to the attribution of her symptoms to anxiety from life stressors. She was treated with supportive measures in the ED and prescribed Xanax by her primary care physician at follow-up. Six days later, the patient returned to the ED with hallucinations and panic attacks. Again, laboratory results were unremarkable, and she was diagnosed …

Case Report - Complex Management Of Tricuspid And Pulmonic Valve Endocarditis In An Intravenous Drug User: A Case Report And Review Of Challenges And Outcomes, Luxhman Gunaseelan, Michael Kattula, Sam Alsabti, Ahmad El-Gammal, Khurram Arshad, James Richard Spears

Conference Presentation Abstracts

Background: Right-sided infective endocarditis (RSIE), commonly associated with intravenous drug use (IVDU), primarily affects the tricuspid valve (TV). With sustained bacteremia, the pulmonic valve may also become involved. Staphylococcus aureus remains the leading cause of tricuspid valve infective endocarditis (TVIE), diagnosed using Duke’s criteria, which integrate clinical findings, blood culture results, and echocardiographic evidence. The management of TVIE poses unique challenges, particularly in patients with IVDU, who often face barriers to surgical intervention despite severe complications like tricuspid regurgitation (TR), which normally carries a poor prognosis if left untreated. Case Presentation: We describe the case of a 39-year-old female with …

Profound Endocarditis Resulting In Recurrent Fatigue, Shawn Matharu, Majid Qazi

Conference Presentation Abstracts

A 46 year-old female with past medical history of congenital aortic stenosis status post bovine bioprosthetic valve replacement and an ascending aortic aneurysm repair 13 years prior to presentation presented with fatigue and generalized weakness. The patient also had a history of non-obstructive coronary artery disease, hypertension, and HFpEF. She recently was diagnosed with infectious mononucleosis 3 weeks prior. In the 1 month prior to her index presentation she had two prior admissions for respiratory symptoms. On physical exam, the patient had a 4/6 holosystolic murmur. Her laboratory markers revealed a profound leukocytosis, mild anemia, a mild troponinemia, hypokalemia, and …

Coronary Subclavian Steal Syndrome: A Rare But Deadly Complication In Post-Cabg Patients, Hazem Alakhras, Parvathy Sankar, James Goldstein

Conference Presentation Abstracts

Coronary Subclavian Steal Syndrome (CSSS) is a rare but serious complication of coronary artery bypass grafting (CABG). It occurs when the left anterior descending (LAD) coronary artery is bypassed from the left subclavian artery (LSA) using the left internal mammary artery (LIMA). The syndrome arises due to stenosis of the LSA, leading to reduced blood flow through the LIMA. This triggers retrograde flow from the LIMA to the distal LSA, resulting in myocardial ischemia despite patent grafts. Clinical presentation can vary from asymptomatic cases to severe manifestations such as new-onset heart failure or acute coronary syndrome (ACS). A 79-year-old female …

Double Trouble: A Case Of Persistent Left-Sided Superior Vena Cava, Lark Steafo, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Shazil Mahmood, Steven Timmis

Conference Presentation Abstracts

A persistent left-sided superior vena cava (PLSVC) is a rare vascular anomaly where the left superior cardinal vein fails to regress during embryogenesis, resulting in an additional venous structure that drains into the right atrium, often via the coronary sinus. It is usually asymptomatic but may be discovered incidentally during imaging or procedures, but its presence can have implications for central venous access and pacemaker placement. Our case features an 82-year-old male with a past medical history of coronary artery disease, remote esophageal cancer, hypertension, hyperlipidemia, and tobacco use disorder, referred to the emergency department from his primary care doctor’s …

Valproate Use Is Associated With Lower Hepatic And Cardiovascular Outcomes When Compared To Levetiracetam In Patients With Masld/Mash: A Multinationalanalysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate and levetiracetam are commonly used to manage epilepsy. While valproate is well-documented to significantly affect lipid metabolism, less is known about the effects of levetiracetam. Given this, worse outcomes in MASLD/MASH are anticipated in patients treated with valproate.

The aim of our study is to compare hepatic and cardiovascular outcomes in MASLD/MASH patients treated with valproate versus levetiracetam.

A Curious Case Of Heart Failure With Reduced Ejection Fraction In A Lupus Patient, Farah Khan Md

Posters

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with cardiovascular risks, including coronary artery disease (CAD) and typically heart failure (HF) with preserved ejection (HFpEF). We report an SLE patient with ventricular arrhythmias and HF with reduced ejection fraction (HFrEF) due to myocarditis, responding positively to Guideline-Directed Medical Therapy (GDMT) for both conditions

Global Results From The Optimize Pro Study: Standardized Tavr Technique And Care Pathway., Kendra J Grubb, Hemal Gada, Douglas Fraser, Josep Rodes-Cabau, Tamim M Nazif, Suneet Mittal, Danny Dvir, Emmanuel Teiger, Lang Lin, Joshua D Rovin, Ramzi F Khalil, Ibrahim Sultan, Matias B Yudi, Blake Gardner, David Lorenz, Stanley Chetcuti, Nainesh C Patel, James Harvey, Paul Mahoney, Deepak Talreja, Carlo Trani, Darren Mylotte, Brian Schwartz, Zubair Jafar, Jan Van Der Heyden, Diego Maffeo, Gerald Yong, Cesar Moris, John Wang, Robert Gooley, Katie Flor, Yu Jung Yeh, Steven J Yakubov

OhioHealth Research Institute Articles

BACKGROUND: The safety and efficacy of utilizing standardized implant protocols and care pathways are limited in large global prospective studies of transcatheter aortic valve replacement (TAVR), and institutional variability remains. This analysis aims to report 30-day outcomes from the global Optimize PRO study evaluating valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving Evolut PRO/PRO+ valves.

METHODS: The Optimize PRO study is a multicenter, postmarket, prospective study conducted in 50 centers in the United States, Canada, Europe, the Middle East, and Australia. Patients with symptomatic severe aortic stenosis and …

Broadening And Broadcasting The Impact Of Cardiovascular Risk Factors Among Muslim Residents Of Southern New Jersey With Special Emphasis On Opportunities Of Future Interventions And Prevention Tactics, Maikel Mansour, Ocean Alam, Samiha Hossain, Kirsten M. Carlberg, Katarina Rusinak

Rowan-Virtua Research Day

According to AHA and NIH, CVD includes stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease. Between 2017 and 2020, 127.9 million US adults (48.6%) had some form of CVD.

Among the target population, it was found that observing Ramadan fasting leads to an increase in total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels post-fasting. Yet, Islam emphasizes the importance of physical health as a privilege from God (Allah (swt)) and is seen as a religious duty.

The objective of the HCOP service project was to investigate the …

Comparative Long-Term Outcomes Of Cell Therapy And Cardiac Rehabilitation In The Treatment Of Non-Ischemic Dilated Cardiomyopathy, Awrush Sean Namazi, Susrut Dube, Jay Kishor Patel

Rowan-Virtua Research Day

This systematic review explores long-term treatment approaches for non-ischemic dilated cardiomyopathy, comparing cell therapy and cardiac rehabilitation. Cardiomyopathy is characterized by the progressive thinning and deterioration of cardiac muscle and is a significant cause of heart failure. Various treatment modalities have been developed to combat cardiomyopathy and prevent the onset of heart failure, with more recent efforts focusing on cell therapy—particularly allogeneic and autologous stem cell transplants. The efficacy of these novel treatments was compared to more established regimens, particularly cardiac rehabilitation. Studies demonstrate that both treatment modalities are associated with a significant overall improvement in ejection fraction (effect size …

Outcomes Of Left Atrial Appendage Occlusion In Patients With Obstructive Sleep Apnea: A Comprehensive National Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to explore a sample of the inpatient population with OSA with AF who underwent LAAO.

Artificial Intelligence In Detecting Heart Failure - A Systematic Review, Dale Shober, Kyle Kowalski, Aria Sen

Rowan-Virtua Research Day

Many studies have presented an artificial intelligence (AI) model to read electrocardiograms (ECGs) for the purpose of detecting or classifying the severity of heart failure. While most literature suggests that these AI-ECG models are effective at detecting or classifying heart failure, their efficacy in comparison to the current standards of care is not well researched. Furthermore, the barriers to implementation and the risks of these systems have not been studied and compiled. This literature review aims to outline the efficacy of AI-ECG models, determine how effective AI-ECG is in comparison to the standards of care, and outline the barriers to …

Enhancing Diagnostic Accuracy In Dyspnea: The Role Of Ai-Enhanced Ecg Interpretation, Sami Asif, Ayesha Mushtaq

Rowan-Virtua Research Day

Dyspnea is a frequent and diagnostically challenging presentation in emergency departments, requiring rapid distinction between cardiac and non-cardiac causes. Traditional approaches, including NT-proBNP testing and clinical assessment, often lack optimal sensitivity and specificity. Recent advancements in artificial intelligence (AI) have introduced AI-enhanced electrocardiogram (ECG) analysis as a promising diagnostic tool capable of identifying cardiac dysfunction with high accuracy.

A structured literature review was performed using PubMed to identify randomized controlled trials, prospective validations, and systematic reviews published between 2018 and 2024. Studies evaluating AI-ECG performance, NT-proBNP testing, and clinical assessment in adult patients presenting with dyspnea were included. Data extracted …

Takotsubo Syndrome: A Case Of Acute Altered Mental Status, Aphasia, And Weakness, Yue Chen, Ramza Rukia, Daniel Goldsmith

Rowan-Virtua Research Day

Background: Stress-induced cardiomyopathy (SICM), also known as Takotsubo syndrome, can mimic acute coronary syndrome despite the absence of obstructive coronary artery disease. This case report explores the diagnostic workup and management of a patient with potential SICM presenting with sudden onset altered mental status, aphasia, and weakness.

Case: A 46-year-old woman with no past medical history presented with acute altered mental status, aphasia, and weakness requiring intubation. Blood glucose level was 123 mg/dL. Initial workup for stroke was negative. Extensive neurological workup, including cranial imaging and electroencephalography, revealed no abnormalities.

Initial ECG was unremarkable, but elevated troponin levels and a …