International Journal of Clinical Cardiology is an open access journal which publishes original clinical research in cardiology. This peer review journal publishes original articles, case reports and reviews targeted to cardiologists, cardiology researchers across the globe. The Journal welcomes submission of papers from experts, clinical academics and researchers. The journal publishes the latest findings in cardiovascular medicine, cardiovascular diseases and observational studies. The journal publishes original communications of scientific excellence concerned with clinical research on cardiology, clinical approach to the diagnosis and treatment of cardiovascular disease.

Through open access it expands shared knowledge across doctors; it provides the free, immediate, availability of the published work online. This journal also involved into publishing news with time by time developments and advances in research of various clinical advancements and their treatments. The journal also publishes all types of article like reviews, commentaries, case reports and many more. We mainly strengthen and request the authors to submit the results with the clear and detailed explanation to follow by the rigorous review process.

Journal Information

Title: International Journal of Clinical Cardiology

ISSN: 2378-2951

Editor-in-chief: Breijo-Marquez

NLM title abbreviation: Int J Clin Cardiol

ICV: 89.24

ISO abbreviation: Int J Clin Cardiol

Other titles: IJCC

Category: Cardiology

DOI: 10.23937/2378-2951

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email:

Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI


 Open Access DOI:10.23937/2378-2951/1410292

Middle Aortic Syndrome Presented in Pregnancy-Treated with Percutaneous Intervention Followed by Successful Management of the Complications

Jayakrishna Niari, Avinash A Gutte, Nagesh Waghmare, Kalyan S Munde, Samkit Mutha and Hariom Kolapkar

Article Type: Case Report | First Published: 2024/03/06

Mid-aortic syndrome is a clinical condition characterized by segmental narrowing of the abdominal or descending thoracic aorta, often resulting in severe hypertension. It can manifest as either a congenital abnormality or as one of several acquired conditions. Given the limited evidence available on the treatment of this syndrome, various approaches have been reported, including surgical intervention and endovascular treatments such as stent placement and medical management alone....

 Open Access DOI:10.23937/2378-2951/1410291

Prevalence and Risk Factors of In-Hospital Mortality of ST Elevation Myocardial Infarction (STEMI) Patients during January-December 2021 at Bekasi District General Hospital

Khanza Rizqullah Syauqi, Mailani Karina Akhmad and Omar Mokhtar Siregar

Article Type: Research Article | First Published: 2024/03/03

Acute coronary syndrome (ACS) is a major cardiovascular problem. According to the World Health Organization (WHO) in 2015, cardiovascular disease caused 17.5 million deaths, while ACS caused 7.4 million deaths. ACS is a condition when the plaques are accumulated in coronary arteries that supply oxygen to the heart muscles. The ST-Elevation Myocardial Infarction (STEMI) is an indicator of total coronary artery occlusion....

 Open Access DOI:10.23937/2378-2951/1410290

Double Trouble: Bilateral Coronary Artery Fistulae - A Case Report

James Millhouse, MD, Harish Kamalanathan, MD, Kuljit Singh, MBBS, FRACP, PhD and Selvanayagam Niranjan, MD, FRACP

Article Type: Case Report | First Published: 2024/01/16

Coronary artery fistulas are abnormal communications between the coronary arteries and other cardiac or pulmonary structures. Many patients are asymptomatic; however, symptoms and complications may develop with increasing age. We discuss a rare case of a 56-year-old woman presenting with chest pain WHO was found to have bilateral coronary fistulae. We also review relevant literature regarding diagnosis and management options....

 Open Access DOI:10.23937/2378-2951/1410289

Dengue Myocarditis with Gitelman Syndrome Presenting as Arrhythmic Syncope: A Case Report of Acute Fulminant Dengue Myocarditis Resulting to Acquired Long QT Syndrome

Billy Joseph David, Donna Aurea Maderazo, Dianne Camille Gaspar-Cabrera1 and Rod Castro

Article Type: Case Report | First Published: 2024/01/11

Dengue is an arthropod-borne viral infection endemic to tropical areas. Dengue myocarditis is a rare cardiac manifestation of arrhythmic syncope; however, the pathophysiology behind it is not yet clearly elucidated. Severe electrolyte imbalance is among the common causes that aggravate cardiac dysrhythmia. One disease entity that presents with salt-losing tubulopathy is Gitelman syndrome....

 Open Access DOI:10.23937/2378-2951/1410288

A Young African Man with Familial Hypercholesterolemia Presenting with Coronary Artery Disease

Justine Namukasa, Daniel Iraguha, Happy Lilian Mbabazi, Isaac Ssinabulya and Charles Lugero

Article Type: Case Report | First Published: 2023/12/24

40-year-old African man presented with typical anginal pain and cutaneous swelling. Examination revealed had corneal arcus, multiple tendon xanthomas and xanthelasmas. The investigation panel showed dyslipidemia with very high total cholesterol of 642.3 mg/dl, very high low-density lipoprotein of 531 mg/dl, low high-density lipoprotein of 36.7 mg/dl and high triglyceride of 248.1 mg/dl and he had a positive stress test....

 Open Access DOI:10.23937/2378-2951/1410287

Cardiac Tamponade as the First Manifestation of a Systemic Disease

Maria Inês Barradas, MD, Fabiana Duarte, MD, Inês Coutinho dos Santos, MD, Anabela Tavares, MD and Dinis Martins, MD

Article Type: Case Report | First Published: 2023/12/03

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation, and is a common cause of pericarditis and pericardial effusion, but significant pericardial effusion and cardiac tamponade are rare and even rarer as the first manifestation. We report the case of a young male who presented with fever, recurrent pericarditis and polyserositis with pericardial and bilateral pleural effusion....

 Open Access DOI:10.23937/2378-2951/1410286

Deferred vs. Performed Percutaneous Coronary Intervention for Coronary Stenosis with Grey-Zone Fractional Flow Reserve Values

Mohamed Abdelsalam Ali Mousa, MD, Hesham Hegazy Ali, MD, Mohamed Ahmed Oraby, MD, Walid Hassan, MD, MACP, FAHA, FACC, FACP and Ahmed Hassan Abdelmoneim, MD

Article Type: Research Article | First Published: 2023/10/21

Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has shown better clinical outcomes than conventional angiography-guided PCI. The optimal FFR cut-off value for revascularization is debated. With FFR ≤ 0.75, revascularization for coronary artery disease (CAD) stenosis is associated with improved clinical outcomes, whereas with FFR ≥ 0.8, medical treatment has been shown to result in favorable long-term outcomes. ...

 Open Access DOI:10.23937/2378-2951/1410285

Right Ventricular Mass: A Unique Approach to Tissue Diagnosis

Bistees George, MD, Marina Sharif, MD, Rishi Bolla, BS, Shaheen Muhammad, MD and Stephen Cook, MD

Article Type: Case Report | First Published: 2023/10/05

A 57-year-old male with history of head and neck squamous cell carcinoma (HNSCC), in remission, presented with face and neck swelling and dyspnea. He was found to have recurrence of his HNSCC at the base of his tongue and a new right ventricular mass. Two endomyocardial biopsy attempts yielded benign tissue. A trans-jugular core needle biopsy performed, under fluoroscopy and intracardiac echocardiogram (ICE) guidance, revealed metastasis of primary tumor....

 Open Access DOI:10.23937/2378-2951/1410282

Surgical Treatment for Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Patient with Rheumatic Heart Disease: A Case Report and Literature Review

Lixi Gan, Oudi Chen, Weiteng Wang, Fanyu Chen, Hongkun Qing, Qingyan Ma, Xin Li and Xuhua Jian

Article Type: Case Report | First Published: 2023/09/30

Anomalous origin of the right coronary artery (RCA) from the pulmonary artery (ARCAPA) is a rare congenital heart disease with varied clinical presentations, ranging from an asymptomatic murmur to sudden death. Surgery to rebuild the physiological coronary system is strongly recommended to prevent complications....

 Open Access DOI:10.23937/2378-2951/1410281

A Rare Case of IgG4-Related Disease Manifesting as Constrictive Pericarditis

Bistees George, MD, Eric Bain, MD, Justin Meier, MD, Justin S Stano, MD and Upasana Jarori, MD

Article Type: Case Report | First Published: 2023/09/15

Constrictive pericarditis (CP) can occur secondary to multiple etiologies such as idiopathic pericarditis, post-cardiovascular surgeries, post-chest radiation therapy, and rarely rheumatologic diseases. We report a rare case of a 41-year-old male who was found to have IgG4-related disease (RD) manifesting as isolated constrictive pericarditis treated with pericardiectomy and immunosuppressive agents....

 Open Access DOI:10.23937/2378-2951/1410280

CIED Infection Management: Gaps between Guidelines and Patients

Michael M Dore, MD

Article Type: Review Article | First Published: 2023/09/09

The implantation of cardiac implantable electronic devices (CIED) and subsequent CIED infections have risen in recent years; a retrospective study the National Inpatient Sample (NIS) discharge records revealed an 96% increase in CIED implantations between 1996 and 2008; in accordance with the increase in device implantations, this study showed a 210% increase in CIED infections in the same time period....

 Open Access DOI:10.23937/2378-2951/1410279

Atrial Flutter as the Primary Manifestation of Lupus Flare Up

Varinder Bansro, MD, Tekabe Birhane, MD, Marvi Gurbakhshani, MD, Fregenet Gichamo, MD and Uchenna Unamba MD

Article Type: Case Report | First Published: 2023/08/07

This review article explores the association between atrial flutter and systemic lupus erythematosus (SLE). Atrial flutter, a common cardiac arrhythmia, has been recognized as a potential cardiovascular manifestation of SLE, a chronic autoimmune disease. The abstract summarizes the current literature on the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of atrial flutter in patients with SLE. Furthermore, it highlights the challenges in diagnosing and treating th...

 Open Access DOI:10.23937/2378-2951/1410278

Uric Acid as a Novel Component of Metabolic Syndrome

Rodney G Bowden, PhD, Kathleen A Richardson, PhD and Luke T Richardson, PhD

Article Type: Original Research | First Published: 2023/06/30

A cross-sectional data analysis was conducted using the 2013-2018 NHANES datasets. Sample weights were assigned by NHANES researchers to each participant allowing researchers to generalize results to all non-institutionalized US civilians. The analysis included 6,432 individuals, which were representative of 94,729,059 US citizens....

 Open Access DOI:10.23937/2378-2951/1410277

Fever-Induced Brugada Syndrome (BrS): Clinical Case Presentation and Short Review on Brugada Syndrome

Almontasser Bella Kassier, MD, Adnan Kassier, MD, Yashwant Agrawal, MD and Jagadeesh Kalavakunta, MD

Article Type: Case Report | First Published: 2023/06/22

In 1992, Brugada syndrome (BrS) was described for the first time as a pattern of ST-segment elevation in right precordial electrocardiography (EKG) leads with a high incidence of unexplained cardiac arrest (UCA) and sudden cardiac death (SCD) in patients with structurally normal hearts [1]. It is associated with an autosomal dominant genetic predisposition. Therefore, in the case of diagnosed UCA or SCD, first-degree relatives are advised to be screened for cardiac abnormalities....

 Open Access DOI:10.23937/2378-2951/1410275

Non-Uremic Calciphylaxis in Patient of Non Recovered Postpartum Cardiomyopathy with Apla Syndrome

Aman Makhija, Jignesh Vanani, Arun Mohanty, Manchanda SG, Shashi Dhawan, Shilpa Garg, Manish Malik and Mantri RR

Article Type: Case Report | First Published: 2023/04/30

Calciphylaxis is rare, life-threatening calcific uremic arteriolopathy in patients with end stage renal disease. Rarely, it can occur in patients with normal renal function known as non-uremic calciphylaxis. Very scant literature and few case reports are available about non-uremic calciphylaxis. We present a case of 51-year-old female with reduced LV ejection fraction as sequelae of peripartum cardiomyopathy on long term warfarin who presented with calciphylaxis lesions with normal renal functio...

 Open Access DOI:10.23937/2378-2951/1410274

Effects of Performance Enhancement Drugs on Body Mass Index, Blood Pressure, and Blood Sugar Levels on a Healthy Adult Male: A Case Study

Resti Tito H Villarino and Maureen Lorence F Villarino

Article Type: Original Article | First Published: April 12, 2023

Anabolic-androgenic steroids (AASs) are used as performance enhancement and are widely utilized among athletes and non-athletes worldwide. Although the risk-benefit ratio of using Performance Enhancing Drugs (PEDs) explicitly Anabolic-androgenic steroids are primarily published as systematic reviews and post-mortem case reports, there are limited reports on the effects of PEDs on body mass index, blood pressure, and blood sugar levels. ...

 Open Access DOI:10.23937/2378-2951/1410273

The Impact of Novel Active Fixation Left Ventricular Leads and Conventional Passive Fixation Leads in Cardiac Resynchronization Therapy

Makoto Takano, MD, Hisao Matsuda, Tomoo Harada and Yoshihiro J Akashi

Article Type: Original Article | First Published: January 27, 2023

Left ventricular (LV) leads are important devices for stimulating the most delayed site in cardiac resynchronization therapy (CRT). Since April 2020, the Attain Stability Quad (ASQ) lead, which has a side helix for facilitating active fixation, has become available in Japan. We evaluated the benefits of ASQ leads compared with those of conventional passive fixation LV leads....

 Open Access DOI:10.23937/2378-2951/1410272

Effect of Edoxaban, F-Xa-Directed Oral Anticoagulant on Spontaneous Thrombolytic Activity in Apoe-/- and Ldlr-/- Double Knockout Mice

Kanae Hyodo, MS, Naotaka Ohta, PhD, Hiromitsu Ishii, MD and Tsutomu Yamashita, PhD*

Article Type: Original Article | First Published: December 01, 2022

The details of thrombolytic activity in occlusive disease associated with atherosclerotic lesions are not clear. This study investigated the novel effects of activated coagulation factor X (F-Xa)-directed oral anticoagulant (DOAC) edoxaban on in vivo thrombolytic activity and atherosclerosis progression. Mice were fed an experimental diet (edoxaban 15-50 mg/kg) for 18 weeks. The degree of progression of atherosclerosis was assessed as the area of atherosclerotic vessels as a percentage of the to...

 Open Access DOI:10.23937/2378-2951/1410271

siRNA-Induced Silencing of LP(a) Gene: An Ideal Choice to Prevent Genetic Risk of Myocardial Infarction

Muhammad Arslan

Article Type: Review Article | First Published: November 18, 2022

Elevated level of lipoprotein (a) gene is the main cause of inherited risk of myocardial infarction (MI). Several RNA based therapies are being developed to reduce the expression of LP(a) gene, but none of them are neither available in market, nor have been declared as perfect choice for treatment. An American multinational biopharmaceutical company, Amgen Inc, has recently disclosed remarkable test results of phase II trial of Olpasiran [a small interfering RNA-based (siRNA) therapy to target L...

 Open Access DOI:10.23937/2378-2951/1410270

Unusual Cause of a Left Ventricular Mass in an Octogenarian with Metastatic Squamous Cell Lung Cancer

Steven J Grampp, Christopher D Manko, Pranjal Boruah and Stephen Voyce

Article Type: Case Report | First Published: November 03, 2022

A computed tomography scan of the chest in an 83-year- old male patient with a history of metastatic squamous cell lung cancer revealed a mass localized to the left ventricle. Subsequent imaging revealed this to be an incidental cardiac fibroma. Echocardiographic, computed tomography and cardiac magnetic resonance images and a review of the literature is presented....

 Open Access DOI:10.23937/2378-2951/1410269

Multimodality Imaging Applied to Dilated Cardiomyopathy

João Baltazar Ferreira, Marco Beringuilho, Inês Fialho, Mariana Passos, Joana Lopes and Carlos Morais

Article Type: Review Article | First Published: October 03, 2022

Dilated cardiomyopathy is a heterogeneous group of diseases, in which imaging modalities are important for diagnosis, guiding therapy and prognostic assessment. Given the plethora of imaging techniques available, each one with its strengths and limitations, it is of crucial importance to appropriately select which ones to use based on the clinical context....

 Open Access DOI:10.23937/2378-2951/1410268

Single-Access Technique and Manta Device in Acute Myocardial Infarction Related Cardiogenic Shock

Andrea Bezzeccheri, MD, Antonietta Di Iorio, MD, Mario Scarpelli, MD and Carlo Briguori, MD, PhD, FACC, FSCAI

Article Type: Case Report | First Published: October 02, 2022

Cardiogenic shock (CS) occurs up to 10% of patients with acute myocardial infarction (AMI) and is associated with a high (> 50%) in-hospital mortality. Mechanical circulatory support (MCS) devices, such as Impella CP, are increasingly being used in patients with AMI complicated by CS. Recent data highlighted the issue of vascular complication and bleeding events in cardiogenic shock patients treated with Impella. In this setting, the “Single-access for High-risk PCI” (SHiP) technique and the...

 Open Access DOI:10.23937/2378-2951/1410265

Innovations in Electrophysiology Technologies and Devices

Samir Rafla, Aly Aboelhoda and Amr Kamal

Article Type: Review article | First Published: August 03, 2022

There are major advances and achievements in devices used in electrophysiology diagnosis and treatment. This short summary is collection of recent publications around this subject....

 Open Access DOI:10.23937/2378-2951/1410264

Improvement in Hypertension Symptoms and Measurement Readings of Blood Pressure with Non-Invasive Positive Pressure Ventilation in Hypertensive Patients having Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS)

Original Article

Article Type: Original Article | First Published: August 04, 2022

Hypertension is a common comorbidity in obstructive sleep apnea/hypopnea syndrome (OSAHS). OSAHS can raise blood pressures to pre-hypertensive and hypertensive ranges, increase the prevalence of “nondipping” overnight blood pressure patterns, and increase the risk of resistant hypertension. The gold standard treatment for OSAHS is non-invasive ventilation through CPAP...

 Open Access DOI:10.23937/2378-2951/1410262

Atrial Flow Regulator: A New Player for the Treatment of Refractory Heart Failure

Vincenzo Rizza, MD, Giuseppe Uccello, MD, Francesco Federico, MD, Mariano Pellicano, MD, PhD, Maurizio Tespili, MD and Alfonso Ielasi, MD

Article Type: Case Report | First Published: July 23, 2022

Described herein the case of a 55-year-old man diagnosed with advanced heart failure. He had a history of ischemic heart disease leading to moderate left ventricular systolic disfunction, symptomatic for effort dyspnoea despite optimal medical therapy. After coronary angiography and right heart catheterization (showing basal pulmonary capillary wedge pressures - PCWP - 20 mmHg), the patient underwent percutaneous inter-atrial shunt therapy (IAST) through the opposition of an Atrial Flow Regulato...

 Open Access DOI:10.23937/2378-2951/1410261

A New Method for Left Ventricular Lead Delivery: A Side Helix Can Overcome the Tortuous Left Lateral Vein of the Coronary Sinus

Makoto Takano, MD, Yukihiro Inamura, Hisao Matsuda, Tomoo Harada and Yoshihiro J Akashi

Article Type: Review Article | First Published: July 20, 2022

Cardiac resynchronization therapy (CRT) has become an established treatment for heart failure patients with conduction disorders and a significantly reduced ejection fraction. Nevertheless, CRT is limited by several complications, many of which are associated with the insertion of the left ventricular (LV) lead. The LV lead should be placed at the most delayed site in the left ventricle....

 Open Access DOI:10.23937/2378-2951/1410260

In-Hospital Cardiac Manifestations of COVID-19 Pneumonia and their Management

Rajkumar Gangappa Nadakinamani, Prashanth Panduranga, Mohammed Aziz Khandekar, James Pallivathukkal and Baher Youssef Hanna

Article Type: Review Article | First Published: July 09, 2022

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 has been declared a pandemic. Broadly, hospitalized COVID-19 pneumonia patients suffer two important cardiac effects. Firstly, when COVID-19 pneumonia affects people with pre-existing cardiovascular disease (CVD), they have worst outcomes compared to those without CVD....

 Open Access DOI:10.23937/2378-2951/1410259

Sudden Cardiac Arrest in Patient with Aortic Stenosis and Preexcitation

Vikas Kalra, MD and Krittapoom Akrawinthawong, MD

Article Type: Case Report | First Published: June 23, 2022

58-year-old male sustained sudden cardiac arrest (SCA) due to ventricular fibrillation (VF) while at work and was resuscitated with shock therapy. He had prior history of coronary artery disease with bypass, preexcitation, pulmonary hypertension, hyperlipidemia, Hodgkin's disease, hypothyroidism and squamous cell carcinoma....

 Open Access DOI:10.23937/2378-2951/1410258

Awareness of Smoking Cessation Aids in Heart Disease Patients at Governmental Hospitals

Hanin Bogari, Raghad Althubaiti, Ghaidaa Garoot and Asmaa Ali

Article Type: Original research article | First Published: June 13, 2022

Over one million people are smoking worldwide and the total numbers is expected to increase each year. Several studies have shown a relation between smoking and heart problems, which highlight special consideration in smoking cessation awareness in heart disease patients with established vascular disease as a secondary prevention....

 Open Access DOI:10.23937/2378-2951/1410257

Recurrent Pericardial Effusion following Diaphragmatic Hernia Repair

Rony Shah, MD, Aakash Patel, MD, James Craig, MD, Hassan Baydoun, MD and Jeffrey Jordan, MD

Article Type: Case report | First Published: June 13, 2022

The pericardial space is defined as the cavity between the visceral and parietal pericardium and it normally contains 10-50 mL of fluid. A pericardial effusion exists when the intrapericardial volume exceeds these limits. Any process that causes inflammation, injury, or decreased lymphatic drainage can cause a pericardial effusion....

 Open Access DOI:10.23937/2378-2951/1410256

The Effects of Intracoronary Nitroglycerine Administration on Lesion Parameters, Intervention Success and 1-Year MACE in Patients with Acute Coronary Syndromes

Hakan Duman, MD, Elif Ergül, MD, Hikmet Hamur, MD and Selami Demirelli

Article Type: Original Article | First Published: June 03, 2022

Nitroglycerine (NTG) was used to relieve ischemic symptoms in patients with coronary artery disease. However, some studies demonstrated the positive effects of NTG on coronary circulation. In addition, NTG has been administrated to evaluate culprit lesion characteristics during coronary angiography....

 Open Access DOI:10.23937/2378-2951/1410255

Acute Management of a Spontaneous Coronary Artery Dissection with a Distal Occlusive Thrombus

Trinava Roy, DO, Jason Naftulin, DO, Keith Brown, DO and Nicholas Roy, DO

Article Type: Case Report | First Published: May 30, 2022

We describe a unique case of a 57-year-old female who presented with chest pain who was found to have a ST segment elevation myocardial infarction (STEMI) on electrocardiogram....

 Open Access DOI:10.23937/2378-2951/1410254

Coronary Artery Ectasia and Oral Anticoagulation: A Case Report

Shivum Desai, BS, Justin Dombrowski, BS and Joseph Klag, DO, FACC, FSCAI

Article Type: Case Report with Brief Literature Review | First Published: April 30, 2022

Coronary Artery Ectasia is a pathology effecting nearly 4.9% of the general population. This disease process can be found in any one of the coronary arteries and often presents in patients with comorbid conditions such as coronary artery atherosclerosis and hypertension. This combination of disease processes is often difficult to treat due to the lack of peer-reviewed data and treatment guidelines for coronary artery aneurysms. Additionally, there is currently no general consensus on the use of ...

 Open Access DOI:10.23937/2378-2951/1410253

Partially Resolving Myocardial Fibrosis Five Months Following the mRNA COVID-19 Vaccine: An MRI Based Case Report

AFM Ashik Imran, DO, MBBS, Won Jun Park, MD and Michael R Sood, MD, MS

Article Type: Case Report | First Published: April 27, 2022

Myocarditis is a disease that has varying degrees of clinical manifestations. Furthermore, its diagnosis and management can pose as a challenge to clinicians. With over 250 million people receiving the mRNA covid vaccine, there have been rare reports of myocarditis, pericarditis or other cardiovascular involvement. However, its natural course remains unclear. We report a 30-year-old healthy male who was hospitalized 3 days after the second dose of the covid-19 vaccination. He had high cardiac la...

 Open Access DOI:10.23937/2378-2951/1410251

STEMI during Cardiocerebral Infarction (CCI): Is it Safe to Perform Primary Percutaneous Coronary Intervention?

Thon Hon Yong, Jia Hao Jason See and Boon Wah Liew

Article Type: Case Series | First Published: April 14, 2022

Emergency percutaneous coronary intervention (PCI) is a critically important reperfusion strategy for myocardial salvage in the event of acute ST elevation myocardial infarction (STEMI). However, it poses great challenges to the treating cardiologist if there is a simultaneous acute cerebral infarction because of potential intracranial complications. Particularly, the use of dual antiplatelet and high dose anticoagulants during PCI has been well documented to increase the risk for cerebral hemor...

 Open Access DOI:10.23937/2378-2951/1410252

Enlarged Left Ventricular Diastolic Dimension does not Predict Irreversible Left Ventricular Systolic Function in Patients with Atrial Arrhythmia

Hisao Matsuda, Yui Nakayama, Airi Noda, Toru Nakanishi, Dan Koto, Mizuho Kasahara, Takayuki Warisawa, Kei Mizukoshi, Makoto Takano, Koichi Mizuno, Akira Kasagawa, Tarou Suchi, Daisuke Togashi, Ikutarou Nakajima, Kenichi Sasaki, Hidekazu Miyazaki, Toshiyuki Furukawa, Tomoo Harada and Yoshihiro J Akashi

Article Type: Original Article | First Published: April 20, 2022

Atrial arrhythmia (AA) and left ventricular systolic dysfunction (LVSD) frequently co-exist, and potentially represent growing public health problems. Determining whether tachycardia is an indicator or consequence of LVSD in patients with tachycardia and LVSD is difficult. Tachycardia-mediated cardiomyopathy (TCM) raises a “chicken or egg” question. Regardless of the etiology, patients with severe LVSD are considered candidates for the implantation of a cardioverter defibrillator as primary ...

 Open Access DOI:10.23937/2378-2951/1410250

Left Atrial Myxoma and Systolic Anterior Motion of the Mitral Valve with Sigmoid Septum complicated by Left Ventricular Outflow Tract Obstruction

Zhenwei Teo, Jian Jing Tan, Chakaramakkil Mathew Jose and Jia Hao Jason See

Article Type: Case Report | First Published: March 30, 2022

Patients with symptomatic systolic anterior motion (SAM) of the anterior mitral valve leaflet and left ventricular outflow tract obstruction (LVOTO) pose significant challenges in their management. This often occurs in a setting of hypertrophic cardiomyopathy (HCM), and occurrence of SAM without HCM is uncommon. In this report, we present a case of anterior mitral valve leaflet SAM with sigmoid septum complicated by LVOT obstruction, as well as a concomitant left atrial myxoma, which was treated...

 Open Access DOI:10.23937/2378-2951/1410249

Patient Outcomes Cost, and Length of Stay Associated with Biventricular Assist Devices in the United States (2009- 2015)

Hyeon-Ju Ryoo Ali, Afshin Ehsan, Kevin Kennedy, Peter Riley, Angie Seo, Navkaranbir S Bajaj, Amitoj Singh, Frank Sellke, Daniel Levine, Michael Kiernan and Rayan Yousefzai

Article Type: Original Research | First Published: February 19, 2022

With recent advances in left ventricular assist device (LVAD) technology, the utilization of LVADs has increased while mortality, cost, and length of stay (LOS) have significantly decreased. This study sought to determine the national trends of surgically implanted biventricular assist devices (BiVADs). ...

 Open Access DOI:10.23937/2378-2951/1410248

Mitral Regurgitation in Hypertrophic Cardiomyopathy: A Narrative Review of Mechanism and Current Management

Ashraf M Anwar, MD, PhD, FESC

Article Type: Review Article | First Published: February 10, 2022

Significant mitral regurgitation (MR) is frequent in patients with hypertrophic cardiomyopathy (HCM) either obstructive or non-obstructive. Many studies described that significant MR is associated with poor long-term outcome of HCM patients, which indicate the importance of an adequate MR assessment including detailed evaluation of the mitral valve (MV) anatomy. Mitral malformations have been identified in HCM at all levels. They occur in the MV leaflets with a wide array of malformations of the...

 Open Access DOI:10.23937/2378-2951/1410247

Caseous Calcification of the Mitral Annulus: From Asymptomatic Lesion to Embolic Complication- Case Report

Slavica Mitrovska, MD, PhD, Sasko Jovev, Vasil Papestiev and Vesna Mitashova

Article Type: Case Report | First Published: January 24, 2022

Caseous calcification of the mitral annulus (CCMA) is a rare form of mitral annular calcification with a prevalence of 0.06% in the general population. It is considered a benign condition, but in some cases it carries a risk for cardiovascular and cerebrovascular events. There is no consensus regarding treatment strategy and surgery is recommended for mitral valve dysfunction or thromboembolic events. We present a case of surgical management of caseous mass of the posterior commissures of the mi...

 Open Access DOI:10.23937/2378-2951/1410245

Evolution of Pediatric Cardiology over the Last 50 Years - Part IV

P Syamasundar Rao, MD

Article Type: Review Article | First Published: December 17, 2021

The author has just written a book on the evolution of the specialty of Pediatric Cardiology over the last 50 years. The intent of this review is to present a summary of this book. Because of large amount of the material, the review is separated into four parts. In the Parts I and II, percutaneous interventional procedures were discussed. The Part III reviewed electrocardiography, echocardiography, and cardiac catheterization. In this last paper, subjects that were not discussed in the first thr...

 Open Access DOI:10.23937/2378-2951/1410246

Taurine in Congestive Heart Failure

Farrukh Ahmad, MD, Nitish Kumar Sharma, MD and Michelle Hadley, DO, FACC

Article Type: Review Article | First Published: December 23, 2021

Taurine is a ubiquitous amino acid found across the animal kingdom. It is a sulfur-containing amino acid, found in high concentration in the intracellular compartment of excitable tissue, including the myocardium. It functions as an intracellular osmolyte, involved in cell volume regulation. Being a neutral zwitterion, transport of taurine is not accompanied by a change in charge gradient across membranes. This chemical property makes taurine the perfect candidate of cellular osmoregulation. Tau...

 Open Access DOI:10.23937/2378-2951/1410244

A 75-Year-Old Female with Left Anterior Descending Coronary Artery Originating from the Right Coronary Artery Presenting with Recurrent Major Bleeding due to Dual Antiplatelet Therapy Managed with Percutaneous Coronary Intervention and Ticagrelor Monotherapy

Bekele Alemayehu Shashu, MD

Article Type: Case Report | First Published: December 09, 2021

A 75-year-old female with unstable angina who was found to have anomalous left anterior descending coronary artery originating from the right coronary artery close to the ostium presented with recurrent major bleeding while on dual antiplatelet therapy with aspirin and clopidogrel following percutaneous coronary intervention despite treatment with proton pump inhibitor and blood transfusion. When aspirin was discontinued the bleeding episodes subsided for 5 months which was followed by return of...

 Open Access DOI:10.23937/2378-2951/1410243

Draw your Heart Disease: A Graphic Assessment of the Knowledge of Congenital Heart Disease of Patients and their Parents

Paula Mariño García, Ángeles Fuertes Moure, Isaac Martínez Bendayán, Vanesa Balboa Barreiro and Fernando Rueda Núñez

Article Type: Descriptive Cross-Sectional Study | First Published: December 03, 2021

Patients with congenital heart disease are a chronically ill population. Knowledge of the disease is a key factor in promoting an appropriate attitude towards health. The aim of this study is to evaluate the understanding of heart involvement by describing the heart disease and drawing a picture of the heart by patients and parents. Descriptive cross-sectional study over an 8-month period in a tertiary pediatric cardiology center, involving 201 parents and 123 patients, of whom 74 were between 8...

 Open Access DOI:10.23937/2378-2951/1410241

Premature Ventricular Contraction Induced Cardiomyopathy Presenting as Trigeminy in the Setting of a Submandibular Abscess and Sepsis

George S Prousi, James A Davis, Barry J Feldman and Sultan Siddique

Article Type: Case Report | First Published: November 15, 2021

A 33-year-old female with no significant past medical history presented to the emergency department with 3-days of worsening right sided jaw pain, swelling and associated anorexia. She reported progressive pain and subjective fevers prompting a visit to her primary care physician and subsequently the emergency department. On arrival, vital signs were not able for a temperature of 100.4 F, blood pressure 107/62 mmHg and heart rate of 116 BPM. Laboratory evaluation demonstrated WBC 16.9 with a lef...

 Open Access DOI:10.23937/2378-2951/1410240

A Case Report of Pre-excited Atrial Fibrillation Encounters Ebstein's Anomaly: Is Amiodarone a Good Alternative Choice?

Hsiang-Wei Yang and Wai-Kin Wong

Article Type: Case Report | First Published: October 23, 2021

This is a case report of a 39-year-old man who presented to the emergency room with atrial fibrillation (AF), pre-excitation, and Ebstein's anomaly (EA). Currently, there was no suggestion of pharmacologic management if the patient declines surgical or catheter ablation therapy. A review of the literature concluded that amiodarone may be a suitable therapy for the pharmacological management of this patient. This 39-year-old man experienced occasional palpitations but on this occasion, the palpit...

 Open Access DOI:10.23937/2378-2951/1410239

The Incidence and Risk Factors Associated with Stroke among Patients Who Attended the Medical Ward of Mettu Karl Referral Hospital, South Western, Ethiopia: A Prospective Observational Study

Gudisa Bereda and Gemechis Bereda

Article Type: Research Article | First Published: October 04, 2021

Stroke as a clinical syndrome typified by “rapidly developing clinical signs of focal or global disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause apart that of vascular origin. Stroke is a major cause of death and disability in many countries. If left untreated, stroke is a debilitating disease that can lead to death. To ascertain the incidence and risk factors associated with stroke among patients who attended the medical ward of Mettu Ka...

 Open Access DOI:10.23937/2378-2951/1410238

Correlation between Self-Reported Daily Activity and Submaximal Walk Test in the Assessment of Functional Capacity among Patients with Hypertension

Tolulope O Olatunbosun, MSc PT, Taofeek O Awotidebe, PT, PhD, Rufus A Adedoyin, PT, PhD, Olufesola M Fasakin, RN, MSc, Suraj A Ogunyemi, MBChB, FWACP, Abayomi A Olawoye, PT, DPT and Adekola J Odunlade, MSc, PT

Article Type: Original Article | First Published: September 13, 2021

Time constraint on the part of clinicians or musculoskeletal comorbidities in the lower limbs in some patients with hypertension may sometimes prevent submaximal walk test. Hence, self-reported activity thus becomes an alternative method for assessing quick functional capacity (FC). This study assessed FC using a self-reported daily activity tool; Duke Activity Status Index (DASI) and correlated its value with 6-Minute Treadmill Walk (6-MTW) among patients with hypertension. This cross-sectional...

 Open Access DOI:10.23937/2378-2951/1410237

A Case of a Large Coronary Artery Fistula

Yevgeniy Latyshev, MD

Article Type: Case Report | First Published: September 11, 2021

Coronary artery fistulas are rare anomalies found during coronary angiography and non-invasive cardiac imaging. Recent advances in understanding of the pathophysiology allow more effective surgical and percutaneous treatments. It is important to recognize and treat hemodynamically significant fistulas when appropriate before ischemia and or heart failure occurs. We present a case of coronary artery fistula that was treated conservatively after a heart team discussion. Coronary artery fistulas (C...

 Open Access DOI:10.23937/2378-2951/1410236

An Electrocardiographic Early Repolarization Pattern in a Competitive Athlete: Is it a Sign of Danger?

Daniel B Petrov, MD, FESC and Yoana D Petrova, M. Pharm

Article Type: Case Report | First Published: September 06, 2021

The 12-leads electrocardiogram (ECG), can play a key role in the diagnosis of ERP, and many pre-participation screening protocols include an ECG, because is it a simple, inexpensive initial tool in the evaluation a both symptomatic and asymptomatic athletes. In the setting of pre-participation screening appropriate differential diagnosis between physiologic and pathologic ST-segment elevation is of importance not only to prevent sport related sudden cardiac deaths (SCD), but also to avoid unnece...

 Open Access DOI:10.23937/2378-2951/1410235

Appropriate Use and Outcomes of In-Hospital Telemetry: Implications Regarding the Contemporary Code Blue

Ronald F Espinosa, DO, Christopher A Woolley II, MD, Scot W Nolan, DNP, RN, Jill M Waalen, MD, MPH and Bruce J Kimura, MD, FACC

Article Type: Retrospective Cohort | First Published: September 03, 2021

Although practice standards for telemetry reflect the historical benefit of early monitoring for arrhythmias in select admissions, few data exist on the initial appropriateness of telemetry for contemporary inpatients who then later suffered a “code blue.” As telemetry monitoring is a significant resource, we sought to review appropriate use, detection of causative arrhythmias, and the timing and outcomes of telemetry use in code blues. Over a 3-year period in a 300-bed teaching hospital, da...

 Open Access DOI:10.23937/2378-2951/1410234

Pulse Wave Velocity is an Independent Predictor of Office Hypertension

İsmail Sahin, MD, Ömer Şatıroğlu, MD, Hakan Duman, MD, Ali Gokhan Ozyildiz, MD, and Murtaza Emre Durakoğlugil, MD

Article Type: Original Article | First Published: August 25, 2021

Carotid-femoral pulse wave velocity (cf-PWV) is the gold standard measure of arterial stiffness and a stronger predictor of poor outcomes for cardiovascular events. Pulse wave velocity is closely related to blood pressure, but its effect on office hypertension (OHT) is unclear. The study aims to investigate the relationship between OHT and cf-PWV. This was a prospective, singlecenter, clinical trial. A total of 102 subjects were included in the study: 48 patients with OHT and 54 subjects with no...

 Open Access DOI:10.23937/2378-2951/1410233

Intermediate-Term Outcomes of 3F Stentless Bioroot for Bentall Operation

Guglielmo Stefanelli, Fabrizio Pirro, Luigi Steffanon, Alessandro Bellisario and Luca Weltert

Article Type: Original Article | First Published: July 23, 2021

Aim of this study was to assess the intermediate-term outcome after Bentall operation using a self-assembled bio-root conduit containing a 3F stentless valve. Between April 2010 and August, 2015, 30 patients affected by aortic root dilatation with aortic valve disease underwent Bentall operation at our Unit, using a conduit assembled by including a 3F® stentless valve into a straight woven tube graft. Mean age at surgery was 66.3 yrs. Mean Logistic EUROscore was 10.01. Mean pre-operative Ejecti...

 Open Access DOI:10.23937/2378-2951/1410232

COVID-19 mRNA Vaccine Induced Troponinemia - Is the Vaccine a Cardiac Stressor?

Sameer Acharya, MD, Malcolm Brand, MD, FACC, Janette Lee, MD, Douglas MacQueen, MD, Angela Arbach, MD and Samjhauta Bhattarai, MBBS

Article Type: Case Report | First Published: July 03, 2021

There have been emerging concerns of myocarditis with Covid-19 vaccines recently which could be from inflammatory or immunogenic response to vaccine components or something else which is yet to be understood. The most common side effects of the vaccine noted in phase three trials were local reactions and few self-remitting systemic reactions. But we cannot overlook the emerging cardiac manifestations associated with COVID-19 vaccine. Here, we report a young healthy male presenting with atypical ...

 Open Access DOI:10.23937/2378-2951/1410231

A Rare Case of Mycobacterium abscessus Cardiac Resynchronization Therapy Defibrillator (CRT-D) Device Infection

Adam S Potter, MD, PhD, Brittany Duong, DO, Abraham Lee, DO, Bao X Nguyen, DO, David Reynoso, MD, PhD and Asif A Sewani, MD

Article Type: Case Report | First Published: July 03, 2021

Rapid-growing Mycobacteria comprise approximately half of the currently known mycobacterial species and are divided into five major groups: Mycobacterium fortuitum, M. chelonae/M. abscessus complex, M. smegmatis, M. mucogenicum, and the pigmented rapidly-growing Mycobacteria. In clinical practice, the most commonly encountered species are M. fortuitum and M. chelonae/abscessus. A 57-year-old male presented to the ED with fever, night sweats, erythema and slight purulent drainage from his CRT-D p...

 Open Access DOI:10.23937/2378-2951/1410230

Prevalence, Types and Clinical Presentation of Heart Failure among Hypertensive Patients Seen at a Tertiary Hospital in Dar Es Salaam, Tanzania

Gervas George Nyaisonga, MD, MMED and Pilly Chillo, MD, MMED, PhD

Article Type: Original Research Article | First Published: May 31, 2021

Heart failure (HF) is a common complication in patients with hypertension who may present as HF with preserved ejection fraction (HFpEF) or HF with reduced ejection fraction (HFrEF). These categories have different clinical presentations and may require special attention to diagnose, especially when the presentation is HFpEF. The aim of this study was to assess the prevalence, types and clinical presentation of HF among hypertensive patients being followed-up at a tertiary hospital in Tanzania. ...

 Open Access DOI:10.23937/2378-2951/1410229

CVA to BPA: Using Balloon Pulmonary Angioplasty to Treat Chronic Thromboembolic Pulmonary Hypertension Post Stroke

Adinan Kanda, MD and Kurt Prins, MD, PhD

Article Type: Case Report | First Published: May 31, 2021

In patients with CTEPH who are not eligible for PTE, BPA may be a treatment option. It is important to diagnose and treat patients early since delays are associated with worse clinical outcomes. We present a case of CTEPH where early diagnosis and treatment resulted in normalization of PA pressures. Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic thromboembolism in the proximal pulmonary arteries and small-vessel disease in the pulmonary capillary system. This r...

 Open Access DOI:10.23937/2378-2951/1410228

Congenital Heart Disease - A Review of the Treatment Methods

Cynthia Wong

Article Type: Review Article | First Published: May 31, 2021

This paper seeks to provide a review of the existing treatment methods for Congenital Heart Disease. The paper will focus on the existing treatment methods for CHD, such as cardiac catheterization, patent ductus arteriosus (PDA), balloon valvulop, percutaneous mitral valve repair, hybrid intraoperative pulmonary artery stenting, catheter ablation, atrial septal defect (ASD), and transcatheter pulmonary valve therapy. It will also analyze coarctation of the aorta, balloon atrial septostomy, tricu...

 Open Access DOI:10.23937/2378-2951/1410227

Takotsubo Cardiomyopathy Triggered by Intervention for a Threatened Acute Myocardial Infarction - It is not over till it is over!

Anver Sethwala, MBBS (Hons), Jonathan Habersberger, FRACP, Joshua Sher, Michael Pearson, B.App.Sc (Med Rad) and Nathan Better, FRACP

Article Type: Case Report | First Published: May 31, 2021

Takotsubo cardiomyopathy is commonly associated with a sudden psychological, emotional or physical stress such as a death of a family member. Here we present a case of Takotsubo cardiomyopathy occurring after revascularization of an acute coronary syndrome providing evidence that these two discrete, separate, but inherently inter-related events can coexist. Takotsubo cardiomyopathy or stress cardiomyopathy was first described in 1990 by Sato, et al. and is characterized as a transient cardiac sy...

 Open Access DOI:10.23937/2378-2951/1410226

Evolution of Pediatric Cardiology over the Last 50 Years - Part II

P Syamasundar Rao, MD

Article Type: Review Article | First Published: May 29, 2021

The author has just written a book on the evolution of the specialty of Pediatric Cardiology over the last 50 years. The intent of this review is to present a summary of this book. Because of large amount of this material, the review is separated into four parts. In the first part, transcatheter interventions (balloon angioplasty/ valvuloplasty procedures) were appraised. In this paper, transcatheter occlusions and other transcatheter interventional procedures will be discussed. Initially, the p...

 Open Access DOI:10.23937/2378-2951/1410225

Evolution of Pediatric Cardiology over the Last 50 Years - Part III

P Syamasundar Rao, MD

Article Type: Review Article | First Published: May 14, 2021

The author has just written a book on the evolution of the specialty of Pediatric Cardiology over the last 50 years. The intent of this review is to present a summary of this book. Because of large amount of this material, the review is separated into four parts. In these first and second parts, transcatheter interventions (balloon angioplasty/valvuloplasty procedures and percutaneous occlusions) were appraised. In this paper, electrocardiography, echocardiography, and cardiac catheterization wi...

 Open Access DOI:10.23937/2378-2951/1410224

Interatrial Block and Intermittent Paroxysmal Atrial Fibrillation in Amyotrophic Lateral Sclerosis Patient Treated with Flecainide

Athanassios Antonopoulos, MD, PhD, FESC and Giulia Ricci Lucchi, MD

Article Type: Case Report | First Published: May 05, 2021

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting both upper and lower motor neurons. Cardiovascular consequences related to ALS are relatively under appreciated. Autonomic dysfunction in ALS is common. In fact, patients with ALS often exhibit bulbar dysfunction impacting centrally mediated vagal and sympathetic nerves with resultant greater autonomic dysfunction. The consequences of disruptions in the autonomic reflex loop on the cardiovascular system include chronot...

 Open Access DOI:10.23937/2378-2951/1410223

A Rare Case of Syncope Secondary to Sinus Node Dysfunction Associated with Brugada Syndrome

Maya Khodor, MD and Joseph Chattahi, MD

Article Type: Case Report | First Published: April 24, 2021

Brugada Syndrome is a rare arrhythmogenic entity that poses a risk of sudden cardiac death due to ventricular arrhythmias. Sinus node dysfunction is a less recognized and acknowledged conduction abnormality associated with Brugada syndrome, but nevertheless an important potential manifestation that can alter management. We present a case of a young patient who presented with syncope initially presumed to be secondary to a ventricular arrhythmia in the setting of newly diagnosed Brugada syndrome ...

 Open Access DOI:10.23937/2378-2951/1410222

Innovative Technique of Primary Percutaneous Coronary Intervention in Patients with Impaired Renal Function using Ultra Low Volume Contrast Agent Using Side Branch Wire as a Marker

Santosh Kumar Sinha, FACC, FAESC, FSCAI, Awadesh Kumar Sharma, Mahmodullah Razi and Umeshwar Pandey

Article Type: Case Report | First Published: March 22, 2021

Contrast-induced nephropathy (CIN) is a serious complication in patients with chronic kidney disease with coronary artery disease who undergo percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality in short and long term. The limiting volume of contrast agent is safest and most reliable strategy to prevent CIN. Here, we report a case of suc¬cessful primary PCI using only 13 ml of contrast (iodixanol) of mid left anterior descending artery where wire in di...

 Open Access DOI:10.23937/2378-2951/1410221

Giant Coronary Artery Aneurysm due to Polyarteritis Nodosa in an Eight-Year-Old Child

Olga Cecilia Maza, MD, Carlos Alberto Gallon, MD, Rafael Vicente Echeverria, MD, Cristina Isabel Morales, MD and John Jairo Araujo, MBBS, MASt, MD, MSIAC

Article Type: Case Report | First Published: March 20, 2021

Systemic polyarteritis nodosa is a vasculitis characterized by inflammation and fibrinoid necrosis of medium and small arteries, with a global incidence of 0.7/100,000 and a prevalence of 6.3/100,000. Its cause is as yet unknown, and it affects both children and adults. The clinical presentation tends to be insidious and vague in its initial stages. Cardiac involvement is one of the signs of severity, with coronary artery impairment and aneurysmal lesions of varying degrees. The consequent heart...

 Open Access DOI:10.23937/2378-2951/1410220

Evolution of Pediatric Cardiology over the Last 50 Years (Trends in Transcatheter Interventions for Pediatric Heart Disease - Part I)

P Syamasundar Rao, MD

Article Type: Review Article | First Published: March 08, 2021

The author has just written a book on the evolution of the specialty of Pediatric Cardiology over the last 50 years. The intent of this review is to present a summary of this book. Because of large amount of this material, the review is separated into four parts. In this first part, transcatheter interventions (balloon angioplasty/ valvuloplasty procedures) will be appraised. Based a thorough review of the literature it appears that Rubio-Alvarez, et al. were the very first to do and report tra...

 Open Access DOI:10.23937/2378-2951/1410219

Large Spontaneous Coronary Artery Dissection Presenting as Acute STEMI - Is Intervention the Only Answer?

Santosh Kumar Sinha, FACC, FAESC, FSCAI, Awadesh Kumar Sharma, Mahmodullah Razi and Umeshwar Pandey

Article Type: Case Report | First Published: February 27, 2021

Spontaneous coronary artery dissection (SCAD) is a rare but an important cause of ST elevation myocardial infarction (STEMI) in young patients. Here, we report case of a 32-year-old male presenting as acute anterior wall STEMI for which was thrombolysed. Coronary angiogram revealed spiral luminal filling defects with extensive contrast staining of proximal left anterior descending artery involving diagonal branch representing Type D dissection. As patient refused any intervention, he was managed...

 Open Access DOI:10.23937/2378-2951/1410218

Determinants of Spatial Dispersion of P-Wave, QRS Complex, and QT-Interval on 12-Lead Electrocardiogram in Apparently Healthy Adults

Nelson I Oguanobi, Charles U Odenigbo, Ogonna C Oguejiofor, Uchenna C Okonkwo, Ukamaka M Odenigbo3 and Tobenna Agogbua

Article Type: Original Research | First Published: February 19, 2021

The spatial dispersion of P-wave, QRS complex, and QT interval on 12-lead electrocardiogram are related to the electrical instability in cardiac conducting tissues and elevated parameters are associated with increased risk of cardiovascular morbidity and mortality. We sought to evaluate the dispersion of P-wave, QRS complex, and QT interval in healthy adult Nigerians and assess their relationship to age, gender, anthropometric and some physiologic parameters. A total of 128 subjects were recruit...

 Open Access DOI:10.23937/2378-2951/1410217

Utility of Global Longitudinal Strain to Predict Post-Operative Outcomes in Non-Cardiac Surgeries

Chang Joon Park, Liy Si Tan, Pei Huang, Puay Joo Tan, Jason Jia Hao See, MBBS, MRCP

Article Type: Brief Report | First Published: February 13, 2021

Pre-operative echocardiography is performed in select groups of patients for cardiac risk stratification. Many parameters, including Left Ventricular Ejection Fraction (LVEF), are assessed during echocardiography. While many studies have cited association between low LVEF and poor operative outcomes, patients with preserved LVEF might have subtle LV dysfunction that may result in adverse outcome. Studies have described the routine use of global longitudinal strain (GLS) as an alternative measure...

 Open Access DOI:10.23937/2378-2951/1410216

Coronary Risk Factors and its Reduction by Plant-Based Diet with Emphasis on Diabetes: A Preliminary Report

Gunadhar Panigrahi, MD, FACC, FACP, DipABLM

Article Type: Research Article | First Published: February 13, 2021

Heart disease has been the leading cause of death since 1933 in the US according to the mortality records from CDC. In 2009 coronary heart disease accounted for 64% of the cardiac deaths. This is due to diet high in processed foods, high in meat, saturated fat, added sugars and other high glycemic index carbohydrate, along with sedentary lifestyle. A comprehensive survey of cardiovascular disease of the New Guinea highlanders indicated rare incidence of ischemic heart disease, and no diabetes or...

 Open Access DOI:10.23937/2378-2951/1410215

Left Ventricular Assist Devices and Their Role in Cardiogenic Shock: Literature Review and Contemporary Data

S Tzikas, AP Evangeliou, A Boulmpou, G Loufopoulos, CE Papadopoulos and V Vassilikos

Article Type: Review Article | First Published: January 30, 2021

Despite tremendous progress in the therapeutic algorithms of hemodynamically unstable patients, cardiogenic shock remains a clinical challenge with high mortality rate. Conservative management with inotropic agents remains the first-choice treatment, though it has been associated with serious adverse events and is not always adequate. Circulatory support with mechanical devices has been widely implemented in patients with cardiogenic shock during high- risk percutaneous coronary interventions or...

 Open Access DOI:10.23937/2378-2951/1410214

Maximising the Diagnostic Utility of the Exercise Treadmill Test

Kofi Tekyi Asamoah

Article Type: Case Report | First Published: January 16, 2021

Ischaemic heart disease was the leading cause of mortality according to the World Health Organisation in the year 2018 and disease burden keeps increasing steadily across the globe. Early diagnosis and intervention are therefore key in mitigating its effect on society. The exercise treadmill test is an important, cost-effective investigation employed in the evaluation of coronary artery disease, allowing for early diagnosis and a decision on revascularization to be made. Reliable interpretation ...

 Open Access DOI:10.23937/2378-2951/1410213

A Rare Case of Vagococcus fluvialis Prosthetic Valve Endocarditis and Aortic Root Abscess

Liam M Back, Joseph Magdy, Liam Guiney, Roger Luo, Akram Hussein and David Wong

Article Type: Case Report | First Published: January 16, 2021

We describe a case of Vagococcus fluvialis infective endocarditis with associated aortic root abscess in a 50-year-old male on his second bioprosthetic aortic valve replacement. Only two cases of Vagococcus endocarditis have been recorded to our knowledge, and this case reinforces the fulminant nature of a rare organism. A 50-year-old male presented to our emergency department with 4 weeks of a traumatic back and neck pain with associated night sweats and anorexia. He had a history of intravenou...

 Open Access DOI:10.23937/2378-2951/1410212

Spontaneous Coronary Artery Dissection with Predisposing Fibromuscular Dysplasia: Diagnosed during a Single Catheterisation Procedure

AGW de Lepper, MD, W Aarnoudse, MD, PhD, A Algin, MD, M Winkens, MD and M Magro, MD, PhD

Article Type: Case Report | First Published: January 13, 2021

A middle-aged woman presented with a non-ST-segment elevation myocardial infarction which was due to a spontaneous coronary artery dissection of the distal right coronary artery. Angiography of the femoral artery prior to placement of a closure device revealed tortuosity consistent with multifocal fibromuscular dysplasia....

 Open Access DOI:10.23937/2378-2951/1410211

Incidence of Left Ventricular Systolic Dysfunction in Asymptomatic, Incidently Detected Left Bundle Branch Block (LBBB) in Apparently Healthy Individuals: A Prospective Observational Study at a Tertiary Care Cardiac Center in North India

Sheikh Jan Mohammad, MD, DNB, AM-ACC/AHA, Mohammad Tahir Ganaye, MD, Samiera Hassan3 and Nusrat Bashir

Article Type: Original Research | First Published: December 31, 2020

Left bundle branch block (LBBB) is often associated with significant heart disease and is often the result of myocardial injury, strain or hypertrophy, it can also be seen in patients without any particular clinical disease. The significance of LBBB has not been well studied in subjects without myocardial infarction or pre-existing heart failure. Therefore, we sought to study the incidence of LV systolic dysfunction in asymptomatic, incidentally detected LBBB in apparently healthy individuals. A...

 Open Access DOI:10.23937/2378-2951/1410210

Changes and Outcome of Cardiac Function in Children with SARS-CoV-2 Multisystem Inflammatory Syndrome

Chloé Huet, MD, Thibault Blache, MD, Thomas Perouse de Montclos, MD, Claire Bertail Galoin, MD, Cécile Leconte, MD, Mohamed Bakloul, MD, Etienne Javouhey, MD, PhD, Elodie Perdreau, MD and Sylvie Di Filippo, MD, PhD

Article Type: Original Article | First Published: December 26, 2020

Cardiac involvement has been reported in children with SARS-CoV-2 inflammatory syndrome. The objectives herein were to assess changes in cardiac parameters and compare cardiac pathologies observed in SARS-CoV-2 to Kawasaki-(KW) and myocarditis-(MY). Patients < 18 years of age, with symptoms of Kawasaki disease (KW group) and/or of acute myocarditis (MY group) from March 1 to May 31 2020 were included. Clinical, laboratory data, and cardiac parameters were recorded upon diagnosis and at several p...

 Open Access DOI:10.23937/2378-2951/1410209

Balloon Induced Dissection of Left Anterior Descending Artery and its Bidirectional Progression Involving Left Circumflex Artery

Santosh Kumar Sinha, FACC, FAESC, FSCAI, Puneet Aggarwal and Umeshwar Pandey

Article Type: Case Report | First Published: December 12, 2020

Coronary artery dissection is common after balloon angioplasty, few of which may be catastrophic. Here, we report a case of a76-year-old male who had diffuse disease of proximal left anterior descending artery (LAD). LAD was wired with runthrough (Terumo, Japan) and sequentially dilated with 1.5 × 10 and 2 × 10 mm Sapphire semicompliant balloon. After balloon dilatation, dissection at the distal edge of lesion was noticed. As stent could not be tracked and pushed along the lesion as guide cath...

 Open Access DOI:10.23937/2378-2951/1410208

Haystack Principle - Its Importance in Unearthing the Electrocardiogram in a Patient with Unexplained Syncope

Santosh Kumar Sinha, FACC, FAESC, FSCAI, Awadesh Kumar Sharma , Mahmodullah Razi and Umeshwar Pandey

Article Type: Case Report | First Published: December 12, 2020

The "haystack principle" is of great diagnostic and therapeutic importance to unearth the obscure P waves which gives clue to underlying diagnosis. Here, we report a case of 72-year-old women who came to outdoor department for evaluation of repeated episodes of loss of consciousness. Electrocardiogram revealed complete right bundle branch block pattern with bizarre T wave in lead II, III, and aVF. P wave were not discernible. However, lead aVR revealed well formed P wave with second-degree atrio...

 Open Access DOI:10.23937/2378-2951/1410207

Cardiovascular Diseases in Acromegaly: Not Diagnosed What is Not Suspected

Ivan Lozada Martinez, Daniela Torres Llinás and Andrés Llamas Nieves

Article Type: Commentary | First Published: December 12, 2020

Acromegaly has been described as a rare disease, the result of chronic excessive secretion of growth hormone (GH), with subsequent elevation of Insulin-like Growth Factor I (IGF-1) levels. This condition is associated with an increase in morbidity and mortality compared to the general population, without taking into account that this endocrine disorder per se, increases cardiovascular risk by causing metabolic disorders such as hyperglycemia, dyslipidemia and systemic hypertension...

 Open Access DOI:10.23937/2378-2951/1410206

Implantation of Durable VAD during COVID-19: An Epicenter Experience

Scott Stewart, DNP, David Silber, DO, Bernard Kim, MD, Kumar Satya, MD, George Batsides, MD, Kanika Mody, MD, and Mark Anderson, MD

Article Type: Patient Care | First Published: December 12, 2020

Ventricular Assist Devices (VAD) serves as an advanced treatment modality for end stage systolic heart failure patients. Implantation of VAD requires a multidisciplinary team approach with in depth family meetings and education sessions to ensure a successful outcome. During the COVID-19 pandemic, multiple new barriers were identified to allow for traditional VAD implantation and post-operative care. Modifications to current processes needed to be developed to accommodate a safe and comprehensiv...

 Open Access DOI:10.23937/2378-2951/1410205

A Case of ST-Elevation due to a Primitive Extracardiac Origin in a Cancer Patient: Differential Diagnosis and Review of Literature

Amabile Valotta, MD, Lorenzo Grazioli Gauthier, MD, Laura Anna Leo, MD, Manuela Averaimo, MD and Marco Moccetti, MD

Article Type: Case Report | First Published: December 05, 2020

This case is about a 65-year-old man with a diagnose of stage IV Thymic Carcinoma in 2012, with two recurrences and past surgical treatment followed by radiation and chemotherapy. From that time, CPAP addicted for respiratory failure. He went to emergency department with worsening dyspnoea in the last few days. The ECG showed an ST-elevation in DI-aVL and V4-V6 suggesting an Acute Coronary Syndrome (ACS). The emergency coronary angiogram showed no significant coronary artery stenosis. The transt...

 Open Access DOI:10.23937/2378-2951/1410204

Hypertrabeculation with Infiltrative Features across Multiple Imaging Modalities - A Remnant of Prior Cardiac Sarcoid or Primary Noncompaction Cardiomyopathy

Liam Back, Joseph Magdy and David Wong

Article Type: Case Report | First Published: November 28, 2020

Hypertrabeculation may be a dominant feature in the cardiac imaging of a newly diagnosed dilated non-ischaemic cardiomyopathy, highly suggestive of primary non-compaction cardiomyopathy. It does not necessarily exclude alternative pathologies however, and it is important to utilise a multimodal cardiac imaging approach even when these features are present on index echocardiographic imaging. The distinction between primary non-compaction cardiomyopathy and an alternative diagnosis such as cardiac...

 Open Access DOI:10.23937/2378-2951/1410203

Unexpected Coronary Angiographic Findings in a Patient with Wellens’ Sign

Morris M Kim, MD, Jonathan S Taylor, MD, Jenna S Anderson, MD and Ignatius G Zarraga, MD

Article Type: Case Report | First Published: October 23, 2020

The abnormal electrocardiogram findings of Wellens’ sign that occur in the context of unstable angina are typically associated with significant stenosis in the proximal left anterior descending (LAD) coronary artery. We report an unusual case of a patient who had unstable angina and Wellens’ sign, without significant LAD stenosis. An 81-year-old man with moderate to severe aortic stenosis, hypertension, mild left ventricular hypertrophy, hyperlipidemia, and history of tobacco use presented t...

 Open Access DOI:10.23937/2378-2951/1410202

Vaping Induced Cardiac Complications - A Smokescreen Coming to Engulf the Heart?

Benji LIM, MB BCh BAO, Sheldon LEE, MBBS and Siang Chew CHAI, MBBS

Article Type: Case Report | First Published: September 26, 2020

E-cigarette usage has been shown to be associated with lung injury. However, there has been limited data of cardiovascular complications in e-cigarette users. We present two patients that developed cardiac complications after recent increased e-cigarette usage - the first with non-ischemic cardiomyopathy after a month of electronic cigarette usage at the highest power setting of 40 Watts, and the second with predominantly non-ischemic cardiomyopathy with underlying single vessel coronary artery ...

 Open Access DOI:10.23937/2378-2951/1410201

Enterobacter Related İmplantable Cardiac Defibrillator Lead Endocarditis in Dialysis Patient

Hakan Duman, MD, Oğuzhan Bodur, MD and Yüksel Çiçek, MD

Article Type: Case Report | First Published: September 16, 2020

Use of intracardiac devices for heart diseases is increasing Worldwide. One of the important complications of pacemakers is infective endocarditis from the leads as the source. In this case, we report a 61-years-old male patient who is on dialysis and presented with implantable cardioverter defibrillator (ICD) lead endocarditis caused by Enterobacter Cloacae four months following implantation. Intracardiac devices are one of the predisposing conditions for infective endocarditis. It is known tha...

 Open Access DOI:10.23937/2378-2951/1410200

Therapeutic Strategy for a Patient with Advanced Heart Failure and Schizophrenia without Cardiac Replacement Therapies

Masakazu Hori, MD, Teruhiko Imamura, MD, PhD, Makiko Nakamura, MD, PhD, Masaki Nakagaito, MD, PhD and Koichiro Kinugawa, MD, PhD

Article Type: Case Report | First Published: September 03, 2020

Despite considerable improvement in the cardiac replacement therapy including durable left ventricular assist device and heart transplantation, some patients are not good candidates for such intensive therapies given their comorbidities. We had a 58-year-old patient with advanced heart failure who was assigned to INTERMACS profile 2 with progressive end-organ dysfunction refractory to inotropes. Following the detailed discussion, he decided not to receive cardiac replacement therapy dominantly g...

 Open Access DOI:10.23937/2378-2951/1410199

Multi-Modality Imaging of a Case of Multiple Intra-Cardiac Aneurysms Complicated by Mitral Valve Leaflet Perforation

Ruchika Meel, PhD, Liam Lorentz, FCRAD, Ricardo Goncalves, Bongane Ngutshane, MD and Shungu Mogaladi, MMED

Article Type: Case Report | First Published: September 03, 2020

Intra-Cardiac aneurysms are a rare entity. In the past case reports and series have described the entity of "annular sub-valvular left ventricular aneurysms" in patients of African descent. These authors proposed the aforementioned aneurysms to be of congenital aetiology. Majority of the time the aneurysms were located in the sub-mitral or sub-aortic positions and were diagnosed by echocardiography and ventriculography. Multiple discrete left ventricular aneurysms complicated by mitral valve per...

 Open Access DOI:10.23937/2378-2951/1410198

Primary Percutaneous Coronary Intervention (pPCI) Using Right Fossa Radialis (Dorsal Transradia) Approach

Santosh Kumar Sinha, Puneet aggarwal and Umeshwar Pandey

Article Type: Case Report | First Published: August 31, 2020

Haematoma, dissection, local site granuloma, and persistent radial artery occlusion are few of the complications of conventional transradial access. The distal radial artery located in the fossa radialis or anatomical snuffbox on the dorsal side of the hand may be an attractive alternative to conventional radial stick. Here, we report a case of a 47-year-old diabetic male who presented with retrosternal chest pain and sweating of 2-hours duration, and diagnosed as acute inferior wall myocardial ...

 Open Access DOI:10.23937/2378-2951/1410197

Recurrent Spontaneous Coronary Artery Dissection Leading to Recurrent Sudden Cardiac Arrests: Who is at Risk?

Anthony Weber, MD, Joseph Elliott, MD and Prabhakaran Gopalakrishnan, MD

Article Type: Case Report | First Published: August 20, 2020

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) with medical management and conservative therapies usually resulting in favorable outcomes. SCAD often is recurrent, especially in high risk individuals with underlying connective tissue disorders. Lethal ventricular arrhythmias have been reported in SCAD without clear indications for secondary prevention with implantable cardiovert-defibrillator (ICD). Depending on risk factor for recurrence as well a...

 Open Access DOI:10.23937/2378-2951/1410196

Enhancing the Accuracy of Computerized Interpretation of Old Inferior Wall Myocardial Infarction in a Routine or Preoperative Electrocardiogram by Analyzing Repolarization Abnormalities and Q Waves in Leads II, III and aVF

Zameer Abedin, MS, MD, David Gough, MD, Moeen Abedin, MD, Tariq Siddiqui, MD, Debabrata Mukherjee, MD, Chandra P Ojha, MD, Zuber D Mulla, PhD and Zainul Abedin MD, FRCP(C), FHRS

Article Type: Original Research | First Published: August 14, 2020

Fifty-six patients, in whom computerized interpretation of the ECG resulted in the diagnosis of old IMI, and in whom imaging studies were also available, were included in this study. ECGs were interpreted using the MUSEGE system. These ECGs were also analyzed by manually measuring the depth and the width of the Q waves and morphology of ST and T-wave changes in inferior leads. Echocardiograms and nuclear medicine cardiac imaging were performed and interpreted using standard equipment and techniq...

 Open Access DOI:10.23937/2378-2951/1410195

Extensive Coronary Thrombus in Patients Presenting with STEMI and COVID-19 Infection

Angela Li, MD, Calvin Ngai, MD, Loukas Boutis, MD and Bani M Azari, MD, PhD

Article Type: Case Series | First Published: August 13, 2020

The pathophysiology of ST-elevation myocardial infarction (STEMI) is not well understood in Coronavirus disease 2019 (COVID-19). We present similar angiographic findings in two COVID-19 patients with STEMI. Despite percutaneous coronary intervention (PCI), distal coronary flow was not restored. The pro-thrombotic and inflammatory effects of COVID-19 may lead to myocardial infarction. The COVID-19 pandemic has caused a significant strain on global healthcare systems. STEMI management during this ...

 Open Access DOI:10.23937/2378-2951/1410194

Analysis of Complications of Acute Coronary Syndrome and Related Outcomes in India

Balakumaran V, Namrata H, Anirudhya and Nitin Rathod

Article Type: Research Study- Prospective Cohort | First Published: August 13, 2020

This study was conducted to reflect the clinical profile of patients presented to Emergency department (ED) with complications of acute coronary syndrome in developing country like India. This prospective cohort study was conducted in a cohort of 50 patients’ with acute coronary syndrome (ACS). They were followed up an over duration of three months for the outcome during hospitalization. Male; smoker; age > 60 years; hypertension were representative risk factors for this cohort. More t...

 Open Access DOI:10.23937/2378-2951/1410193

A Case of New Onset Iohexol Contrast Induced Kounis Syndrome after Prior Contrast Exposure

Ahmed Shahab and Maheep Sangha

Article Type: Case Report | First Published: July 31, 2020

A 76-year-old male with past medical history significant for prostate cancer (in remission), diabetes, hyperlipidemia and tobacco dependence but no identified coronary artery disease presented to emergency room complaining of Left abdominal and flank pain which started at rest. His initial work-up only revealed significant hematuria and his pain resolved IV Tylenol administration. The cause of hematuria was investigated with...

 Open Access DOI:10.23937/2378-2951/1410192

Percutaneous Reversal of Cyanosis on Catheterization Table in a 12-Year-Old Boy using Cera Vascular Plug - A Case Report

Santosh Kumar Sinha, FACC, FAESC, FSCAI, Mahmodullah Razi, Umeshwar Pandey and Vinay Krishna

Article Type: Case Report | First Published: July 29, 2020

Pulmonary arteriovenous malformations are commonly treated by embolization with coils or balloons to prevent cerebral complications and to raise the oxygenation of the blood. The Cera vascular plug (Lifetech Scientific, Shenzhen, China) is a new vascular device made of a self-expanding cylindrical nitinol mesh. Here we report a case of a 13-year-old boy who had presented with 4 year history of progressive exertional dyspnoea, cyanosis, and clubbing. Pulmonary arterio-venous malformation (multipl...

 Open Access DOI:10.23937/2378-2951/1410191

Syncope in a Patient with H/O Kearns Sayre Syndrome

Saddam Yasin, MD, Kanwal Mehmood, MBBS and Osama Alsara, MD

Article Type: Case Report | First Published: July 29, 2020

Patients with history of mitochondrial disorders are at increased risk of having conduction disorders and cardiomyopathy and should have low threshold for pacemaker and implantable cardioverter defibrillator placement. Kearns Sayre syndrome is the result of deletions in mitochondrial DNA which causes bilateral pigmentary retinopathy and conduction abnormalities. Judicious use of implantable cardioverter defibrillator in this subset population with cardiomyopathy or prolonged QT interval is requi...

 Open Access DOI:10.23937/2378-2951/1410190

Impact of the SARS-Cov-2 Virus Pandemic on Children and Adults with Congenital Heart Disease: Its Burden and Risk Factors

John Jairo Araujo, MD

Article Type: Short Review | First Published: July 25, 2020

The novel coronavirus causes severe acute respiratory syndrome 2, and can infect any population. With the currently available information on the behavior of the pandemic, we conclude that the virus has come to stay. It is clear that the most aggressive behavior and worst outcome of the infection occurs in already established risk groups, such as those with cardiovascular disease. Those with congenital heart disease make up a special risk group. Due to this group’s high heterogeneity and the pa...

 Open Access DOI:10.23937/2378-2951/1410189

Rapid-Onset Thrombocytopenia Following Tirofiban Administration

Andrew M Smith, MD, Timothy G Petrie, MD and Brian J Page, MD

Article Type: Case Report | First Published: July 24, 2020

A 61-year-old male presented to the emergency department with a two day history of intermittent, burning chest pain which became constant and radiated to the left arm. His past medical history was significant for coronary artery disease with two prior myocardial infarctions, three prior cardiac stenting procedures (in 1999, 2001, and 2006), tobacco use with more than a forty pack year history, hypertension, hyperlipidemia, gastroesophageal reflux, cluster headaches, and an early family history o...

 Open Access DOI:10.23937/2378-2951/1410188

Platelet Aggregation Capacity of Clopidogrel Bisulphate Inhibited by Rabeprazole and Simvastatin in Patients Undergoing Myocardial Infarction in a Tertiary Care System: Drug Interaction Study

Jinesh Bahubali Nagavi and Bannimath Gurupadayya

Article Type: Research Article | First Published: July 22, 2020

Proton pump inhibitors and statins reduce the effectiveness of clopidogrel in inhibiting the platelet aggregation. Clopidogrel, a prodrug adheres to CYP2C19, a hepatic enzyme to convert to its active metabolite in order to provide expected therapeutic action. Statins, mainly simvastatin metabolize through cytochrome P450 3A4, which also metabolizes clopidogrel partially. The combination of clopidogrel and PPI’s are co-administered in patients going through ST segment elevated Myocardial infarc...

 Open Access DOI:10.23937/2378-2951/1410187

Increased Incidence and Prevalence of Cardiovascular Events and Mortality in Female Patients with NAFLD: A Meta-Analysis and Meta-Regression

Yaser Khalid, DO , Neethi Dasu, DO, Herman Suga, DO, Kirti Dasu, BA, Debashis Reja, MD, Ankit Shah, DO, Donald McMahon, DO and Adam Levine, DO

Article Type: Meta-Analysis | First Published: July 10, 2020

Non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD) share similar risk factors. Recent studies have focused on obesity and insulin-resistance, but the link between NAFLD and CVD persists regardless of traditional risk factors. Despite the increased incidence and prevalence of NAFLD world-wide, there has been no thorough investigation of gender disparities nor a closer look taken into investigating the role gender may play in increased cardiovascular (CV) mortality inciden...

 Open Access DOI:10.23937/2378-2951/1410186

Transpedal Approach for the Treatment of Acute Limb Ischemia in a Patient with Limited Access Sites

Robert Abed, MD, MPH, Naveed Rajper, MD, Joseph Puma, MD and Justin Ratcliffe, MD

Article Type: Case Report | First Published: June 27, 2020

We present a 53-year-old male with a history of extensive peripheral vascular disease, including a repaired type B aortic dissection complicated by occlusion of the left subclavian artery requiring carotid to subclavian bypass. The patient then had a subsequent repair of a graft endoleak complicated by left iliac artery occlusion requiring fem-fem bypass. He presented to the ED with left foot pain concerning for acute limb ischemia needing for prompt revascularization. However, given the extensi...

 Open Access DOI:10.23937/2378-2951/1410185

The Covid-19 Pandemic and Triggered Acute Myocardial Infarction among Non-Infected Individuals

Ayman Hammoudeh, MD, FACC, Hadi Abu-Hantash, MD, FACC, Ramzi Tabbalat, MD, FACC, Eyas Al-Mousa, MD, FACC, Eyadeh Madanat, MD, Raad Al-Muhaisen, MD, Mahmoud Fakhri, MD and Imad A Alhaddad, MD, FACP, FACC

Article Type: Commentary | First Published: June 18, 2020

We examined the exposure to various triggering events among adults who presented with AMI (including ST-segment elevation MI [STEMI] and non-ST-segment elevation MI [NSTEMI]) to 6 tertiary care centers in Amman, Jordan during the Covid-19 imposed lockdown period from March 4 through June 1, 2020. Patients were enrolled if they reported exposure to at least one Covid-19 lockdown-related triggering event. Data obtained from patients or their immediate family members included baseline clinical char...

 Open Access DOI:10.23937/2378-2951/1410184

A Case Report of Aerococcus urinae Prosthetic Valve Infective Endocarditis Initially Misidentify

atalia Lattanzio, MD, Qassem Abdelal, MD, Stephen Bell, MD, Talal Alkayali, MD, Christian Lorenzo, MD, Ricardo Villasmil, MD, Wilhelmine Wiese-Rometsch, MD and Manuel Gordillo, MD

Article Type: Case Report | First Published: June 18, 2020

Infective endocarditis (IE) is most commonly caused by species such as staphylococci, streptococcus and enterococci. When IE is caused by organisms such as Aerococcus urinae, misidentification of the organism in culture is common, resulting in misdiagnosis. We present a case of IE caused by Aerococcus urinae in a 67-year-old male with a bioprosthetic aortic valve whose culture initially grew micrococcus. Aerococcus urinae is a gram-positive catalase negative cocci that has been recognized as par...

 Open Access DOI:10.23937/2378-2951/1410183

The Show Must Go On: Using Proximie to Facilitate Collaboration between Experts to Perform a Complex Mitral Clip Procedure during COVID-19

F Sawaya, A Zgheib, JS Karim and N Hachach-Haram

Article Type: Case Report | First Published: June 12, 2020

As COVID-19 spreads across the globe at an alarming pace, clinicians of all specialties are being forced to re-evaluate how they can continue to deliver the best quality of care to their patients during this turbulent time. Although elective procedures have been canceled indefinitely in many countries, urgent interventional cardiology procedures are still being performed. The interventional suite during COVID-19, however, is almost unrecognizable. Interventional suites used to be a welcome setti...

 Open Access DOI:10.23937/2378-2951/1410182

ABO-Rhesus Blood Group Distribution among Peri-Partum Cardiomyopathy Patients: A Multi-Center Study in Sokoto, Nigeria

Hayatu Umar, MBBS, MSc, FWACP, Simeon Alabi Isezuo, MBBS, MPH, FMCP, FESC, Muawiyya Zagga Usman, MBBS, FMCP, Adeshina A Yusuf, MBBS, Bello Tambuwal Umar, MBBS, MMED (Int. Med), Femi Akindotun Akintomide, MBBS, FMCP, Abdulaziz Aminu, MBBS, Aminu Sakajiki Muhammad, MBBS, MSc, FMCP, Abubakar Sadiq Maiyaki, MBBS, FWACP, Hamidu Muhammad Liman, MBBS, FMCP, Isah Omokhudu Oborien, MBBS, FMCP, Musa Baba Muhammad, MBBS, FWACP, Abdulmumini Yakubu, MBBS, FWACP, Samaila Bello, MBBS, Usman Muhammad Waziri, MB

Article Type: Original Research | First Published: June 12, 2020

Cardiovascular disease is a major cause of death among women of child bearing age in Northern Nigeria. As much as 60% of Peripartum Cardiomyopathy (PPCM) was reported among women with heart failures in a tertiary health institution in Sokoto, Northwestern Nigeria and was responsible for about 34% of deaths in peripartum women in South Africa. The Millennium and Sustainable Development Goals (MDG & SDG) 2000 to 2015 and 2015 to 2030, respectively have it as their cardinal quests, to reduce matern...

 Open Access DOI:10.23937/2378-2951/1410181

A Rare Case of End-Stage HF Salvaged by Rescue Cardiac Resynchronization Therapy (CRT)

Yaser Khalid, DO, Neethi Dasu, DO, Kirti Dasu, BA, Paul Jang, DO and Vivek Sailam

Article Type: Case Report | First Published: June 06, 2020

End-stage heart failure (HF) is defined as a lack of improvement of HF symptoms and frequent exacerbations despite maximal medical therapy. Current guidelines recommend against the use of Cardiac Resynchronization Therapy (CRT) as a rescue device in end-stage HF. CRT is a promising intervention for new-onset end-stage HF for patients who may be able to recover enough of their EF to restart goal-directed medical therapy (GDMT). This report highlights the promising clinical outcome of an unconvent...

 Open Access DOI:10.23937/2378-2951/1410180

Covid-19 Therapeutic Prospects: Cardiotoxicity Concerns

Olawale Adeyemi, BS, MD

Article Type: Commentary | First Published: June 03, 2020

There has been extensive research on developing a treatment regimen for COVID-19. Coadministering Chloroquine and Azithromycin have shown promising results in infected people. However, these medications have a peculiar side effect; QT prolongation. Physicians should be aware of the populations taking them and routine EKGs are recommended in these candidates. Since December 2019, there was an outbreak of a novel coronavirus disease (COVID-19), which was first reported in Wuhan, China. However, th...

 Open Access DOI:10.23937/2378-2951/1410179

Transcatheter Tricuspid Valve Replacement and Repair: Pooled Analysis of the Outcomes and Complications of Novel Emerging Treatments

Yaser Khalid, DO, Neethi Dasu, DO and Kirti Dasu, BA

Article Type: Original Article | First Published: June 01, 2020

Tricuspid regurgitation is a poor prognostic marker of end-stage heart failure. Treatment options for severe tricuspid regurgitation are currently limited because these procedures have the highest mortality rates of all valve procedures. Isolated tricuspid valve surgery is reserved for rare cases during surgical viability evaluation with repair favored over tricuspid valve replacement, owing to the slightly more favorable mortality and downstream complication associated with the latter. Transcat...

 Open Access DOI:10.23937/2378-2951/1410178

A Case of Left Ventricular Pseudo-Aneurysm

Allam Harfoush and Ousama Hayder

Article Type: Case Report | First Published: June 01, 2020

The patient was transferred from abroad hospital due to its medical costs, after performing a diagnostic CAG without PCI. However, the gentle-man did not have documents from his previous hospitalization but the videos of the CAG. Also, the patient has an undefined type of ACS due to the lack of information. The patient was asymptomatic when he consults the cardiovascular department in Tishreen University Hospital....

 Open Access DOI:10.23937/2378-2951/1410177

A Misleading Diagnosis: Anterolateral STEMI Disguising Type A Aortic Dissection in Postpartum

Hema Balina, MD and Thomas Wool, MD

Article Type: Case Report | First Published: June 01, 2020

Acute Myocardial Infarction (AMI) during the early postpartum period is a rare event and carries a high mortality rate. We report an unusual case of Type A aortic dissection involving the left coronary ostium and presenting as anterolateral ST segment elevation myocardial infarction. Our patient was diagnosed to have aortic dissection at the time of left heart catheterization, and suffered a cardiac arrest prior to undergoing surgical intervention....

 Open Access DOI:10.23937/2378-2951/1410176

Quality over Quantity: A Case Based Review of HDL Function and Dysfunction

Suleiman Suleiman, MB, BCH, BAO, JJ Coughlan, MB, BCH, BAO, MRCPI and Vincent Maher, MD, FRCPI, FESCFACC

Article Type: Review Article | First Published: May 16, 2020

High density lipoprotein cholesterol (HDL) has traditionally been considered athero-protective and has been associated with a reduced risk of atherosclerotic cardiovascular disease (ASCVD). This has led to an approach of increasing HDL levels in high risk patients. However, due the complexity of the HDL particle and its diverse role in inflammation and immunity, this simple approach may be detrimental to cardiovascular health. Recent analysis of large population cohorts has established a U-shape...

 Open Access DOI:10.23937/2378-2951/1410175

New Onset Atrial Fibrillation in Health Profession Student with Newly Diagnosed ADHD: A Case Report on Wellness and Cardiovascular Consequences of Burnout

Mary Gao, Justin Chin, DO, Gayathri Nagendiram, Derek Chen, Parth Rajyaguru, DO and Christine Lomiguen, MD

Article Type: Case Report | First Published: May 06, 2020

A 23-year-old Caucasian male presented to the emergency department after a 10-minute episode of dizziness, headache with visual aura, shortness of breath, palpitations, and chest pain after exercise, specifically running. Past medical history was significant for recent diagnosis of attention deficit hyperactivity disorder for which he was started on 54 mg Ritalin (extended release methylphenidate) three months prior. He denied any known congenital or structural heart disease, prior cardiac arrhy...

 Open Access DOI:10.23937/2378-2951/1410174

Covid-19 and the Cardiologist!

Sharma Prachi, MD, DNB, Sethi Rishi , MD, DM, FACC, FESC, FRCP (Edin.), FCSAI, FAPSIC, MAMS, FCSI, FISC and V S Narain, MD, DM, FSCAI, FESC

Article Type: Commentary | First Published: April 29, 2020

While the world is badly hit by this SARS-CoV-2 pandemic, the cardiologists have a special role to play and risks too to bear. Patients with known cardiovascular diseases are at a risk of increased morbidity and mortality by this infection. Also, Covid-19 may present with varied cardiovascular manifestations. This puts the upfront managing cardiologist and his team at greater risk of catching infection. So, they need to find the best possible way to help such patients with minimum possible risk ...

 Open Access DOI:10.23937/2378-2951/1410173

National Trends and Outcomes of Myocardial Infarction: Result from National Inpatient Sample 2000 to 2015

Abdulrahman S Museedi, MD, Mouhamed Nashawi, BS, Abdullah Ghali, BS, Aws Alameri, MD, Mustafa Al Qaysi, MD and Robert Nathanson, MD, FACP

Article Type: Observational study | First Published: April 20, 2020

The burden of cardiovascular disease within the United States is profound, with large volumes of economic and academic resources being utilized to treat patients with cardiovascular diseases. Myocardial infarctions (MI) represent one of the most acute forms of cardiovascular pathology, with a profound mortality rate if prompt treatment and medical attention is not sought out after. While elements of changes in clinical practice and the spurring of new guidelines are responsible for improved heal...

 Open Access DOI:10.23937/2378-2951/1410172

Coronary-Pulmonary Arterial Fistula in a Heart Transplant Patient

Weiliang Huang, MBBS, MRCP

Article Type: Case Report | First Published: April 21, 2020

A 40-year-old Indian gentleman has a history of dilated cardiomyopathy secondary to viral myocarditis. He was treated with heart failure medications, received an automated implantable cardioverter-defibrillator in 2005, and left ventricular assist device (LVAD) in 2009. He subsequently underwent an orthotopic heart transplant in 2011 at the age of 34. The donor was a 38-year old male patient with a brain tumour, which was complicated by seizures that resulted in hypoxic-ischaemic encephalopathy....

 Open Access DOI:10.23937/2378-2951/1410171

Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials

Danielle Louis E Villanueva, MD, Lauren Kay Evangelista, MD, Ma Cristina Espanillo-Villanueva, MD and John C Anonuevo, MD

Article Type: Research Article | First Published: April 10, 2020

Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demon...

 Open Access DOI:10.23937/2378-2951/1410170

A Case Report of Aspergillus Endocarditis, its Complications and Associated Morbidities

Jian Jing Tan, Sheldon Shao Guang Lee, Siang Chew Chai and Jason Jia Hao See

Article Type: Case Report | First Published: April 03, 2020

Fungal endocarditis is a notorious disease with a high mortality rate and commonly presents with embolic phenomenon. We report a case of prosthetic valve-related Aspergillus endocarditis with aortic root pseudoaneurysm that presented with acute limb ischemia. In addition, we highlight the significant morbidity that is associated with this fungal infection. With a high clinical index of suspicion and a multidisciplinary team approach, a favourable outcome can be achieved....

 Open Access DOI:10.23937/2378-2951/1410169

Non-Bacterial Thrombotic (Marantic) Endocarditis of the Aortic Valve: A Rare Cause of STEMI Revealing a Polycythemia

Judit Ozse , Rainer Knur and Nicolas Von Beckerath

Article Type: Case report | First Published: March 24, 2020

Acute myocardial infarction is a major cause of death and disability worldwide. In general 4% to 7% of all patients diagnosed with AMI do not have coronary artery disease (CAD) at coronary angiography or autopsy. Embolisation as a mechanism of myocardial infarction is well known. Large diversity of aetiologies makes the precise diagnosis challenging. Its sources can be thrombi from left sided heart cavities, paradoxal embolism, tumors (myxoma, fibroelastoma), endocarditis (infective or nonbacter...

 Open Access DOI:10.23937/2378-2951/1410167

Radiofrequency Ablation as a Treatment Modality for Hypertrophic Cardiomyopathy

Kareem M. M. Ibrahim, MBBCH

Article Type: Review Article | First Published: Feb 29, 2020

Hypertrophic cardiomyopathy is one of the major causes of cardiac death that affects 1 in every 500 persons worldwide. Surgical myectomy and alcohol septal ablation have been the gold standard well established procedures for the treatment of this condition. Starting 2004 a new procedure, radiofrequency septal ablation, has been applied and showed significant improvement in the NYHA classification as well as the left ventricular outflow tract (LVOT) gradients of these patients. With overall less ...

 Open Access DOI:10.23937/2378-2951/1410166

Percutaneous Repair of an Aortic Pseudoaneurysm Status Post-Surgical Repair of Stanford Type A Dissection

Brinder S Kanda, MD, FACC, FSCAI, Nicholas E Hoyt , John Haas, MD, Houman Tavaf-Motamen, MD, Ronald Morford, MD, Tina Wesley, BSN, Kenneth Saum, MD and Michael MacCormac, MD

Article Type: Case Report | First Published: Feb 29, 2020

A middle-aged Caucasian woman presented with an ascending aortic pseudoaneurysm (AAP) located at the suture site of her previous surgical dissection repair. The pseudoaneurysm was located along the anterior aspect of the ascending thoracic aorta, above the right coronary cusp. We demonstrate successful percutaneous repair of the pseudoaneurysm using a ventricular septal occluder (VSO) and discuss the significance of this procedure for future cardiovascular care. A 56-year-old Caucasian woman wit...

 Open Access DOI:10.23937/2378-2951/1410165

Idiopathic Large Pericardial Effusion and Cardiac Tamponade in Children with Down Syndrome

Numra Aleem, MD, Amna Qasim, MD and Ashraf M Aly, MD, PhD

Article Type: Case Report | First Published: February 26, 2020

Pericardial effusions (PE) in patients with Down syndrome (Trisomy 21) have been associated with hypothyroidism, viral infections and malignancies (particularly leukemia). The PE is usually not large enough to cause cardiac tamponade. We report two cases of idiopathic large PE with one of them progressing to develop a cardiac tamponade that required an urgent pericardiocentesis. A 3-year-old female with Trisomy 21 was seen at cardiology clinic for follow up of a small secundum ASD. Patient has b...

 Open Access DOI:10.23937/2378-2951/1410164

Electrical Cardioversion: A Review

Max E Valentinuzzi, EE, PhD and Luis Aguinaga Arriascu, MD

Article Type: Review Article | First Published: January 23, 2020

Atrial fibrillation (AF), not to be confused with atrial flutter, is the term used to describe an irregular or abnormal heart rate. While AF and atrial flutter are similar, AF has more serious health implications such as an increased risk of having a stroke or a blood clot (thrombosis). The resting heart rate of someone without AF is usually between 60 and 100 beats per minute but this number is usually over 100 in AF. It is usually the result of an underlying condition such as hypertension (hig...

 Open Access DOI:10.23937/2378-2951/1410163

Two Unique Cases of Takotsubo Syndrome: Asymptomatic Takotsubo Complicated by Massive Left Ventricular Thrombus and Nightmare Induced Takotsubo Syndrome

Robert W Murdock, DO, Todd Thomas, DO and David K Murdock, MD

Article Type: Case Report | First Published: December 13, 2019

Takotsubo syndrome (TTS) typically presents like an acute coronary syndrome and is commonly associated with acute physical and/or emotional stress. TTS is characterized by transient moderate to severe left ventricular (LV) dysfunction in the absence of obstructive coronary artery disease (CAD). Excessive beta adrenergic stimulation remains the most widely accepted theory to account for development of TTS. Importantly a variety of commonly used pharmacologic agents which enhance catecholaminergic...

 Open Access DOI:10.23937/2378-2951/1410162

Progressive First Degree AV Block Indicates the Need for Permanent Pacing

Han B Xiao, Waleed Arshad, Arvinder Kurbaan and Timothy J Bowker

Article Type: Research Article | First Published: November 27, 2019

First-degree AV block, though considered benign, has been reported to be associated with an increased risk for atrial fibrillation, permanent pacing, heart failure and allcause mortality. It is possible that the extent of PR prolongation indicates the severity of adverse outcome. This study investigated whether the length of PR and its change with heart rate can predict the need for permanent pacing. We retrospectively studied 21 patients with a PR over 270 ms. Nine patients underwent permanent ...

 Open Access DOI:10.23937/2378-2951/1410161

Spontaneous Hemopericardium as an Adverse Effect of Rivaroxaban Administration

Asif Surani, MD, Beatriz Martinez Quintero, MD, David Brual, MD, Hadi Elias, MD, Fahad Uddin Ahmed, MD and Matthew Peters, MD

Article Type: Case Report | First Published: November 25, 2019

Rivaroxaban is a direct oral anticoagulant with a favorable safety profile when compared to warfarin in respect to bleeding. During post-marketing surveillance, intracranial and retroperitoneal bleedings have been reported; however, hemopericardium has not been frequently described. In this case series, we present three cases of spontaneous hemopericardium where rivaroxaban was thought to be the causative agent. Predisposing factors for rivaroxaban induced hemopericardium might include impaired ...

 Open Access DOI:10.23937/2378-2951/1410160

Safety of Hydrochlorothiazide in the Real World: A Commentary on the Italian Medicines Agency (AIFA) Pronouncements

Valerio Massimo Magro, MD, Carla Coppola, MD, Eugenio Boccalone, MD, Michele Caturano, MD, Giovanni Scala, MD and Walter Verrusio, MD, PhD

Article Type: Commentaries | First Published: October 14, 2019

Thiazide diuretic drugs are the most commonly used molecules for the treatment of systemic hypertension. Despite their established role in the treatment of this disease, well recognized by the guidelines of national (such as the Italian Society of Cardiology - SIC - for example, which incorporates the directives of the European Society of Cardiology - ESC -) scientific societies. Several evidences have shown that hydrochlorothiazide therapy in chronic renal disease with advanced grade of kidney ...

 Open Access DOI:10.23937/2378-2951/1410159

Association between Platelet/Lymphocyte Ratio and Angiographic No-Reflow in Patients with None-St Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention

Ramazan Asoglu, Abdulmecit Afsin, Emin Asoglu3 and Arif Suner

Article Type: Research Article | First Published: September 26, 2019

Inflammation and platelet activation play a central role in the initiation and progression of the atherosclerosis process. The Platelet-to-lymphocyte ratio (PLR) is a new prognostic marker in coronary artery disease. The PLR is a significant independent predictor of longterm mortality after none-ST elevated myocardial infarction (NSTEMI). We aimed to evaluate the relationship between PLR and no-reflow (NR) in patients with NSTEMI. The present study included 173 patients with NSTEMI. The patients...

 Open Access DOI:10.23937/2378-2951/1410158

Systemic Atherosclerosis Treated by Hybrid Surgical and Systemic Percutaneous Endovascular Management

Walid Hassan, MD, MACP, FACC, FSCAI, Amr Aljareh, MD, Mariam Hassan, Khaldoun Al Saadi, MD and Sahar Sharaf Eldin, MD

Article Type: Case Report | First Published: September 23, 2019

Atherosclerotic disease in one arterial site, raise the probability of having other sites affected by about 50% within the vascular axis. Hence once vascular pathology found in one site i.e. coronary artery disease (CAD), other sites i.e. Cerebral and peripheral circulation must be assessed thoroughly, especially in patients with multiple risk factors. Percutaneous intervention (PCI) is a conservative reasonable solution for high risk and inoperable cases; sometimes it supersedes the choice surg...

 Open Access DOI:10.23937/2378-2951/1410157

A Modified Advanced Cardiac Life Support Algorithm

Abdulhalim Jamal Kinsara

Article Type: PATIENT CARE | First Published: September 21, 2019

Advanced cardiac life support (ACLS) has been made with many algorithms. We are suggesting a simple combined one as a time frame expected to attend is minutes and maintaining coherent neurological status is crucial. In institutions with multiple nationalities, the way in which ACLS is taught might vary and the time frame expected to attend the important minutes in saving a life and maintaining coherent neurological status might been delayed....

 Open Access DOI:10.23937/2378-2951/1410156

A Rare Coronary Anomaly: Congenital Absence of the Left Circumflex Artery

Robert Tonks, MD, Rajiv Sharma, MD and Raj Baljepally, MD, FACC

Article Type: Case Report | First Published: August 26, 2019

Congenital anomalies of the coronary vasculature are usually asymptomatic and rare with an incidence of less than 1% and there are few cases reported of congenital absence of the left circumflex artery. It is important to recognize this anomaly and define the anatomy by left heart catheterization or coronary angiography by computerized tomography when considering percutaneous intervention or coronary artery bypass surgery on patients without a left circumflex artery. 71 yo male that recently mov...

 Open Access DOI:10.23937/2378-2951/1410155

Predictors of Heart Failure Caused by Volume Overload Using an Irrigation Catheter during Catheter Ablation for Atrial Fibrillation

Taeko Sato, RN, Issei Yoshimoto, MD, Naoya Oketani, MD, Hideki Okui, MD, Yasuhisa Iriki, MD, Hitoshi Ichiki, MD, Ryuichi Maenosono, PhD, Fuminori Namino, MT, Masaaki Miyata, MD and Mitsuru Ohishi, MD

Article Type: Original Article | First Published: August 14, 2019

Catheter ablation is an effective approach for managing patients with atrial fibrillation (AF). Currently, irrigation catheters are widely used in AF ablation. This causes volume overload during the procedure and occasionally causes heart failure after the procedure. Volume overload during catheter ablation caused heart failure not only in the patient with reduced ejection fraction but also who with preserved left ventricular ejection fraction. Heart failure with preserved left ventricular eject...

 Open Access DOI:10.23937/2378-2951/1410154

Angiographic Pattern of Coronary Artery Disease in Diabetic Patients Having Abnormal Ankle Brachial Index

Syed Haseeb Raza Naqvi, MBBS, FCPS, Han Naung Tun, MBBS, MD, Abdul Razzaq, MBBS, FCPS, Zubair Zaffar, MBBS, FCPS, Syed Nauman Ali, MBBS, FCPS, Haroon Babar, MBBS, FCPS and Tariq Abbas, MBBS, FCPS, FRCP

Article Type: Research Article | First Published: August 09, 2019

A total of 115 patients were included in the study. The mean age of patients was 62.40 years with standard deviation of 2.78 years. Majority of the patients in the study were male (68.7%). Mean ABI was of study participants was 1.2 with standard deviation of 0.58 while mean duration of disease was 3.2 years with standard deviation of 0.7 years. 97 of the study participants were hypertensive and 18 were smokers. A total of 28 patients (24.3%) did not have CAD as per angiography while the rest had...

 Open Access DOI:10.23937/2378-2951/1410153

The Impact of Transcatheter Aortıc Valve Implantatıon on Neutrophıl to Lymphocyte Ratıo: A Retrospective Study

Abdulmecit Afsin, MD, Veysi Kavalcı, MD, Zeynep Ulutas, MD, Hakan Kaya, MD, Erdal Akturk, Arif Suner and Necip Ermis

Article Type: Original Article | First Published: August 03, 2019

Transcatheter aortic valve implantation (TAVI) has become a novel therapeutic option for patients with severe aortic stenosis who have been considered inoperable or high risk for conventional surgical aortic valve replacement. The aim of this study was to determine the effect of TAVI on neutrophil to lymphocyte ratio (NLR). A total of 97 patients with severe aortic valve stenosis undergoing TAVI in our clinic were included in the study. The patients were divided into two groups based on valve t...

 Open Access DOI:10.23937/2378-2951/1410152

Left Main Coronary Artery Dissection during Breastfeeding Treated with CABG Complicated by Severe Ventricular Disfunction and Left Ventricular Thrombosis

Nicolo Sisti, MD, Giulia Elena Mandoli, MD, Antonio Pagliaro, MD, Giuseppe Guerrieri, MD, Carlotta Sciaccaluga, MD, Matteo Cameli, MD, PhD, Sergio Mondillo, MD and Serafina Valente, MD

Article Type: Case Report | First Published: July 18, 2019

Spontaneous coronary artery dissection (SCAD) should always be suspected in presence of chest pain during post-partum, since it is one of the possible causes. Strategies for the management of such disease and its complication are not still clearly encoded. A 40-years-old woman was referred with chest pain, started while breastfeeding, associated with an EKG pattern suggesting ischemia. After hospital admission, coronary angiography was performed showing a Type 1 left main coronary dissection. Gi...

 Open Access DOI:10.23937/2378-2951/1410151

Prevalence and Clinical Correlates of Spontaneous Echo Contrast in Patients on Oral Anticoagulation Undergoing Catheter Ablation for Atrial Fibrillation

Christian Grebmer, Carsten Lennerz, Amir Brkic, Patrick Blazek, Severin Weigand, Verena Semmler, Marc Kottmaier, Felix Bourier, Lena Friedrich, Elena Risse, Stephanie Brooks, Marie Kornmayer, Marta Telishevska, Tilko Reents, Christof Kolb, Gabriele Hessling and Isabel Deisenhofer

Article Type: Research Article | First Published: June 19, 2019

Spontaneous echo contrast (SEC) in the left atrial appendage (LAA) is associated with an increased risk of cerebral embolism in patients with atrial fibrillation (AF). Novel oral anticoagulants (NOACs) are increasingly prescribed as first-line therapy and have shown a comparable benefit-risk ratio compared to vitamin K antagonists (VKAs). The aim of this study was to investigate whether NOACs decrease the incidence of SEC compared to VKA. ...

 Open Access DOI:10.23937/2378-2951/1410150

Unroofed Coronary Sinus Syndrome Presenting with Early Pulmonary Hypertension

Maria E Franco-Fuenmayor, MD, Numra A Aleem, MD, Jorge D Salazar, MD, and Ashraf M Aly, MD

Article Type: Case Report | First Published: June 13, 2019

Isolated partial or complete absence of the coronary sinus roof hemodynamically behaves like an atrial septal defect and rarely causes pulmonary hypertension. We report a case of unroofed coronary sinus (URCS) presenting with post-operative cyanosis due to pulmonary hypertensive crisis following surgical repair of a ventricular septal defect at 6 months of age. He had progressively decreased stamina with gradual increase in pulmonary pressure requiring surgical closure of the URCS by 6 years of ...

 Open Access DOI:10.23937/2378-2951/1410149

Impact of Low-Dose Intracoronary Alteplase Infusion after Successful Primary Percutaneous Coronary Intervention

Ismail Mohamed Ibrahim, Ahmed S Eldamanhory, Mahmoud Abdelaziz and Abdelrashid Abdelaziz

Article Type: Research Article | First Published: June 05, 2019

In ST elevation myocardial infarction (STEMI), intracoronary thrombolysis after primary percutaneous coronary intervention (PPCI) was found to improve microvascular perfusion, yet without improvement in left ventricular (LV) remodeling. Our study aimed to find out possible effect on LV longitudinal function. 102 anterior STEMI patients eligible for PPCI were divided into: Alteplase group (53 patients; received intracoronary 0.3 mg/kg alteplase after PPCI) and control group (49 patients; treated ...

 Open Access DOI:10.23937/2378-2951/1410148

Left Ventricular Pacing in Patients with Mechanical Tricuspid Valve Replacement

Sara Khodor, Shreya Mishra, Dany Sayad and Anant Kharod

Article Type: Case Report | First Published: June 01, 2019

In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alt...

 Open Access DOI:10.23937/2378-2951/1410147

Relationship between Hypovitaminosis D and Cardiac Abnormalities in Pre Dialysis Chronic Kidney Disease

Maria Carolina Neves, Luis Sette, Monica Becker, Lucila Valente and Brivaldo Markman Filho

Article Type: Research Article | First Published: June 01, 2019

The presence of structural and functional changes in the left ventricle (LV) are good predictors of cardiovascular events in patients with chronic kidney disease (CKD) and are associated with decreasing renal function. Studies in CKD patients on hemodialysis evidenced associations of serum 25-OH vitamin D (vit D) with myocardial function and structural changes. However, it is not known whether serum vit D is associated with Doppler echocardiogram (ECHO)-based cardiac changes in patients with CKD...

 Open Access DOI:10.23937/2378-2951/1410146

Hyperlipidemia Management in Proprotein Convertase Subtilisin- Kexin Type 9 (PCSK 9) Inhibitors Era

Abdulhalim Jamal Kinsara

Article Type: Original Article | First Published: June 01, 2019

Significant improvement in control of cardiovascular risk factors has been driven by performance measurement that focused on attainment of specific risk factor thresholds for blood glucose, lipids and blood pressure. Diet, statin and ezetimibe have reasonably controlled hyperlipidemia. However the discovery of proprotein convertase subtilisin-kexin type 9 inhibitors has given new hope of reaching the target lipid profile especially in the high-risk group and familial hypercholesterolemia. Here w...

 Open Access DOI:10.23937/2378-2951/1410145

Molecular Basis of Pulmonary Hypertension

Ambrin Farizah Babu

Article Type: Review Article | First Published: May 31, 2019

Pulmonary hypertension is a life threatening incurable disorder. The advances in physiology, genetics, and molecular biology have greatly improved our understanding of the cellular and molecular mechanisms underlying the disorder. In this review, the recent progresses in the understanding of molecular mechanism are presented. Many studies show that pulmonary hypertension is caused due to mitochondrial dysfunction, endothelin-1, prostacyclin and serotonin. These findings and their exploitation wi...

 Open Access DOI:10.23937/2378-2951/1410144

Current Endocarditis Prophylaxis Guidelines and Incidence of Infection

Nikita Carvalho

Article Type: Review Article | First Published: May 30, 2019

Infective endocarditis (IE) defined as an infection caused by bacteria that enter the bloodstream and settle in the endocardium, a heart valve or a blood vessel, has maintained a high prevalence, morbidity and mortality over the past few decades. The most obvious changes over time have been in terms of factors that lead to IE. For e.g. A larger elderly population, decrease in Rheumatic heart disease (RHD) cases, Increased use of prosthetic heart valves, increased intravenous drug abuse, and incr...

 Open Access DOI:10.23937/2378-2951/1410143

Management of Recurrent Acute Thrombotic Occlusion of a Giant Coronary Artery Aneurysm Presenting with Recurrent Inferior ST Segment Elevation Myocardial Infarction

Liew Boon Wah Matthew, Lee Shao Guang Sheldon and Lim Yaozong Benji

Article Type: Case Report | First Published: May 04, 2019

Giant coronary artery aneurysm is an uncommon finding during coronary angiogram. There is limited data or consensus on the management of patients with giant coronary artery aneurysm in the setting of acute coronary syndrome. We present a unique case of a recurrent thrombotic occlusion of the right coronary artery presenting as recurrent inferior wall ST segment elevation myocardial infarction (STEMI) requiring percutaneous coronary intervention. He had failed trial of novel anticoagulant with an...

 Open Access DOI:10.23937/2378-2951/1410142

Long-Term Clinical and Echocardiographic Outcome in Patients with CRT and Functional Mitral Regurgitation: MitraClip versus Optimal Medical Therapy

Arianna Cirasa, MD, Antonio Popolo Rubbio, MD, Paolo Zappulla, MD, Angelo Di Grazia, MD, Daniela Dugo, MD, Salvatore Scandura, MD, Sarah Mangiafico, MD, Carmelo Grasso, MD, Corrado Tamburino, MD, PhD, Davide Capodanno, MD, PhD and Valeria Calvi, MD, PhD

Article Type: Research Article | First Published: April 03, 2019

This study sought to evaluate the clinical outcome in cardiac resynchronization therapy (CRT) patients with residual moderate-to-severe functional mitral regurgitation (FMR) who underwent percutaneous treatment with the Mitraclip System or were managed with medical therapy alone. Significant FMR can persist in 20-25% of patients after CRT and its management can be a challenge, due to the advanced heart failure (HF) and a variety of concomitant comorbidities. From a single center, two different g...

 Open Access DOI:10.23937/2378-2951/1410141

Ventricular Fibrillation in Arrhythmogenic Cardiomyopathy: Four Strategies to Effective Risk Management

Stefan Peters

Article Type: Case Report | First Published: March 25, 2019

The case of a 52-year-old female patient is reported who suffered aborted sudden cardiac arrest, got layman’s resuscitation, and then defibrillation into normal sinus rhythm with temporary right precordial ST segment elevation. The patient was admitted to hospital, the diagnosis of early-stage arrhythmogenic cardiomyopathy by ECG, echocardiography and left ventricular, right ventricular and coronary angiography was made. Echocardiography findings revealed dilatation of the right ventricular ou...

 Open Access DOI:10.23937/2378-2951/1410140

Relation between Heart Failure Patients with Cardio-Renal Syndrome and Serum Levels of Vitamin D

Haitham Galal Mohammed, MD, Mohammed Ahmed Abdelrahman, MD and Tarek Rashid Mohammed, MD

Article Type: ORIGINAL ARTICLE | First Published: March 06, 2019

Worldwide, the prevalence of vitamin D deficiency is as high as almost 50% among the elderly and the association between vitamin D and heart failure is widely debated. To study the relation between serum 25-hydroxy vitamin D levels and echocardiographic parameters of cardiac function in heart failure patients with cardio-renal syndrome. The study included 90 patients of all age groups and both sexes. They were divided into 3 groups of patients: 1: Systolic dysfunction and renal insufficiency (30...

 Open Access DOI:10.23937/2378-2951/1410139

Two Case Reports of Emergency Stenting of Superior Vena Cava Obstruction Following Cardiac Surgery

Putri Yubbu, Ong Yun Jin, Mohd Amin Itam, Hamdan Leman and Koh Ghee Tiong

Article Type: CASE REPORT | First Published: March 04, 2019

Superior vena cava (SVC) obstruction is a recognized complication following cardiac surgery that may result in significant clinical sequelae if not treated early. Transcatheter stenting is rapidly becoming the treatment of choice, considering its reduced post-procedure morbidity and faster recovery time. In early postoperative vascular lesion, primary stenting is preferred over balloon angioplasty to prevent fresh suture line disruption. In paediatric, small patient sizes as well as the need for...

 Open Access DOI:10.23937/2378-2951/1410138

Effects of Bisoprolol and Flecainide in an Elderly Patient with Paroxysmal Supraventricular Tachycardia and Atrial Fibrillation in Wolff-Parkinson-White Syndrome

Jae-Jin Kwak, Joon Hyung Doh and Sung Yun Lee

Article Type: CASE REPORT | First Published: February 27, 2019

Wolff-Parkinson-White (WPW) syndrome can develop paroxysmal supraventricular tachycardia (PSVT) or/and paroxysmal atrial fibrillation (AF). AF in WPW syndrome is a potentially life-threatening arrhythmia. Radiofrequency catheter ablation is recommended in patients with AF in WPW syndrome. Atrioventricular nodal blockers can precipitate ventricular fibrillation and should not be used. We present patients with PSVT and AF in WPW syndrome who was treated with bisoprolol and flecainide. ...

 Open Access DOI:10.23937/2378-2951/1410137

Complete Right Bundle Branch Block in Arrhythmogenic Cardiomyopathy: Similarities to Brugada Syndrome

Stefan Peters

Article Type: ORIGINAL ARTICLE | First Published: February 14, 2019

Brugada syndrome is characterized by coved-type ST-segment elevation in one or two right precordial leads. Two types of coved-type ST elevation has been described: A form of complete right bundle branch block (about 60%), in which right precordial leads demonstrate complete block and left precordial leads reveal nearly normal QRS configuration. In about 40% complete right bundle branch block with nearly identically increased QRS intervals....

 Open Access DOI:10.23937/2378-2951/1410136

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

Ibrahim AlQassas, MD, Walid Hassan, MD, MACP, Nadia Sunni, MD, Mohammed Lhmdi, MD, Alaa Nazzal, MD, Mohammed J Mohamed, Farhan Dar, MD, Sahar Sharafeldin, MD, Amr Aljareh, MD, Hasan Balubaid, MD, Basema Alshengiti, MD, Ehab Hasan, MD, Heba Waez, MD, Sarah Bahnshal, MD, Momen Nassani, MD, Mohammed Al-Kulak, MD, Maha AlKudsi, MD, Hala Zein Elabidinm, MD and Ibrahim Mansour, MD

Article Type: RESEARCH ARTICLE | First Published: February 14, 2019

Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no correlation was found between age and troponin levels (the statistical number r value needs to be put here). Although expectedly patients with diagnosis of acute coronary syndrome displayed TnT-HS values significantly higher than those of other groups, positivity to TnT-HS (> 40 ng/l) was also observed in patients with other clinical conditions....

 Open Access DOI:10.23937/2378-2951/1410135

Spontaneous Coronary Artery Dissection and the Takotsubo Syndrome: An Association to be Taken into Account

Veronica Hernandez Jimenez, Aranzazu Garcia Romero and Jesus Saavedra Falero

Article Type: Case Report | First Published: January 16, 2019

Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) are two causes of acute non-arteriosclerotic myocardial infarction. These two entities share some characteristics such as greater involvement in women, preceded by an emotional stressor and an etiopathogeny not clearly known. Recently it has been seen that these two entities may be related. We describe a case of a young woman with a myocardial infarction due to a SCAD who developed a TTS. A 44-year-old woman, without know...

 Open Access DOI:10.23937/2378-2951/1410134

Myocardial Infarction Secondary to Multiple Coronary-Pulmonary Fistula in a High Performance Athlete

Gil Ramirez Andreina, Burgos Lucrecia Maria, Chillik Ivan Ezequiel, Pelletier Maria, Larocca Calvino Mariana, Spaletra Pablo and Elizari Maria Amalia

Article Type: Case Report | First Published: January 14, 2019

The incidence of CF is 0.002% of general population, observed in 0.2% of adult patients undergoing coronary angiography. More frequently of congenital origin, they have also been described related to invasive procedures, chest trauma or post myocardial infarction. In 55% of cases they are originated from the right coronary artery, in 35% from left coronary artery and 5% in both simultaneously. Seventy percent of CF drain into right cavities (low pressure circuits), 15% into pulmonary artery and ...

 Open Access DOI:10.23937/2378-2951/1410133

IVUS Findings of Drug Eluting Balloon Failure in the Treatment of In-Stent Restenosis

Sung Yun Lee, Sang-Wook Kim, Jin Bae Lee, Eun-Seok Shin, Joon Hyung Doh, Young Joon Hong, Jae-Jin Kwak and Hyung Yoon Kim

Article Type: Research Article | First Published: December 24, 2018

The objective of this study is to investigate pre-intervention IVUS characteristics of in-stent restenosis (ISR) lesion correlated with PEB failure. We performed pre-intervention IVUS for 58 patients with ISR and treated with PEB angioplasty. The PEB failure was defined as death, myocardial infarction and symptom driven revascularization. IVUS images were analyzed at 6 locations: Proximal and distal vessel segment within 3 mm from stent edge, proximal and distal stent edge, lesion site at minima...

 Open Access DOI:10.23937/2378-2951/1410132

Evaluation of Hemodynamic Behavior of a Stentless Aortic Bioprosthesis under Stress by Exercise Echocardiography

Guglielmo Stefanelli, Fabrizio Pirro, Andrea Macchione, Gianpiero Patrizi, Luca Weltert and Andrea Barbieri

Article Type: Original Article | First Published: December 22, 2018

Aim of this study was to evaluate by transthoracic echo the hemodynamic behaviour and the changes in dimensional data of a stentless aortic bioprosthesis between rest and exercise conditions. se of exercise echocardiography to assess changes in hemodynamics and function of aortic bioprostheses can be helpful in the choice of appropriate aortic valve substitutes. SPF pericardial stentless valve presents favourable and durable hemodynamic characteristics at rest and on exercise, similar to native ...

 Open Access DOI:10.23937/2378-2951/1410131

The Profile of an Adult with Congenital Heart Disease

John Jairo Araujo

Article Type: Short Review | First Published: December 01, 2018

Congenital heart disease is the most frequent malformation. In the most recent data has a prevalence of thirteen cases per 1,000 children and six cases per 1,000 adults. Great strides in pediatric cardiovascular surgery have increased the number of survivors, especially in adulthood. Nowadays more adults are living with congenital heart disease than children, particularly in developed countries, and more than two thirds fall into the categories of moderate and high complexity defects. This growi...

 Open Access DOI:10.23937/2378-2951/1410130

Carotid Sinus Syndrome in a Patient with Symptomatic Abdominal Aortic Aneurysm - A Case Report

Ksenija Stevanovic, Ranko Trailovic, Biljana Kukic, Marko Dragas, Slobodan Cvetkovic and Lazar Davidovic

Article Type: Case Report | First Published: November 12, 2018

Carotid sinus syndrome (CSS) is defined as syncope with reproduction of symptoms during 10s of carotid sinus massage. The etiology of this condition is unknown, patients are usually symptomatic and present with episodes of syncope. Due to the associated marked sinus bradycardia, sinus arrest or severe hypotension, carotid sinus syndrome may be life-threatening. In patients without previous symptoms, CSS must be promptly recognized and treated, otherwise may lead to catastrophic consequences. If ...

 Open Access DOI:10.23937/2378-2951/1410128

Neurologic and Renal Outcomes of Elective Proximal Aortic Repair and Current Cannulation Trends

Sahin Iscan and Bortecin Eygi

Article Type: Research Article | First Published: November 07, 2018

Cerebral protection is a big technical difficulty for aortic surgery. Increased use of antegrade cerebral perfusion (ACP) and deep hypotermic circulatory arrest in experienced hands made open surgery of the ascending aorta and aortic arch aneurysms more successful today. The increase in the variety of surgical equipment to provide unilateral and bilateral cerebral perfusion or monitorization, the effectiveness of the cerebral protection instantly decreased the risk of perioperative stroke or pos...

 Open Access DOI:10.23937/2378-2951/1410127

Measurement of the QT Interval: Lessons from Thirty-Two Animal Species for the Correction of the QT Interval by Heart Rate

Simon W Rabkin

Article Type: Review Article | First Published: November 07, 2018

The optimal method to correct the QT interval, an important indication of arrhythmia risk, for the impact of heart rate has been controversial. The fundamental biologic relationship of the QT interval-heart rate relationship has rarely been studied across different species. The literature on the QT and heart rate of 32 different species was examined specifically in the whales, dolphins, Asian elephants, rhinoceros, camels, brown bears, grizzly bear, lions, tigers, sea lions, seals, donkeys, poni...

 Open Access DOI:10.23937/2378-2951/1410126

Takotsubo Stress Syndrome and Intracoronary Thromboembolic Occlusion: Fact or Myth?

Stefan Peters

Article Type: Case Report | First Published: October 24, 2018

A few case reports found an association between left ventricular apical ballooning and transient thromboembolic occlusion in myocardial bridging of the mid-portion left anterior descending coronary artery. In two additional, so far unpublished case reports distal or mid-portion thromboembolic occlusion of the left anterior descending coronary artery and the first diagonal branch were described. Both cases had a tragic outcome-either due to myocardial perforation or disseminated intravascular coa...

 Open Access DOI:10.23937/2378-2951/1410125

Percutaneous Transcatheter Balloon Valvuloplasty for Bioprosthetic Tricuspid Valve Stenosis in a Patient with Adult Congenital Heart Disease: A Case Report

Manabu Nitta, Teruyasu Sugano, Yusuke Matsumoto and Munetaka Masuda

Article Type: Case Report | First Published: October 11, 2018

A 38-year-old male with previous surgeries for an incomplete atrioventricular septal defect successfully underwent percutaneous transcatheter tricuspid balloon valvuloplasty for a deteriorated bioprosthetic valve. Our case highlights the imperative of considering catheter-based minimally invasive therapy for the increasing number of adults with congenital heart disease who may present multiple risks factors for surgery....

 Open Access DOI:10.23937/2378-2951/1410124

Benign Metastasizing Leiomyoma of the Heart

Amit C Shah, Srijan Shrestha and Mark Rosenthal

Article Type: Case Report | First Published: September 29, 2018

This is a rare case of a 53-year-old woman with history of oophorectomy and hysterectomy 3 years prior to presentation admitted for gait abnormality and found to have a basal ganglia stroke. Transthoracic echocardiogram for stroke work up revealed a cardiac mass in the right atrium emanating from Inferior Vena Cava (IVC). Computed Tomography imaging of abdomen and pelvis ruled out malignancy. The mass was surgically removed due to high risk of embolization. Intraoperative, transesophageal echoca...

 Open Access DOI:10.23937/2378-2951/1410123

Pacemaker Twiddler Syndrome - A Rare but Serious Cause of Pacemaker Malfunction

Gurkirat Singha, Hemant Khemani, Zahidullah Khan and Narender Omprakash Bansal

Article Type: Case Report | First Published: September 27, 2018

Twiddler's syndrome is a rare complication after pacemaker implantation. It is caused by conscious or unconscious manipulation at the implantation site by the patient with the result of device malfunction. It results in lead dislodgment, diaphragmatic stimulation, and loss of capture. In a pacemaker dependent patient, it can be a lethal complication. It usually occurs in the first year following pacemaker implantation. The treatment involves readmission, repositioning of the dislodged leads and ...

 Open Access DOI:10.23937/2378-2951/1410122

Chronic Total Coronary Occlusions: Stress Echocardiography with Speckle Tracking Analysis Study

Ines Monte, Francesco Calvo, Giovanni Millan, Vincenzo Lavanco, Corrado Tamburino

Article Type: Original Article | First Published: September 24, 2018

Chronic total coronary occlusions (CTO) are found in approximately 15-30% of patients who undergo coronary angiography for suspected or known coronary artery disease. Speckle Tracking Echocardiography (STE) is a novel technology to assessing modifications of myocardial deformation with higher accuracy than the simple visual of regional wall motion. The study was to evaluate, using STE applied to dobutamine stress echocardiography (DSE), changes in echo parameters before and after successful reca...

 Open Access DOI:10.23937/2378-2951/1410121

A Rare Late Term Complication of Vascular Surgery: True Common Femoral Artery Aneurysm

Ali Buturak, Ulaankhuu Batgerel and Duhan Fatih Bayrak

Article Type: Case Report | First Published: September 24, 2018

Femoral artery aneurysm is a rarely seen peripheral aneurysm which may lead to thrombosis, embolism and fatal rupture in untreated cases. Although femoral artery aneurysm is usually caused by atherosclerosis or chronic inflammation, aneurysm formation in sites of anastomosis, grafts or endarterectomy territory may occur at late term. A 57-years-old man presenting with stable angina pectoris was admitted for coronary angiography with documented ischemia in exercise stress test. The patient had a ...

 Open Access DOI:10.23937/2378-2951/1410120

Recurrent Prosthetic Thrombosis: About a Case

Blanca Alcon Duran

Article Type: Case Report | First Published: June 25, 2018

Bioprosthetic valve thrombosis (BPVT) is considered to be a rather unusual complication among this type of prosthesis. However, several recent data show the importance of a careful diagnosis and the adequate discrimination with respect to other possible complications, which may be the cause of an underestimation of its incidence. We present the case of a woman with biological prosthesis thrombosis after a mechanical prosthesis thrombosis....

 Open Access DOI:10.23937/2378-2951/1410119

Acute Mechanical Valve Thrombosis in the Setting of Unusual Aetiology

Zain Sharif, Cian O' Carroll-Lolait, David Moore and Bryan Loo

Article Type: Case Report | First Published: June 04, 2018

A 65-year-old caucasian man with a history of aortic valve replacement with a St. Jude bi-leaflet mechanical prosthesis in 1984, mitral valve replacement in 2004 with Edwards Starr Ball and Cage prosthesis, atrial fibrillation and ulcerative colitis presented to our emergency department with central chest pain radiating to his jaw with associated diaphoresis and nausea. Symptom onset was an hour pre-admission....

 Open Access DOI:10.23937/2378-2951/1410118

Medically Managed Iatrogenic Aortic Dissection: A Safer Option for a Dangerous Condition?

Evan D Levine, Arber Kodra, Rachel M Bond, Fadi Khoury, Dan Inder S Sraow and Georges Y Nseir

Article Type: Case Report | First Published: June 04, 2018

Iatrogenic aortic dissection is a rare complication of both diagnostic and interventional coronary angiography. In the few case studies that have been reported in current medical literature, surgical management was generally opted for; however, with poor overall outcomes. Given these unfavorable outcomes, a different treatment strategy should be considered. We report a case of iatrogenic aortic dissection successfully treated with intensive medical therapy and utilization of a multi-modality ser...

 Open Access DOI:10.23937/2378-2951/1410117

Diagnosis and Endovascular Management of Segmental Heel Ischemia

Miguel Montero-Baker, Bernadino Castelo Branco Rocha, David G Armstrong, Kay R Goshima, John Miller and Joseph L Mills Sr

Article Type: Original Article | First Published: June 04, 2018

Diabetic foot ulcers are common, costly, frequently recurrent and chronic. Once infected they all too often are the precursors of major limb amputation. Increased pressure decreased angiogenic response, neuropathy, trauma and deformity all contribute in varying degrees to the pathogenesis of these ulcers. Patients with limited mobility are at higher risk of developing an even more morbid subtype of diabetic foot complication: The heel ulcer....

 Open Access DOI:10.23937/2378-2951/1410116

What if the Ventricle was Innocent for Once? The Infrequent Case of a Guilty Atrium

Angelica Abbate, Giulia Teresi, Davide Piraino, Giuseppe Andolina and Pasquale Assennato

Article Type: Letter To Editor | First Published: June 04, 2018

An 82-year-old man with chronic atrial fibrillation was admitted to our department for progressive dyspnea, III NYHA class. Almost 10 years ago, he underwent replacing of mitral valve with a mechanical prosthesis CarboMedics size 31 (Sorin Group - Milan, Italy) due to severe mitral valve insufficiency and plastic of tricuspid valve due to moderate - severe insufficiency....

 Open Access DOI:10.23937/2378-2951/1410115

Cardiovascular Risk in Patients with Chronic Kidney Disease is Associated with Decrease of HDL Levels

Cicera Jacqueline da Conceicao Silva, Rafaely Pereira de Alencar, Leticia Miranda Tenorio, Nathanielly Lima da Silva, Amanda Feitosa de Barros, Chiara Rachel Maciel Marinho and Raphael de Souza Pinto

Article Type: Research Article | First Published: June 04, 2018

Cardiovascular diseases are the leading causes of death in patients undergoing hemodialysis. Despite new treatments and advances in dialysis processes, patients with chronic kidney disease (CKD) have 10 to 20 times higher mortality rate from cardiovascular disease compared to geral population....

 Open Access DOI:10.23937/2378-2951/1410114

Three-Year Follow-Up of a Single-Center Series of Patients with Device-Aided Left Atrial Appendage Closure and Strict Echocardiographic Control

Jose Ramon Lopez-Minguez, Juan Manuel Nogales-Asensio, Victoria Millan-Nunez, Patricia Marquez-Marquez, Bruno Blenga-Limpo, Carmen Garcia Corrales, Diego Felix Arroyo-Monino, Concepcion Lopez-Fernandez, Eugenia Fuentes-Canamero, Reyes Gonzalez-Fernandez and Antonio Merchan-Herrera

Article Type: Research Article | First Published: June 01, 2018

Non-valvular atrial fibrillation (NVAF) is a significant health problem, particularly in the older population. Since the introduction of novel oral anticoagulants (novel OAC), greater numbers of patients at risk of stroke who previously were not candidates for oral anticoagulation (OAC) with warfarin or acenocumarol due to the risk of bleeding are now being treated. Until then, up to 30%-40% of patients who needed OAC treatment were not treated due to fear of bleeding on the part of the patient ...

 Open Access DOI:10.23937/2378-2951/1410113

Cardiovascular Risk Assessment of Dyslipidemic Middle-Aged Adults without Overt Cardiovascular Disease over the Period of 2009-2016 in Lithuania

Sandra Kutkiene, Zaneta Petrulioniene, Aleksandras Laucevicius, Pranas Serpytis, Justina Staigyte, Akvile Saulyte, Emilija Petrulionyte, Urte Gargalskaite, Egle Skiauteryte, Gabija Matuzeviciene, Milda Kovaite, Egidija Rinkuniene and Vilma Dzenkeviciute

Article Type: Research Article | First Published: May 23, 2018

Cardiovascular mortality in Lithuania is extremely high and abnormal lipid levels are very common among Lithuanian adults. Dyslipidemia is one of the main independent risk factors for cardiovascular diseases (CVD) leading to high absolute CVD risk. The aim of this study was to assess CVD risk in dyslipidemic middle-aged subjects....

 Open Access DOI:10.23937/2378-2951/1410112

Less Phosphorus, More Problems: Hypophosphatemia Induced Polymorphic Ventricular Tachycardia in a Young Male

Robin Jacob, Ritesh S. Patel and Francisco Fuentes

Article Type: Case Report | First Published: May 12, 2018

It is well known that electrolyte derangements such as hypokalemia, hypomagnesaemia, and hypocalcaemia can potentially cause dangerous arrhythmias in hospitalized patients. This can be a common concern for acute care physicians, as the occurrence of arrhythmias predisposes patients to higher morbidity, mortality, and longer length of stay. Phosphorus, however, has been less studied....

 Open Access DOI:10.23937/2378-2951/1410111

Emergent Repair of Cardiac Rupture and Successful AF Ablation Procedure

Sahin Iscan, Bortecin Eygi and Koksal Donmez

Article Type: Case Report | First Published: May 10, 2018

Today, ablation techniques for atrial fibrillation (AF) are successfully increasing but catheter ablation may have important complication risks. We report the case of a 56-year-old woman with chronic AF who had left atrial rupture during catheter ablation. Echocardiography showed pericardial effusion during procedure and she was operated immediately. Left atrial rupture repaired with sternotomy. After stabilizing the hemodynamic and metabolic parameters, intraoperative bipolar ablation was perfo...

 Open Access DOI:10.23937/2378-2951/1410110

Mass Regression after Aortic Valve Replacement in Aortic Stenosis: A Comparison between

Giordano Tasca, FrancescoTrinca, Beatrice Riva, Douglas Skouse, Elisabetta Lobiati, Caterina Chiara DeCarlini and Amando Gamba

Article Type: Research Article | First Published: April 11, 2018

Left ventricular (LV) hypertrophy is a form of adaptation to a chronic cardiac overload. In the setting of aortic stenosis (AS), LV hypertrophy develops to limit the increase of LV systolic wall stress. Aortic valve replacement (AVR), is expected to eliminate the LV burden, inducing regression of LV hypertrophy....

 Open Access DOI:10.23937/2378-2951/1410109

Transplant Renal Artery Stenosis Secondary to De Novo Fibromuscular Dysplasia

Gabriel A Hernandez, Abhijt Ghatak, Jorge M Diego and Eduardo De Marchena

Article Type: Case Report | First Published: February 16, 2018

We present a patient who developed post kidney transplant renovascular hypertension due to Fibromuscular dysplasia, which was unseen on donor's renal artery angiography. The temporal relationship to the clinically manifested hypertension and the patient's profound weight loss makes us postulate her intra-abdominal fat redistribution led to nephroptosis of the transplanted kidney, causing stretching of the renal artery, exaggerating the Fibromuscular dysplasia and hemodynamically significant sten...

 Open Access DOI:10.23937/2378-2951/1410108

Ventricular Tachycardia after Use of Zuclopenthixol Decanoate (Clopixol® Depot) for the Treatment of Psychotic Illnesses: The First Case in the Literature

Emre Ozdemir Farris, Mustafa Karaca and Mehmet Serdar Bayata

Article Type: Case Report | First Published: February 14, 2018

Certain drugs can induce ventricular tachycardia (VT) in a different mechanism. Most knowed mechanisms are creating new reentry, enhancing ventricular after potentials or exaggerating the slope of phase 4. These kind of arrhythmias can or can not be symptomatic, sustained or non-sustained and have variable ECG changes: Monomorphic or polymorphic ventriculer extras, bidirectional or torsades de pointes ventricular tachyarrhythmias. Zuclopenthixol decanoate blocks postsynaptic Dopamine receptor in...

 Open Access DOI:10.23937/2378-2951/1410107

Platypnea-Orthodeoxia Syndrome: Positional Reversal of the Interatrial Pressure Gradient Demonstrated by Atrial Septal Motion

Serio Farris and Serio M Kerala

Article Type: Case Report | First Published: January 11, 2018

Platypnea-Orthodeoxia Syndrome (POS) is a rare clinical syndrome characterized by dyspnea and hypoxemia while upright that are relieved when the patient is supine. A right to left shunt in combination with several hypothesized hemodynamic or structural factors are needed to develop the syndrome. It is an important source of dyspnea in a small percentage of often-elderly patients. The exact mechanism for the positional increase in the shunt has remained elusive....

 Open Access DOI:10.23937/2378-2951/1410106

Adenosine Stress Myocardial Perfusion Scintigraphy and Echocardiography Application with Same Infusion

Zehra Pinar Koc, Necati Dagli, Tansel Ansal Balci, Ilgin Karaca, Ferat Kepenek and Tolga Cakmak

Article Type: Research Article | First Published: December 30, 2017

Stress Echo was performed by an experienced cardiologist and MPS results were interpreted by an experienced nuclear medicine physician who didn't know stress Echo results according to 17 segment models. Sixteen patients underwent coronary angiography. Ischemia territory size in both the adenosine stress Echo and MPS were recorded and compared in segment and in patient basis....

 Open Access DOI:10.23937/2378-2951/1410105

The Heart Remembers: Anterior T wave inversions in a Patient with Intermittent Left Bundle Branch Block

Janaki Rami Reddy Manne

Article Type: Case Report | First Published: October 11, 2017

Even though the new onset of T wave inversions on the electrocardiogram is always an alarming finding, but they are not always pathognomonic of myocardial ischemia. Many cardiac and non-cardiac conditions have been described in association with T wave inversions on the electrocardiogram....

 Open Access DOI:10.23937/2378-2951/1410104

Giant Right Atrium or Ebstein Anomaly?

Hacer Kamalı, Abdullah Erdem, Cengiz Erol and Atıf Akçevin

Article Type: Case Report | First Published: October 09, 2017

Many acquired and congenital pathologies could cause enlargement of Right Atrium (RA). In rare pathologies we couldn't find an obvious reason for enlargement of RA. Sometimes it leads to misdiagnosis if we try to explain an unknown pathology with well known pathology....

 Open Access DOI:10.23937/2378-2951/1410103

Endothelial Function for Cardiovascular Disease Prevention and Management

Minako Yamaoka-Tojo

Article Type: Review Article | First Published: September 27, 2017

Endothelium is a layer of the endothelial cells lining to the lumen of blood vessels, lymphatic vessels, the heart and other organs. Vascular endothelium is considered to be the largest endocrine organ in human body. Its total weight is about 1.5 kg, and it is responsible for maintaining homeostasis of the living body by exerting various functions....

 Open Access DOI:10.23937/2378-2951/1410102

A Feasibility Pilot Study to Assess the Efficacy of NavX Guided Detection of Pulmonary Vein Electrograms during Atrial Fibrillation Ablation [NavX Guided Detection of Pulmonary Vein Electrograms]

Yaariv Khaykin, Pouria Alipour, Meysam Pirbaglou, Paul Ritvo, Zahra Azizi, Zaev Wulffhart, Bonnie Whaley, David Giewercer, Kellie Winger and Atul Verma

Article Type: Research Article | First Published: September 25, 2017

Pulmonary Vein Antrum Isolation (PVAI) targeting PV triggers is an established treatment for paroxysmal Atrial Fibrillation (AF). Ablation lesions are typically delivered around the entire circumference of each individual PV. This study tested a strategy where electrical inputs to the PVs were mapped using the NavX system and selectively targeted before ablation....

 Open Access DOI:10.23937/2378-2951/1410101

Value of a New QT Interval Correction Formula in Adjusting for Increases in Heart Rate

Simon W Rabkin

Article Type: Research Article | First Published: August 03, 2017

QT interval correction for heart rate (QTc) is essential for clinical usage. A new QTc formula has been developed based on a data agnostic mathematical approach in a large population ECG data base. The formula requires testing on a within individual basis under conditions of intervention to increase heart rate....

 Open Access DOI:10.23937/2378-2951/1410100

Why Cardiac Resynchronization Therapy (CRT) is Usually Prescribed along with Automatic Implantable Defibrillation (AID)? Is it a Sensible Decision? Historical Perspective

Max E Valentinuzzi

Article Type: Critical Review | First Published: July 26, 2017

The objective of this paper tries to answer the questions posed in the title, that is, why Cardiac Resynchronization Therapy (CRT) is usually prescribed along with Automatic Implantable Defibrillation (AID)? Is it a sensible decision? For that matter....

 Open Access DOI:10.23937/2378-2951/1410099

A Case of Sudden Unexpected Death with the Presence of Multiple Myocardial Bridges

Naoki Nishida and Yukiko Hata

Article Type: Case Report | First Published: June 26, 2017

We present an autopsy case of a 66-year-old man who died during walking. Besides a history of hypertension for 5 years, mild chest oppression appeared to occur shortly before death. A full autopsy and the police examination concluded that the cause of death was sudden cardiac death....

 Open Access DOI:10.23937/2378-2951/1410098

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

Anna F Thomsen J Tobias Kuhl, Klaus F Kofoed, Andreas Fuchs, Patricia M Udholm, Jakob B Norsk, Xu Chen, Steen Pehrson, Borge G Nordestgaard, Lars Kober and Peter K Jacobsen

Article Type: Research Article | First Published: June 26, 2017

Atrial Fibrillation (AF) is the most common cardiac arrhythmia and a cause of increased morbidity and mortality. Left Atrial (LA) tissue characteristics play an important role in the pathogenesis of AF. Catheter ablation of AF has emerged as a popular treatment option, however predictors of treatment success are not clearly defined....

 Open Access DOI:10.23937/2378-2951/1410097

Long Term High-Fat Diet-Induced Modification of Vascular Wall and Perivascular Adipose Tissue-Mediated Oxidative Stress: Consequences for Endothelium-Independent Vascular Function in Rats

Caroline Sanchez, Vincent Achard, Michel Grino and Stephane Tanguy

Article Type: Research Article | First Published: June 24, 2017

Visceral obesity, a feature of the metabolic syndrome, is associated with metabolic and cardiovascular diseases. Our aim was to study the influence of increased fat intake, a major determinant of central obesity, on Smooth Muscle Cells (SMC) reactivity and its interaction with Perivascular Adipose Tissue (PVAT), which plays an important role in the local regulation of vascular function, with a special emphasis on oxidative stress....

 Open Access DOI:10.23937/2378-2951/1410096

Pulmonary Artery Agenesis in Young Adult - Two Case Reports

Walter Serra Francesco Tafuni, Nicola Sverzellati, Maria Alberta Cattabiani and Angelo Placci

Article Type: Case Report | First Published: June 08, 2017

A 21-year-old woman presented for a history of exertional dyspnoea and atypical chest pain. No history of allergies or tuberculosis. A chest X-ray showed asymmetry of the chest walls from a reduced expansion of the right lung caused by parenchymal loss and right deviation of the mediastinum and ipsilateral elevation of the diaphragm....

 Open Access DOI:10.23937/2378-2951/1410095

A Case of Coronary Artery Spasm Associated with Lisdexamfetamine Use

Harmony R Reynolds and Leon H Charney

Article Type: Case Report | First Published: April 13, 2017

Coronary artery spasm is a cause of myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary spasm may occur spontaneously or in response to prescribed or illicit drugs. Myocardial injury and cardiomyopathies have been reported in association with the use of stimulants in children and adults with attention deficit hyperactivity disorder (ADHD)....

 Open Access DOI:10.23937/2378-2951/1410094

Intravenous Immunoglobulins in the Management of Parvovirus B19 Induced Fulminant Myocarditis: Case Report

Maysa Saleh and Samir Sajwany

Article Type: Case Report | First Published: April 01, 2017

One-year-old boy was admitted to a hospital suffering from acute myocarditis, dilated cardiomyopathy and congestive heart failure. He was experiencing vomiting for 2 days, breathing difficulty and poor oral intake. In view of deterioration of his condition that has required ventilator support, inotropes, anti-failure medications and antibiotics, hence, he was transferred to our hospital....

 Open Access DOI:10.23937/2378-2951/1410093

Early Therapy with Beta Blockers Plus Ivabradine Versus Beta Blockers Alone in Patients Hospitalised with Heart Failure and Reduced Ejection Fraction (ETHIC-AHF Study): Results at One-Year Follow-Up

Francisco J Hidalgo, Francisco Carrasco, Juan C Castillo, Sara Rodriguez, Laura Pardo, Enrique Duran, Carlos Ferreiro, Jose Sanchez, Monica Delgado, Dolores Mesa, Martin Ruiz and Manuel Anguita

Article Type: Original Article | First Published: March 06, 2017

Heart rate (Hr) has prognostic value in patients with heart failure, depressed ejection fraction (HFrEF) and sinus rhythm. Objective: Is to analyze the effect of the early co-administration of ivabradine added to beta-blockers (intervention group) versus only beta blockers (control group) in patients hospitalized with HFrEF on Hr and clinical and functional outcomes at long term. ...

 Open Access DOI:10.23937/2378-2951/1410092

Pattern of Gender Variations in Acute Coronary Syndrome for Patients in Kuwait (Pagacks Study)

Jadan Alsaddah, Mohammad Almutairi, Wael Aboshokka, Saad Alkandari, PRS Remya and Hany Younan

Article Type: Original Article | First Published: February 25, 2017

Acute coronary syndrome (ACS) is a major cause of morbidity and mortality globally. The world has started laying emphasis on risk stratification based on gender differences. Hence, there seemed to be a void to be filled regarding ACS which aimed to identify patient characteristics (especially gender) and clinical management, as well as angiographic, PCI, and hospital outcomes in Kuwait....

 Open Access DOI:10.23937/2378-2951/1410091

Screening for Familial Hypercholesterolemia: West and North Zone in Manaus-Amazonas

Marco A Trujillo, Haydee M Carmona and Jorge T Mendoza

Article Type: Perspective | First Published: February 23, 2017

In the city Manaus, Amazonas, with the Dutch Lipid Register Network. Were analyzed 1294 lipid profiles, of the North and West zone of city, neither with DMII, between June 2014 and March 2015, from people aged range 18 to 77 years old. Whose clinical history of familial cardiovascular disease (CVD) was wondered....

 Open Access DOI:10.23937/2378-2951/1410090

Gender Effects on Coronary Artery Flow and Left Ventricular Function in Patients with Acute Anterior ST Elevation Myocardial Infarction (STEMI) after Primary Coronary Angioplasty

Dawod Sharif, Saeed Khaleeliah, Amal Sharif-Rasslan and Uri Rosenschein

Article Type: Original Article | First Published: February 21, 2017

Coronary disease is the most frequent disease and cause of mortality in women. The aim of this study was to examine gender effects in acute anterior ST-elevation myocardial infarction (STEMI) and primary percutaneous intervention (PPCI) on coronary artery and myocardial perfusion and left ventricular systolic function....

 Open Access DOI:10.23937/2378-2951/1410089

Type A Aortic Dissection in an Asymptomatic 28-Week Pregnant Patient with Marfan Syndrome

Mario Gioia, Reehan Shahzad and Jordan Safirstein

Article Type: Case Report | First Published: January 21, 2017

Acute aortic dissection during pregnancy is a rare and potentially fatal disease. Connective tissues disorders, including Marfan syndrome, in combination with the physiological stress of pregnancy and delivery substantially increase the risk of aortic dissection. It is vital to recognize symptoms early, if present, in order to undergo medical and surgical management to increase the chance of survival....

 Open Access DOI:10.23937/2378-2951/1410088

Timing of Catheterization Post Cabg Surgery: (Tic-Postcabg)

Nasser Hayat, Jadan Al Saddah, Mohammad Al Mutairi, Mariam Abdulla Almelahi and PRS Remya

Article Type: Original Article | First Published: January 20, 2017

Post coronary artery bypass graft (CABG) patients were arbitrarily divided into 2 groups at the time of cardiac catheterization. Catheterization was performed because of ischemic manifestations. Group A had their surgery less than 5 years. Group B had their surgery more than 5 years....

 Open Access DOI:10.23937/2378-2951/1410087

Validation and Simplification of a Scoring Model Derived for Prediction of Poor Coronary Collateral Circulation in Acute Non-St Elevation Myocardial Infarction

Mehmet İleri, Koray Gursel, Funda Basyigit, Pınar Turker Bayır, Deniz Sahin, Umit Guray, Ozgul Ucar, Burak Acer and Yahya Buyukasık

Article Type: Research Article | First Published: September 20, 2016

Determinants of coronary collateral circulation (CCC) in human heart are still incompletely identified. In acute non-ST elevation myocardial infarction (NSTEMI), abrupt vessel occlusion results in myocardial necrosis in the jeopardized area. Angiographic collaterals to myocardial tissue distal to an acutely occluded coronary vessel can reduce infarct size and risk for post-infarct complications as well as infarct related mortality. These prognostic implications of collateral function, makes it n...

 Open Access DOI:10.23937/2378-2951/1410086

Coronary-Cameral Fistula Presenting as Worsening Refractory Heart Failure

Dhruti Mankodi, Ashish Sharma, Fulvia Banu, Sameer Shaharyar, Pedro Martinez-Clark and Ali Bazzi

Article Type: Case Report | First Published: August 12, 2016

Coronary-cameral fistula (CCF) is a rare condition most commonly caused by an embryologic developmental anomaly. Fifty-five percent of CCFs originate from the right coronary artery, 35% from the left coronary artery, and 5% from both. More than 90% of them drain into the venous system and low pressure sites such as the right ventricle (41%), right atrium (26%), pulmonary artery (17%) and only 3% drain into the left ventricle or atrium....

 Open Access DOI:10.23937/2378-2951/1410085

Progress in an Adult Male Suffering from Coronary Artery Ectasia as Assessed with Exercise Stress Testing: A Nine-Year Case Report

Charles Micallef

Article Type: Case Report | First Published: August 11, 2016

A nine-year history of a young to middle-aged male who was diagnosed with coronary artery ectasia after presenting with impaired vision in one of his eyes is presented. Throughout this period, four exercise stress tests were carried out and improvements were noted: from a positive stress test indicative of myocardial ischemia, the outcome gradually progressed to negative. A distinct feature of this case is that the patient was only on moderate statin and dual antiplatelet therapy and his cholest...

 Open Access DOI:10.23937/2378-2951/1410084

Dilated Cardiomyopathy due to Vitamin D Deficiency

Nalan Karabayir, Kelesoglu E, Helen Bornau, Kazim Oztarhan, Aktas D and Erdem A

Article Type: Case Series | First Published: August 06, 2016

Dilated cardiomyopathy, which mostly has an idiopathic etiology or is caused by genetic inheritance or infection, may cause irreversible congestive heart failure. Hypocalcemia is a rare etiology of reversible dilated cardiomyopathy. Cardiogenic shock related to hypocalcemic cardiomyopathy is a rare event. Here we report two cases with congestive heart failure who was diagnosed as having dilated cardiomyopathy secondary to hypocalcemia....

 Open Access DOI:10.23937/2378-2951/1410083

Successful Surgical Embolectomy for Acute Massive Pulmonary Embolism in Pregnant Woman

Nobuhiko Hiraiwa, Kohei Abe, Kunihiko Yoshino, Manabu Yamasaki and Hiroyasu Misumi

Article Type: Case Report | First Published: July 30, 2016

A 28-year-old pregnant woman was admitted to our hospital with tonic seizure and dyspnea, and was diagnosed with acute massive pulmonary embolism. An emergency surgical embolectomy was performed under cardiopulmonary bypass (CPB). Several fragments of the thrombi were carefully removed from the right and the main pulmonary arteries, and sufficient back-flow from the pulmonary artery was established. The postoperative course was uneventful. After the embolectomy, the ratio of pulmonary to systemi...

 Open Access DOI:10.23937/2378-2951/1410082

Circulating Endothelial Cells, Flow Mediated Dilatation % as Markers of Endothelial Dysfunction in Paroxysmal Lone Atrial Fibrillation

Rania Gaber, Wessam Salah Ibrahim and Manal Hamesa

Article Type: Research Article | First Published: July 30, 2016

Atrial Fibrillation (AF) is the commonest arrhythmia encountered in clinical practice and is increasingly considered as an emerging health epidemic. Despite rapidly evolving treatment strategies, AF presents a complex management challenge to the physician and is now attracting substantial clinical and academic interest because of a strong association with substantial mortality and morbidity....

 Open Access DOI:10.23937/2378-2951/1410081

Evaluation of Left Ventricular Systolic Function Immediately after Pulmonary Vein Isolation in Patients with Chronic Atrial Fibrillation using Speckle Tracking Echocardiography

Hisao Matsuda, Tomoo Harada, Yui Nakayama, Marika Yamada, Yasushi Takagi, Makoto Takano, Ikutarou Nakajima, Emi Nakano, Yukako Takimura, Satoru Nishio, Toshiyuki Furukawa, Hidekazu Miyazaki and Yoshihiro J Akashi

Article Type: Original Article | First Published: July 18, 2016

Background:The effect of pulmonary vein isolation (PVI) on left ventricular (LV) function after restoration of sinus rhythm remains unclear in patients with chronic atrial fibrillation (CAF). This study aimed to evaluate LV systolic function in the early phase after PVI using speckle tracking echocardiography. Methods:Twelve patients with CAF could be restored to sinus rhythm by PVI and maintained sinus rhythm after PVI. Echocardiography was performed before, immediately after and 3 months afte...

 Open Access DOI:10.23937/2378-2951/1410080

Transcatheter Closure of Large Bilateral Coronary Arteriovenous Fistulae using Amplatzer Vascular Plugs

Akika Ando, Adnan Bhopalwala and Christian Spies

Article Type: Case Report | First Published: June 23, 2016

A coronary arteriovenous (AV) fistula is defined as a connection between one or more coronary arteries and a cardiac chamber or great vessel, bypassing the myocardial capillary bed. For symptomatic patients, surgical intervention is the standard treatment plan. Recently, the use of transcatheter vascular plugs for the percutaneous closure of coronary AV fistulae has been reported in a few selected cases. We report the case of a 66-year-old woman with diffusely ectatic right and left coronary AV ...

 Open Access DOI:10.23937/2378-2951/1410079

Myocardial Infarction in Young versus Older Adults: An Analysis of Differences in Proportion, Risk Factors, Clinical Demographics, Angiographic Findings and in-Hospital Outcomes

Nadim Shah, Christopher Wang, Vanessa Lee, Nicholas Cox, Chiew Wong, Anne-Maree Kelly and Kean Soon

Article Type: Original Article | First Published: May 28, 2016

Background: Coronary heart disease (CHD) remains a major cause of death worldwide. This study looked at the proportions, demographics, risk profile, angiographic data and in-hospital outcomes of young versus older myocardial infarction (MI) patients presenting to a community teaching hospital in Melbourne, Australia. Methods: This was a retrospective study of patients presenting prospectively, with acute MI between August 2013 and July 2014, who demonstrated coronary stenosis ≥ 50% on inva...

 Open Access DOI:10.23937/2378-2951/1410078

Clinical Characterization of Pharmacologically Induced Takotsubo Syndrome: Implications for Treatment and Mechanisms

Robert W Murdock and David K Murdock

Article Type: Original Article | First Published: May 27, 2016

Takotsubo Syndrome (TS) is characterized by sudden localized left ventricular (LV) dysfunction and clinical features suggesting an acute coronary syndrome. It occurs more in women and is frequently associated with emotional or physical stress. Pharmacologically induced TS (PITS) has been reported but a comprehensive characterization has not been performed. Such a characterization could provide insight into mechanisms and treatment of spontaneous TS....

 Open Access DOI:10.23937/2378-2951/1410077

Improving Atherosclerotic Cardiovascular Risk Documentation and Consequent Preventive Management in the Electronic Medical Records of Diabetic Patients

Muna aseel, Amal Al-Ali, Zelaikha Alwahedi and Mohamed Salem

Article Type: Research Article | First Published: May 18, 2016

Proper documentation of Atherosclerotic Cardiovascular Disease (ASCVD) risk score and its consequent management in the newly applied electronic medical records (EMR) for diabetic's patients attending non-communicable diseases clinic in West Bay Health Center is less than ideal during Jan 2015 and Feb 2015. Poor documentation of ASCVD risk score and its consequent management will result in improper management for type 2 diabetic patients, and it will lead to undesirable consequences....

 Open Access DOI:10.23937/2378-2951/1410076

Effect of Exercise Training on Heart Sympathetic Activity and Lung Function in Mexican obese Adolescents

Benigno Linares-Segovia, Estela Nunez Lemus, Manuel Lara Marquez, Rogelio Torres Guzman, Juan Manuel Guizar-Mendoza and Norma Amador-Licona

Article Type: Research Article | First Published: April 28, 2016

Introduction: The aim of this study was to evaluate the short term effect of a moderate-intensity physical activity program on heart sympathetic activity and lung function in Mexican obese adolescents. Materials and methods: We performed a longitudinal study in 38 healthy obese adolescents (24 female and 14 male). Subjects were submitted to aerobic exercise training during 90 minutes for 16 weeks, 5 days per week. Before and after the intervention program, blood pressure, anthropometric measurem...

 Open Access DOI:10.23937/2378-2951/1410075

Temporal Trends in Insertion of Implantable Cardioverter Defibrillators from an Australian Regional Tertiary Centre's Perspective

Harsh V Thakkar and John V Amerena

Article Type: Original Article | First Published: April 20, 2016

Implantable Cardioverter Defibrillator (ICD) therapy is now standard therapy for prevention of Sudden Cardiac Death (SCD) in high-risk patients. In 2006, the Medical Services Advisory Committee (MSAC) reviewed the role of ICDs and approved them to be used for both primary and secondary prevention. This study reviews the temporal trends in indications for insertion of ICD at Geelong Cardiology Practice (GCP)....

 Open Access DOI:10.23937/2378-2951/1410073

Radial-Linear Ablation in Peri-pulmonary Vein Area Prevents Inducible Atrial Fibrillation in Dogs

Xue Zhao, Yinxiang Zhu, Xiang Mei, Jiayou Zhang, Jianqiang Hu, Wenliang Lu, Xingui Guo, Li Dai, Kailei Shi and Zhenguo Liu

Article Type: Research Article | First Published: March 16, 2016

A total of 22 dogs of both sexes (5-7 years old) were divided into two groups: 10 in control and 12 in ablation group. Multiple radial-linear lesions were created from PV orifice to peri-PV area in the dogs with CARTO guidance. The control animals went through the same procedure except ablation. AF inducibility was evaluated before and immediately after the procedure. All animals had inducible AF (100%) by atrial pacing combined with or without isoproterenol at baseline....

 Open Access DOI:10.23937/2378-2951/1410072

Increased Corrected QT Interval (QTc) in First Nations Women of Northern British Columbia with Systemic Lupus Erythematosus (SLE)

Fritha A Munday, Sirisha Asuri, Sarah McIntosh, Heather Jackson, Anthony Tang and Laura Arbour

Article Type: Original Article | First Published: January 30, 2016

Long QT Syndrome (LQTS), a genetic predisposition to sudden cardiac death is defined by a prolonged corrected QT interval (QTc) measured on electrocardiogram (ECG). A participatory research project has been underway with the Gitxsan of Northern BC for more than ten years where the condition (LQTS1) is common, due to a founder mutation (V205M) in KCNQ1. It is effectively treated with beta blockers and avoidance of QT prolonging drugs. Some chronic conditions are also known to increase the QTc, wh...

 Open Access DOI:10.23937/2378-2951/1410071

Effects of Erythropoietin Administration on Cardiomyocytes in Landrace/Large White Pigs after Ventricular Fibrillation

Armando Faa, Gavino Faa, Eliana Di Felice, Pietro Pampaloni, Daniela Fanni, Daniele Scano, Clara Gerosa, Maria Elena Pais, Panagiotis Vasileiou, Dimitrios Barouxis, Pavlos Lelovas, Theodoros Xanthos, Charalampos Pantazopoulos, Apostolos Papalois and Nicoletta Iacovidou

Article Type: Research Article | First Published: January 28, 2016

Ventricular fibrillation was induced via a pacing wire forwarded into the right ventricle in 20 female Landrace/Large-White pigs, allocated into 2 groups; the experimental group treated with a bolus dose of 5,000 U/Kg recombinant human erythropoietin and the control group which was administered saline. Cardiopulmonary resuscitation (CPR) was performed immediately after drug administration....

 Open Access DOI:10.23937/2378-2951/1410070

Spontaneous Coronary Artery Dissection: Report of 6 Cases and Literature Review

Adolfo Ferrero Guadagnoli, Miguel A Ballarino, Carlos R Leonardi, Alejandro E Contreras, Eduardo J Brenna and Jonathan Miara

Article Type: Research Article | First Published: January 27, 2016

We present our recent casuistry on such an interesting issue as coronary dissections. Provide data to assist the diagnosis and treatment of this disease. Spontaneous coronary artery dissection is a non-traumatic and non-iatrogenic separation of the coronary artery walls. It is a rare cause of acute coronary syndrome, mainly affecting women with no significant cardiovascular risk factors and has varying presentations from mild chest pains to sudden cardiac death....

 Open Access DOI:10.23937/2378-2951/1410069

Left Ventricular Assist Device Placement through Left Thoracotomy in Difficult Scenarios

Lyndsay M. Mueller, Samuel H. Cho, Timothy Fritz and Asghar Khaghani

Article Type: Case Report | First Published: January 18, 2016

Standard surgical approach to the implantation of a Left Ventricular Assist Device (LVAD) is through a median sternotomy. The inflow cannula is attached to the apex of the left ventricle, while the outflow graft is usually attached to the ascending aorta. We present 2 patients with prohibitive chest wall abnormalities who underwent left thoracotomy for LVAD placement, and the outflow graft alternatively attached to the descending aorta....

 Open Access DOI:10.23937/2378-2951/1410068

Electrocardiographic Changes in Primary Hyperparathyroidism

Alexander Alzate, Marcela Munoz Urbano and Kenny Buitrago-Toro

Article Type: Case Report | First Published: December 15, 2015

Electrolytic variability modifies normal structures of segments and intervals on the electrocardiogram (ECG). We present a case that was referred to the Internal Medicine department by the Neurosurgery division for several pathological fractures.The electrocardiogram led us to a diagnostic approach and finally we show how electrocardiographic tracing changed after a treatment implementation. Finally, in this study we highlight the importance of an electrocardiogram on a patient's approach....

 Open Access DOI:10.23937/2378-2951/1410067

Recurrent Thrombus Formation in Left Ventricle with Preserved Systolic Function

Mustafa Yilmaztepe, Fatih Mehmet Ucar, Gokay Taylan, Hanefi Yekta Gurlertop, Volkan Yuksel, Suat Canbaz and Serhat Huseyin

Article Type: Case Report | First Published: December 12, 2015

A 48 years old male patient was referred to our clinic for intraventricular mass, detected incidentally during non-cardiac preoperative evaluation. The medical history of the patient was unremarkable except suspicious history of heart attack four years ago. Physical examination was normal. ECG showed normal sinus rhythm 76 beats per minute. Echocardiographic examination (Figure 1) revealed isodense mobile mass attached to left ventricle apex, moving in every systole towards the left ventricle o...

 Open Access DOI:10.23937/2378-2951/1410066

Accuracy of Doppler Echocardiographic Estimates of Pulmonary Artery Pressures at the King Faisal Specialist Hospital and Research Center Riyadh

I.Y. Nizami and Saeed Akram

Article Type: Research Article | First Published: December 11, 2015

The accuracy of Doppler echocardiography in estimating pulmonary arterial hypertension has been a center of debate with recent reports suggesting poor correlation between the Doppler echocardiographic estimation of pulmonary pressure with the one measured by right heart catheterization. Our aim is to study the correlation between the Doppler echocardiographic estimates of pulmonary artery pressures with the right heart catheterization measured pulmonary artery pressures at our center....

 Open Access DOI:10.23937/2378-2951/1410065

Effectiveness of Cardiac Rehabilitation in Increased Left Ventricle Ejection Fraction and Cardiovascular Secondary Prevention

Lopez-Aguilera J, Suarez de Lezo J, Mazuelos-Bellido F, Suarez-de-Lezo Jr, Casado-Adam P, Heredia-Torres MA, Mayordomo-Riera FJ and Cano-Lliteras MP

Article Type: Research Article | First Published: December 10, 2015

Prospective observational before-after study in the Cardiac Rehabilitation Unit of Cordoba (Spain) between March 2013 and June 2014 during phase 2 of cardiac rehabilitation program (CRP). Demographic variables, LVEF, functional capacity and biochemical parameters were analyzed. Outcome variables at the beginning and end of the treatment were compared using the paired student t-test. In addition, a multiple linear regression analysis was completed to identify the variables related to the increase...

 Open Access DOI:10.23937/2378-2951/1410064

Ambiguous Left Ventricular Outflow Tract Obstruction: The Key Role of the Cardiac CT-Scan

Marie-Philippe Verge, Geraldine Allain, Luc-Philippe Christiaens and Guillaume Lucas

Article Type: Case Report | First Published: December 09, 2015

Subaortic membranes are uncommon causes of left ventricular outflow tract obstruction. Combined subaortic membrane and aortic valve stenosis is even more rare and can be challenging for echocardiographic diagnosis. A 58 year old woman, known for symptomatic aortic stenosis was referred to our hospital department for dyspnoea. Her most important medical history was aortic coarctation surgery at the age of 13 without any significant event since that time. The trans-thoracic echocardiography showed...

 Open Access DOI:10.23937/2378-2951/1410063

Diagnosis of Stress-Induced Cardiomyopathy in a Patient with an Abnormal Myocardial SPECT Imaging

Teo Tee Yin Tracy, McNeely Parren, Demetroulis Elaine, Staffey Kimberly and Graham Michael

Article Type: Case Report | First Published: November 30, 2015

We present a case of stress-induced cardiomyopathy in a 66 year old male precipitated by electroconvulsive (ECT) for catatonia related to severe recurrent depression. Patient suffered from decades of bipolar syndrome with severe depression that is refractory from medication therapies. As the frequency of the recent admissions increases, the patient's guardian consented to ECT to treat his depression. During the ECT procedure, he developed non-sustained ventricular tachycardia (NSVT). The onset o...

 Open Access DOI:10.23937/2378-2951/1410062

Early Recurrence of Myocardial Infarction in a Young Female caused by Left Main Coronary Artery Thrombosis

Silvio Nocco, Laura Concas, Daniele Congiu and Rinaldo Aste

Article Type: Case Report | First Published: November 30, 2015

A young female, cardiovascular risk factors free, was admitted to the coronary care unit for a sub-acute myocardial infarction caused by a critical ostial stenosis of the left anterior descending artery, treated with coronary angioplasty and insertion of two drug-eluting stents. Despite the administration of aggressive treatment, just 5 days after discharge, the patient was readmitted for early recurrence of myocardial infarction caused by left main coronary artery thrombosis treated with emerge...

 Open Access DOI:10.23937/2378-2951/1410061

Serum Omentin-1 Concentrations and Biochemical Markers of Chronic Subclinical Inflammation in Obese Subjects

Eman M Alissa, Maisa'a M Al-Salmi, Nabeela Alama and Gordon A Ferns

Article Type: Original Research Article | First Published: November 21, 2015

Background: Whilst chronic subclinical inflammation is now considered to be a predisposing risk factor of cardiovascular diseases. The extent by which adipokines induce metabolic abnormalities in humans is not fully resolved. The purpose of this study was to examine the relationship between insulin resistance and serum inflammatory markers in obese subjects. Methods: One hundred and five subjects without any clinically evident CVD were classified into 3 coronary risk levels according to Framingh...

 Open Access DOI:10.23937/2378-2951/1410060

Brugada Syndrome; Cause of Syncope during Transcutaneous Electrical Nerve Stimulation Therapy

Abdulmelik Yildiz, Mustafa Budancamanak and Cennet Yildiz

Article Type: Case Report | First Published: November 20, 2015

38 year old male patient with preauricular abcess developed presyncope during high-grade fever and diagnosed as having Brugada syndrome with type 1 ECG pattern. The diagnosis of Brugada syndrome was made in educational and research hospital. His Electroencephalography (EEG) was normal. Coronary angiography showed myocardial bridging of the left anteriyor descending coronary artery after second diagonal branch and no hemodynamically significant coronary artery disease. Technesium (TC99 MIBI) Myoc...

 Open Access DOI:10.23937/2378-2951/1410059

The Psychological and Compliance Factors can Modulate the Outcome of STEMI Patients Treated by Stem Cell Therapy - A Pilot Study

Miruna Mihaela Micheu, Oana-Maria Udrea, Nicoleta Oprescu, Alina Ioana Scarlatescu, Daniela Pitic, Lucian Calmac and Maria Dorobantu

Article Type: Research Article | First Published: November 13, 2015

In the assessment of stem cell therapy post myocardial infarction, the rapport between the medical intervention and the patient's compliance and psychological factors represent a research and treatment management challenge. Purpose: Identifying the implication of psychological and behavioral factors associated with compliance on therapeutic success in relation to cell therapy in acute myocardial infarction patients....

 Open Access DOI:10.23937/2378-2951/1410058

Comparison of Clinical Presentation Related on Risk Factors in Older and Younger Patients with Acute Coronary Syndrome

Hossein Asgar Pour, Reza Norouzzadeh and Mohammad Reza Heidari

Article Type: Original Article | First Published: November 05, 2015

Acute coronary syndromes (ACS) are the leading cause of death in older adults. Early recognition of symptoms suggestive of ACS by the emergency triage nurse can improve patient outcomes. The aim of this study was to determine risk factors associated with typical and atypical symptoms in older and younger patients with ACS....

 Open Access DOI:10.23937/2378-2951/1410057

The Effects of Coexistent Psychiatric Disorders in Patients Operated on for Acute Aortic Dissection on Postoperative Mental Health Status and on Mid-Term Time Period

Antonio Pellegrino, Paolo Nardi, Luigi Chiariello, Marco Russo, Guglielmo Saitto, Juxhin Ganellari, Alberto Siracusano, Francesco Bianchi and Piero Caporali

Article Type: Research Article | First Published: October 13, 2015

Although relationships between ischemic heart disease and psychiatric disorders (PD) have been highlighted, a link between PD and acute aortic dissection (AAD) has not been shown. Aim of this study was to define the psychological profile of patients treated for AAD and analyze the impact of PD postoperatively and at 5-year follow-up period....

 Open Access DOI:10.23937/2378-2951/1410056

Methyl-Ergonovine Stress Echocardiography in the Study of Kounis Syndrome due to Anisakis Simplex: A Case Report

Jorge A Restrepo, Jorge Salamanca, Guillermo Diego, Fernando Rivero, Fernando Alfonso and Rio Aguilar

Article Type: Case Report | First Published: October 10, 2015

A 51-year-old man, smoker (20 packs-year) with no known allergies and no medical history of previous symptoms or cardiovascular disease. Two hours after eating a raw fish dish of hake and prawn, the patient presented intense oppressive chest pain, dyspnea, diaphoresis, abdominal pain, diarrhea, nausea and vomit....

 Open Access DOI:10.23937/2378-2951/1410055

Mycophenolate Mofetil-Induced Colitis in a Pediatric Heart Transplant Recipient

Lindy Moore, Anita L Sengupta and Bibhuti Das

Article Type: Case Report | First Published: October 10, 2015

Mycophenolate Mofetil (MMF) is a frequently used immunosuppressive medication in pediatric heart transplant (HT) patients. Although therapeutic monitoring of MMF has been an integral part of routine practice for many years, there is growing evidence that genetic variation in host can lead to adverse outcomes such as drug toxicities. Maintaining a reasonable balance between efficacy and toxicity in an individual patient remains one of the major challenges in pediatric HT recipients....

 Open Access DOI:10.23937/2378-2951/1410054

Ultrafiltration in Heart Failure: Experience in a French University Hospital

David Boutarin Raphaelle - Ashley Guerbaai and Patricia Armand

Article Type: Perspective | First Published: September 24, 2015

Venovenous ultrafiltration is an alternative therapy used in patients with chronic heart failure (CHF), persistent congestion and failing diuretics. This therapy enables removal of excess water in order to reduce fluid overload. Ultrafiltration has been used for over ten years in the United-States, however was only introduced in France three years ago, in very few hospitals....

 Open Access DOI:10.23937/2378-2951/1410053

Symptomatic Main Coronary Artery Fistula with Stress/Rest Myocardial Perfusion SPET Ischemia

Ramirez-Moreno A and JR. Siles-Rubio

Article Type: Case Report | First Published: September 21, 2015

We report a case of 65-year-old woman who presented sporadic exercise chest pain episodes. The rest ECG, cardiac ultrasound were normal, exercise test shows nonspecific repolarization ECG changes, myocardial Stress/Rest Tc-99m MIBI SPET disclosed a reversible defect in the medial and distal portions of the anterior wall and the apex....

 Open Access DOI:10.23937/2378-2951/1410052

Variable Phenotypic Expression Including Late Presentation of Hypertrophic Cardiomyopathy in LEOPARD Syndrome with P.Q510E Mutation in PTPN11 Gene

Md. Zahidus Sayeed, Md. Abdus Salam, Muhammad Afsar Siddiqui, Pampa Chandra, Joydeep Bhaduri and Zahurul A. Bhuiyan

Article Type: Case Report | First Published: September 17, 2015

LEOPARD syndrome is a complex dysmorphogenetic disorder of variable penetrance and expressivity. Mutations in the PTPN11 gene are frequently reported in patients with Noonan syndrome (NS) and LEOPARD syndrome (LS). Q510E mutation in PTPN11 has always been associated with lethal or rapidly progressive hypertrophic cardiomyopathy both in NS and LS patients. Besides, deafness is also frequently present in these patients, but reproductive fitness is questioned. ...

 Open Access DOI:10.23937/2378-2951/1410051

Preventing Acute Cardiac Events during Marathons with Pre-Race Aspirin

Arthur J. Siegel

Article Type: Review Article | First Published: September 15, 2015

Reducing sudden cardiac death during sport is the highest clinical priority in preventive sports cardiology. While the overall cardiovascular risk of long distance running is low, the frequency of cardiac arrest and sudden death in middle-aged males during marathons has increased since the year 2000. An evidence-based strategy for reducing race-related acute cardiac events in this vulnerable subgroup is considered based on identification of the underlying cause....

 Open Access DOI:10.23937/2378-2951/1410050

Transient Isolated Right Ventricular Hypertrophy in A Neonate

Muhittin Celik, Heybet Tuzun, Bedri Aldudak and Osman Akdeniz

Article Type: Case Report | First Published: September 15, 2015

Transient isolated right ventricular hypertrophy is rarely encountered in neonates. We describe a term neonate in whom right ventricular hypertrophy was detected in the first postnatal day by echocardiography. There are several reasons that cause transient isolated right ventricular hypertrophy such as gestational diabetes, mother's dietary patterns, and certain drugs....

 Open Access DOI:10.23937/2378-2951/1410049

Heart Transplant for Dextrocardia Situs Inversus with Very Complex Congenital Lesion: a Challenge of Cardiac Surgery

Nguyen Huu Uoc and Pham Tien Quan

Article Type: Research Article | First Published: September 14, 2015

27 year-old female patient had complex CHD that involved dextrocardia situs inversus, double outlet right ventricle type TGA, pulmonary artery stenosis, total atrio-ventricular canal, and total anomalous pulmonary venous connection type supra-cardia. She was experiencing end-stage heart failure and severely cachexia with risk of death within few months. The transplanted heart was from a multi-organ donor; male, 26 years old, normal heart structure. Although the difference in biological parameter...

 Open Access DOI:10.23937/2378-2951/1410048

Arrhythmic Manifestation of Prinzmetal' Sangina Induced by Therapeutic Hypothermia

Abellas-Sequeiros RA, Ocaranza-Sanchez R, Garcia-Acuna JM and Gonzalez-Juanatey JR

Article Type: Case Report | First Published: September 03, 2015

We report the case of a 37-year-old Caucasian man, with prior history of smoking and DM. He had complained about multiple episodes of syncope during last year. However, the day of his hospitalization, he described a sudden and acute episode of chest pain which stopped him from sleeping. He arrived to the emergency department after 45 minutes of successful resuscitation, with VF as first cardiac rhythm detected....

 Open Access DOI:10.23937/2378-2951/1410047

Guidewire Fracture during Crossing A Chronic Coronary Total Occlusion: A Troublesome Experience

ErsanTatli, MustafaYilmaztepe, Ali Buturak and Yusuf Can

Article Type: Case Report | First Published: August 30, 2015

Increased interest focusing on coronary chronic total occlusions has emerged since several studies have proven improved cardiovascular outcomes and quality of life after successful chronic total occlusion (CTO) revascularization. CTO of an epicardial coronary artery is one of the leading challenging complex lesion type when percutaneous coronary intervention (PCI) is indicated. Advanced antegrade and retrograde techniques performed with dedicated equipment have provided significant improvements ...

 Open Access DOI:10.23937/2378-2951/1410046

Pioglitazone Improves Endothelial Function in Patients with Paroxysmal Atrial Fibrillation and Type 2 Diabetes Mellitus Following Catheter Ablation

Jun Gu, Wei Hu, Xu Liu and Chang-Qian Wang

Article Type: Research Article | First Published: August 30, 2015

Atrial Fibrillation (AF) is the most common type of sustained heart rhythm disorder confronted in clinical practice, which confers a high risk of mortality and morbidity from abnormal hemodynamics and thromboembolism. The beat-to-beat alteration of flow dynamics in AF has disadvantageous effects on cardiac haemodynamics and is associated with endothelial dysfunction. Endothelial dysfunction may contribute to a prothrombotic state in patients with AF and cardiovascular events. Besides, the presen...

 Open Access DOI:10.23937/2378-2951/1410045

Prevalence of Pulmonary Hypertension among Chronic Kidney Disease Patients and its Relation to Location and Blood Flow of Vascular Access

Osama A. Khamis, Tarek Abd El-Hamid Elzyat and Abd El-Rahman Ibrahim Mohammed Ali

Article Type: Research Article | First Published: August 29, 2015

Background:Pulmonary hypertension is increasingly being recognized as a factor that can affect outcome in end stage renal disease. This study was carried out to evaluate the prevalence of pulmonary hypertension among CKD patients and it's relation to vascular access blood flow and location. Patient and Methods:30 patients on regular hemodialysis, 30 patients in predialysis and 30 healthy individuals participated in this study. Each patient underwent full clinical evaluation, chest radiography...

 Open Access DOI:10.23937/2378-2951/1410044

Randomized Trial of a Discharge Planning and Telehealth Intervention for Patients Aged 65 and older after Coronary Artery Bypass Surgery

Ruth M. Kleinpell, Boaz Avitall, Cathy Catrambone, Tricia Johnson, Louis Fogg, Shirley Moore and Nicole T. Thompson

Article Type: Research Article | First Published: August 28, 2015

Despite diagnostic and treatment advances, coronary heart disease (CHD) remains the leading cause of death in Americans over the age of 65. Coronary artery bypass surgery (CABG) is the most frequently performed major surgery for CHD in the United States (U.S.). While the rates of CABG surgeries have declined in recent years due to the increased use of percutaneous coronary procedures, current treatment guidelines from the American Heart Association and the American College of Cardiology identify...

 Open Access DOI:10.23937/2378-2951/1410043

Hemolytic Anemia 19 Years after Mitral Valve Replacement with A Porcine Bioprosthesis

Debora Corsi, Michele Celiento, Stefano Pratali, Alberto Balbarini and Uberto Bortolotti

Article Type: Case Report | First Published: August 27, 2015

A 58-year-old man had undergone mitral valve replacement with a 27 mm Carpentier-Edwards porcine bioprosthesis (Edwards Lifesciences, Irvine, USA) in 1993. Nineteen years later he presented with dark urine, fatigue and moderate dyspnea denying any history of infection. He was in atrial fibrillation with a systolic mitral regurgitant murmur. Hematologic evaluation was consistent with haemolytic anemia; particularly, reduced hemoglobin, hematocrit and haptoglobin (6.6 mg/dl), and increased total b...

 Open Access DOI:10.23937/2378-2951/1410042

Herpes Simplex Encephalitis, an Unusual Cause of Sinus Node Dysfunction: Case Report and Literature Review

Pierre-Philippe Nicol, Jean-Philippe Talarmin and Thierry Joseph

Article Type: Case Report | First Published: July 25, 2015

Herpes simplex encephalitis is responsible for progressive alteration of behaviour, epilepsy, focal neurological signs, and cognitive problems, but is rarely involved in sinus node dysfunction. We describe this association in a 66-year-old woman with a complete cardiac and neurologic recovery after acyclovir treatment. Consequently, this aetiology of sinoatrial arrest should be recognized in order to systematically assess cardiac monitoring and avoid unnecessary pacemaker implantation. Moreover ...

 Open Access DOI:10.23937/2378-2951/1410041

Origin of Right Coronary Artery from the Ascending Aorta: An Extremely Rare Anomaly

Abdulrahman M Abdulbaki and Shivang Shah

Article Type: Case Report | First Published: June 24, 2015

The incidence of coronary anomalies in patients undergoing coronary angiography varies from 0.27% to 1.66%. Many of these anomalies are clinically benign; while, others are associated with serious morbidity. We describe the case of a patient undergoing coronary angiogram to evaluate her cardiomyopathy revealing an anomalous right coronary artery arising from the ascending aorta above the left sintubular junction plane. We discuss the rarity of this anomaly along with its clinical importance....

 Open Access DOI:10.23937/2378-2951/1410040

Favorable Plaque Sealing Process after Implantation of Endeavor Zotarolimus-Eluting Stent into Chronic Total Occlusion of Sirolimus Eluting Stent

Minoru Ichikawa and Yoshiyuki Kijima

Article Type: Case Report | First Published: July 23, 2015

We here report a case with in-stent chronic total occlusion (CTO) of sirolimus-eluting stent (SES). The SES-CTO lesion was successfully treated with additional implantation of Endeavorzotarolimus-eluting stent (E-ZES) into the lesion. During the follow up period of 50 months, coronary angioscopy and optical coherence tomography revealed the favorable plaque sealing process after E-ZES implantation into SES-CTO....

 Open Access DOI:10.23937/2378-2951/1410039

Ranolazine: Beyond the Treatment of Chronic Stable Angina Pectoris

Nicola Vitulano, Pio Cialdella, Massimo Gustapane, Lorenzo Vitulano, Daniela Pedicino and Gemma Pelargonio

Article Type: Review Article | First Published: July 18, 2015

The aims in the treatment of angina are relief of pain and prevention of disease progression through risk reduction. A number of patients may have contraindications or remain unrelieved from anginal discomfort with conventional drugs. Among newer alternatives, ranolazine indirectly prevents the intracellular calcium overload involved in cardiac ischemia and it is a considered as a valid addition to traditional treatments. Recent findings showed potential positive side effect of ranolazine in the...

 Open Access DOI:10.23937/2378-2951/1410038

Chiari Network: An Embryological Remnant - A Case Report and Review

Shivadeep S, Anandaraja S and Devi Jansirani D

Article Type: Case Report | First Published: June 30, 2015

Chiari network is a fenestrated membranous structure most commonly observed near the valve of inferior vena cava. It is considered as an embryological remnant of right valve of sinus venosus. Inspite of its benignity, its complications have been reported in the literature. This article contributes a detailed review compiling the association of Chiari network with various pathological conditions and its complications. We report a case of Chiari network diagnosed in a 36-year old female by trans-e...

 Open Access DOI:10.23937/2378-2951/1410037

Sad and Worried Hearts: A Psychological Treatment for Clinically Significant Depression, Anxiety, and Post-traumatic Stress in Patients with Cardiac Disease

Paul S. Greenman, Jonathan Jette, Isabelle Green-Demers and Jean Grenier

Article Type: Research Article | First Published: June 25, 2015

People who suffer from depression, post-traumatic stress, or anxiety following cardiac events and treatment are more likely to have further cardiac complications resulting in death than are people who do not. Although there have been advances in psychological techniques to elicit behavior and lifestyle changes in heart patients, there is currently a dearth of information on how to address the psychological sequelae of heart disease effectively....

 Open Access DOI:10.23937/2378-2951/1410036

Non-Invasive Assessment of Cardiac Autonomic Functions in Healthy Young Adults in Ile-Ife, South-Western Nigeria

Oluwadare Ogunlade, Abiodun O Ayoka, Anthony Akintomide, Rufus Ojo Akomolafe, Olumide S Akinsomisoye and David Oyewusi Oyebola

Article Type: Research Article | First Published: June 10, 2015

Background: This study assessed the responses of Blood Pressure (BP) and Heart Rate (HR) to change of posture, Sustained Handgrip (SH),deep breathing(DB) and Valsalva manoeuvre (VM) in order to determining the normal limits and pattern of Autonomic Cardiovascular Indices (ACI) among healthy young adults. Methods: Two hundred and four volunteer (98 men and 106 women) aged 18-40 years (mean, 22.45 +/- 4.86 years) participated in the study. After excluding systemic diseases by clinical evaluation, ...

 Open Access DOI:10.23937/2378-2951/1410035

Early Administration of Tirofibanin Mid- to High-risk Patients with Non-ST Elevation Acute Coronary Syndrome Referred for Elective Percutaneous Coronary Intervention (ETN-STEP): A Multi-center Randomized Controlled Clinical Trial in China

Jianping Li, Bo Zheng, Xingang Wang, Tieci Yi, Wei Dong, Zhan Gao, Shaoping Nie, Yawei Luo, Xiaobo Mao, Xi Su, Hui Chen, Ning Tan, Xufen Cao, Jun Zhang and Yong Huo

Article Type: Review Article | First Published: June 08, 2015

The objective of this randomized controlled clinical trial was to evaluate the efficacy and safety of upstream administration of Tirofiban in mid- to high-risk patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing early percutaneous coronary intervention (PCI)....

 Open Access DOI:10.23937/2378-2951/1410034

An Update on Peripartum Cardiomyopathy in the 21st Century

Kavita Sharma and Stuart D Russell

Article Type: Review Article | First Published: June 02, 2015

Peripartum cardiomyopathy (PPCM) is a pregnancy-associated idiopathic cardiomyopathy secondary to marked left ventricular systolic dysfunction. The disease presents towards the end of pregnancy through the first 5 months post-delivery, with ethnic and geographic variation in incidence and outcomes. While it is relatively rare, PPCM is associated with significant morbidity and can be fatal....

 Open Access DOI:10.23937/2378-2951/1410033

On the Logic of Percutaneous Coronary Interventions

P. Lanzer and P. Wang

Article Type: Logical Study | First Published: May 30, 2015

Performance of percutaneous coronary interventions (PCI) is largely based on empirical experience of individual operators. Due to the perceived mostly intuitive character to date little data concerning formal and reasoning structure of PCI is available. Non-axiomatic logic (NAL) provides consistent format allowing systematic analysis of reasoning applicable to PCI. In this report we introduce the basic principles of NAL and provide relevant introductory examples representing clinical reasoning i...

 Open Access DOI:10.23937/2378-2951/1410032

Can a Genetic Test Predict the Development of Postoperative Atrial Fibrillation

Gurpreet Sodhi, Jennifer Shea, Farzad Najam and Allen J Solomon

Article Type: Research Article | First Published: May 26, 2015

Atrial fibrillation (AF) is the most common postoperative complication of cardiovascular surgery. In large cohorts, genetic variants in the 4q25 chromosome region have been associated with postoperative AF. However, the role of genetic testing in an individual patient to predict the development of AF has been understudied....

 Open Access DOI:10.23937/2378-2951/1410031

Anomalous Right Coronary Artery Arising from the Ascending Aorta Above the Left Sinus of Valsalva in the Setting of Acute Inferior ST-Elevation Myocardial Infarction: Unique Challenges and Literature Review

Nisharahmed Kherada, Sandeep Singla, Saqib Ali Gowani, Francesca Gallarello and Nirat Beohar

Article Type: Case Report | First Published: May 02, 2015

Anomalous origin of the right coronary artery arising from ascending aorta above the left sinus of Valsalva is an extremely rare coronary anomaly. In the setting of an acute myocardial infarction rapid identification, localization and selective cannulation of this 'culprit' anomalous right coronary artery presents a challenging scenario. Here we describe a case with this anomaly presenting as an acute inferior wall myocardial infarction along with description of its distinctive interventional ch...

 Open Access DOI:10.23937/2378-2951/1410030

Influence of MRI-Conditional Cardiac Pacemakers on Quality and Interpretability of Images Acquired in 1.5-T Cardiac MRI

Kenichi Yokoyama, Toshiya Kariyasu, Shigehide Kuhara, Masamichi Imai, Rieko Ishimura and Toshiaki Nitatori

Article Type: Research Article | First Published: April 24, 2015

Purpose: The influence of MRI-conditional cardiac pacemakers on the quality and interpretability of images acquired in cardiac MRI (CMR) examinations was retrospectively investigated. Materials and methods: The subjects in this study were 12 patients (7 men and 5 women, mean age: 68.4 +/- 8.7 years) with MRI-conditional cardiac pacemakers who underwent CMR examinations at our institution between July 2013 and December 2014....

 Open Access DOI:10.23937/2378-2951/1410029

An Unlikely Cause of Atrial Fibrillation-Induced Cardiomyopathy: Phentermine, A Diet pill

Sunny-Skye Keppel and Philip Varriale

Article Type: Case Report | First Published: April 19, 2015

We present a case of an unusual cause of atrial fibrillation-induced cardiomyopathy, which is a diet pill, known as phentermine. This medication used for weight loss and can function as a stimulant is intended for short-term use but when taken for an extensive period of time can become a significant risk factor for developing arrhythmias such as atrial fibrillation....

 Open Access DOI:10.23937/2378-2951/1410028

Takotsubo Cardiomyopathy Associated with Prolong QT Interval and Ventricular Tachyarrhythmia

Dhavalkumar Patel and Rajendrakumar Patel

Article Type: Case Report | First Published: April 13, 2015

Takotsubo Cardiomyopathy (TCMP), also known as apical ballooning syndrome or stress induced cardiomyopathy, is characterized by left ventricular mid and/or apical wall motion abnormality in the absence of obstructive coronary artery disease. TCMP is a disorder of left ventricular myocardial contractility, and rarely associated with serious cardiac conduction abnormalities....

 Open Access DOI:10.23937/2378-2951/1410027

Asymptomatic Left Atrial Appendage Aneurysm

Norliza Othman, Alwi Mohamed Yunus, Raad H. Mohiaddin and Masliza Mahmod

Article Type: Case Report | First Published: April 11, 2015

We report a patient with asymptomatic left atrial appendage aneurysm. Cardiac magnetic resonance was performed to further delineate the aneurysm, and the patient underwent successful surgical resection....

 Open Access DOI:10.23937/2378-2951/1410026

Association between Syncope and Myocardial Bridge

Lins TCB, Valente LM, Oliveira KTMN and Brandao SCS

Article Type: Case Report | First Published: April 10, 2015

Myocardial bridge is a cause of sudden death in athletes, but syncope is somewhat related to this disease symptom. This paper reports a case of a young athlete, swimming practitioner with syncopal episodes related to physical exertion....

 Open Access DOI:10.23937/2378-2951/1410025

Functional Mitral Regurgitation Tenting Area is Directly Related to Non-Ischemic Cadiomyopathy

Ovidio A. Garcia-Villarreal

Article Type: Letter to the Editor | First Published: March 22, 2015

I have read with great interest the article by Kammoun et al., and I congratulate them for this paper. Functional mitral regurgitation (MR) is a very hard-to-treat illness, because it is not a disease itself but just the final result of an impaired and/or geometrically distorted left ventricle. Agricola et al. have described in a fie way the high impact played by the tethering mechanism of the posterior mitral complex in this kind of patients....

 Open Access DOI:10.23937/2378-2951/1410024

Thrombosis and Multiple System Embolization from an on- X Aortic Valve on Clopidogrel- A Review of Pooled Analysis of 2,389 Patient

Kalgi Modi

Article Type: Case Report | First Published: March 21, 2015

Thombosis of a mechanical aortic valve is a rare but life threatening complication and in most cases is caused by inadequate or interrupted anticoagulant treatment. Prosthetic valve thrombosis may cause systemic embolization with clinical manifestation dependent on the organ involved. Multiple systemic embolization resulting from non-infective thrombotic aortic prosthetic valve is a rare occurrence....

 Open Access DOI:10.23937/2378-2951/1410023

Erythropoietin Treatment Improves Peak VO2 and Oxygen Uptake Efficiency Slope without Changing VE vs. VCO2 Slope in Anemic Patients

Ayumi Goda, Haruki Itoh, Yoshiko Ebi, Kumiko Kondo, Tomoko Maeda and Toshitsune Shimada

Article Type: Research Article | First Published: March 20, 2015

The aim of this study was to evaluate the improvement in hemodynamic, metabolic, and ventilatory response during exercise along with the improvement of anemia with EPO treatment in anemic hemodialysis patients. Methods: Thirty-seven hemodialysis patients with anemia (48.8 +/- 13.6 years) received EPO (1500 or 3000 unit, 3 times a week). Parameters measured prospectively before and after EPO treatment included hemoglobin, cardiac output by dye dilution method, echocardiography, and cardiopulmonar...

 Open Access DOI:10.23937/2378-2951/1410022

Double-Stenting of the Left Main Coronary Artery lesions: Safety, Clinical Outcome and Long Term Follow-up

William Ng and Robert Lundstrom

Article Type: Research Article | First Published: February 28, 2015

This study aimed to assess the safety & medium/long-term outcome of using double-stenting strategy on left main (LM) stem for the treatment of significant suboptimal angiographic result after initial left main coronary artery (LMCA) stent implantation. Between August 2005 & June 2010, patients undergoing PCI with double stenting of LMCA lesions comprised the study cohort....

 Open Access DOI:10.23937/2378-2951/1410021

High Prevalence of Atrial Fibrillation in Elderly Patients Hospitalized with Heart Failure

Urrutia A, Cepeda JM, Formiga F, Manzano L, Conde-Martel A, Aramburu-Bodas O, Suarez I, Gonzalez-Franco A, Quiros-Lopez R and Montero Perez-Barquero M

Article Type: Research Article | First Published: February 12, 2015

Background: Atrial Fibrillation (AF) is a common condition in the elderly and often occurs together with Heart Failure (HF). The differences between elderly patients with HF according to the presence or absence of AF were analysed. Material and methods: Patient data were collected from consecutively admitted patients 75 years of age and older with acute decompensated HF from the Spanish National Heart Failure Registry (RICA) with data retrieved from internal medicine settings....

 Open Access DOI:10.23937/2378-2951/1410020

Relationship between Insulin Levels and Coronary Atherosclerosis in Newly Diagnosed Diabetes Mellitus and Impaired Glucose Tolerance

Naohiko Nemoto, Rintarou Nakajima, Kennji Ymazaki, Makoto Utsunomiya, Masaki Hori, Shingo Ito, Itaru Yokouchi, Masamichi Wada, Masanori Shiba, Hisao Hara, Hidehiko Hara, Takuro Takagi, Kaoru Sugi and Masato Nakamura

Article Type: Review Article | First Published: February 06, 2015

Background: While some therapies implemented for newly diagnosed Diabetes Mellitus (DM) or impaired Glucose Tolerance (IGT) are effective in preventing cardiovascular events, investigations of coronary plaque in patients with newly diagnosed DM or IGT are lacking. Methods: We evaluated 96 patients with acute coronary syndrome. The External Elastic Membrane (EEM), Lumen Cross-Sectional Area (CSA), plaque CSA, and plaque burden in the Left Anterior Descending (LAD) artery proximal to the lesion, d...

 Open Access DOI:10.23937/2378-2951/1410019

Physical Examination of the Cardiovascular System

John P. Higgins

Article Type: Review Article | First Published: January 27, 2015

The physical examination, while frequently not performed well, is critical to the diagnosis and management of cardiovascular disorders. This paper describes a basic cardiovascular physical examination and explains findings, with the goal of improving skills in this area....

 Open Access DOI:10.23937/2378-2951/1410018

Cardiovascular Risk Factors, Diet and Lifestyle among a Group of Italian Young Adults Students

Gregoriana Zanini, Elio Gorga, Francesca Del Magro, Bola Okunuga, Federica Pasini and Gian Franco Pasini

Article Type: Research Article | First Published: January 06, 2015

The prevalence of cardiovascular disease has shown a marked increase over the last decade, representing the leading cause of death in the United States of America but also in Italy. Cardiovascular diseases recognize a multifactorial etiology: age, obesity, distribution of body fat, cigarette smoking, sedentary lifestyle, high blood pressure, dyslipidemia. In recent years has been paid particular attention to the cardiovascular risk factors prevention particularly in adulthood (> 30 years old). T...

 Open Access DOI:10.23937/2378-2951/1410017

Patients Treated with Catheter Ablation for Atrial Fibrillation have Long-Term Renal Function Similar to Patients without Atrial Fibrillation

David L. Johnson, John D. Day, Brian G. Crandall, J. Peter Weiss, Heidi T. May, Tami L. Bair, Jeffrey S. Osborn, Jeffrey L. Anderson, Joseph B. Muhlestein, Donald L. Lappe and T. Jared Bunch

Article Type: Research Article | First Published: December 29, 2014

Background: Atrial fibrillation (AF) has been reported to worsen renal function over time. Renal dysfunction in the setting of AF decreases response to rhythm control approaches and increases risk of cardiovascular morbidity and mortality. Aggressive rhythm control approaches, such as catheter ablation, may interrupt this cycle and impact renal function favorably over time. Methods: Patients were enrolled from the large ongoing prospective Intermountain Cardiovascular Health Study....

 Open Access DOI:10.23937/2378-2951/1410016

Use of Statins in an Australian Elderly Population

Svetla Gadzhanova, Elizabeth Roughead and Jenni Ilomaki

Article Type: Research Article | First Published: December 28, 2014

Background: Statins are the fist drug choice for lowering high cholesterol and are one of the most widely used classes of medicines in Australia. Although well tolerated, some adverse effects are dose and potency dependent to which older people are particularly susceptible. Objective: The aim of this study was to examine the use of statins in elderly Australians, and how usage had changed over time with respect to dose and potency of statin prescribed....

 Open Access DOI:10.23937/2378-2951/1410015

Necrotizing Pancreatitis Causing Acute Focal Pericarditis

William F McIntyre, Andres Enriquez, Kevin Michael and Adrian Baranchuk

Article Type: Case Report | First Published: December 15, 2014

We describe the case of a 39-year old man with acute necrotizing pancreatitis. A twelve-lead electrocardiogram (A) showed signs of pericarditis and a computed tomography of the abdomen showed focal pericardial effusion, confirming the diagnosis....

 Open Access DOI:10.23937/2378-2951/1410014

A Case Report of Immediate Extubation Post Primary PCI in STEMI

Sharan Rufus Ponniah, Pradeepto Ghosh, Nagapradeep Nagajothi, Srinivasa Satti, Kavitha Nidamanuri and Baskar Rajala

Article Type: Case Report | First Published: December 16, 2014

We report a case of immediate extubation following primary percutaneous intervention (PCI) for ST elevation myocardial infarction (STEMI). The optimal timing of extubation following revascularization in STEMI is unclear. Early extubation in this scenario, if feasible has a mortality benefit. Duration of mechanical ventilation following STEMI is a strong predictor of mortality. In this case, we report a scenario of immediate extubation following revascularization, which we believe contributed to ...

 Open Access DOI:10.23937/2378-2951/1410013

Beverage Specific Effect of Alcohol on Ishaemic Heart Disease Mortality in Russia

Y. E. Razvodovsky

Article Type: Research Article | First Published: November 26, 2014

Objective: It was repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate and the dramatic fluctuation in Russian Ischemic Heart Disease (IHD) mortality rate during the last decades, while other traditional risk factors identified in epidemiologic studies had little predictive value. The link between IHD mortality and beverage-specific alcohol drinking has been analyzed in a number of aggregate-level studies with conflicting results. The aim of this stud...

 Open Access DOI:10.23937/2378-2951/1410012

Carotid Sinus Syndrome as a Manifestation of Head and Neck Cancer Case Report and Literature Review

Nikhil Mehta, Medhat Abdelmessih, Lachlan Smith, Daniel Jacoby and Mark Marieb

Article Type: Research Article | First Published: November 25, 2014

Head and neck cancers rarely manifest as Carotid Sinus Syndrome (CSS). CSS is a rare complex of symptoms found in 1% of all patients who experience syncope, the pathophysiology of which is yet to be fully understood. Common trigger mechanisms for CSS include neck movement, shaving, constricting neck wear, coughing, sneezing and straining to lift heavy objects. The left carotid sinus mainly causes AV block while the right carotid sinus mainly causes sinus bradycardia. The incidence of AV block in...

 Open Access DOI:10.23937/2378-2951/1410011

Cardiac Troponin Assessment Following Atrial Fibrillation Ablation: Implications for Chest Pain Evaluation

Jason C. Rubenstein, Jason Jacobson, Jeffrey J. Goldberger, Rod Passman, Alan Kadish and Michael H. Kim

Article Type: Research Article | First Published: November 25, 2014

Background: The range of elevation of troponin I (tI) that is within expected limits from left atrial radiofrequency ablation for atrial fibrillation (AF) is not well described, though such information may be of clinical value. Objectives: Identify the expected range of tI values post-atrial fibrillation (AF) ablation. Methods: 31 patients undergoing AF ablation had a single tI level drawn the day following the procedure. Clinical variables were also collected, such as ablation type and radiof...

 Open Access DOI:10.23937/2378-2951/1410010

Discriminant Analysis of Heart Rate Variability after Electrical Cardioversion Predicts Atrial Fibrillation Recurrence

Donatella B, Angela V, Emilia I, Kristian E, Claudia C, Rita SA, Francesco F and Riccardo F

Article Type: Research Article | First Published: November 25, 2014

Aims: Cardiac Autonomic Modulation (CAM) may be pivotal for Atrial Fibrillation (AF) occurrence and affect early recurrence (ER) after Electrical Cardioversion (EC). Previous studies investigating linear (L) Heart Rate Variability (HRV) after EC have given conflicting results about which CAM pattern favours ER. This study aimed at evaluating if non-linear (NL) HRV analysis (HRVa) could provide better accuracy in predicting ER. Methods: 36 patients, 16 under Antiarrhythmic Drugs (AAD), were enrol...

 Open Access DOI:10.23937/2378-2951/1410009

Surgical Treatment of Severe Tricuspid Valve Regurgitation Due to Permanent Pacemaker

Wenjian Jiang, Haiyang Li, Dong Guo, Yongqiang Lai and Hongjia Zhang

Article Type: Case Report | First Published: November 24, 2014

A 64-year-old woman, received implantation of a Permanent Pace Maker (PPM) 7 years ago, was referred for severe tricuspid valve regurgitation with a lead impingement of the tricuspid valve leaflets. We fied the lead to the posterior septal commissure, used 28 # Edwards MC3 ring to annulus form the tricuspid valve ring and then sutured the posterior septal commissure by edge to edge. This patient recovered uneventfully, with only mild tricuspid valve regurgitation by echocardiography after one ye...

 Open Access DOI:10.23937/2378-2951/1410008

Parameters of Mitral Deformability in Patients with Functional Mitral Regurgitation

Kammoun I, Marrakchi S, Zouari F, Fersi I, Ibn Elhaj Z, Mokrani S, Added F and Kachboura S

Article Type: Research Article | First Published: November 21, 2014

Background: Functional mitral regurgitation (FMR) is one of the common and severe complications in patients with dilated cardiomyopathy. Then determinants of degree of FMR must be more defined. Purpose: We sought to determine a cut off value of the tenting area and the coaptation depth which correlate with the severity of the FMR. Methods and results: We enrolled prospectively 96 patients (71 males; age 57 ± 13 years) with left ventricular (LV) dilation and systolic dysfunction (LV ejecti...

 Open Access DOI:10.23937/2378-2951/1410007

Rheumatic Mitral Restenosis with Concomitant Coronary artery Disease

Anupam Dey, Ramesh Aggarwal and Shridhar Dwivedi

Article Type: Letter to Editor | First Published: November 21, 2014

Rheumatic heart disease (RHD) has practically vanished from developed countries; however one often sees complicated rheumatic valvular disease in elderly individuals, in developing countries. It is not very common to see operated cases of mitral stenosis (MS) coexisting with coronary artery disease (CAD). Studies have reported prevalence of CAD coexisting with rheumatic MS ranging from 1.7% to 28%. We recently had a case of rheumatic MS, who was operated twice, had again developed restenosis, an...

 Open Access DOI:10.23937/2378-2951/1410006

Energy Drink Ingredients and their Effect on Endothelial Function: A Review

John P. Higgins and Brandon L. Ortiz

Article Type: Review Article | First Published: October 31, 2014

It is an age-old idea to try to boost one's performance in order to achieve an elusive goal or conquer an obstacle. Many energy products, especially energy drinks (ED) are now marketed to this need, and examples include Red Bulls' 'Gives You Wings', as well as Monster Energy's 'Unleash the Beast' advertising campaigns. In the light of ED consumption recently being associated with high risk behaviors, unhealthy habits, and some deaths in adolescents and young adults, especially when consumed wh...

 Open Access DOI:10.23937/2378-2951/1410005

A Rare Manifestation of Organophosphorus Poisoning: Hypothermia with Cardiotoxicity

Valliappan Muthu, Sahajal Dhooria and Inderpaul Singh Sehgal

Article Type: Case Report | First Published: October 30, 2014

Organophosphorus pesticides related self-harm is afairly common clinical entity responsible for over two thirds of pesticide related deaths in the rural areas of developing countries. Organophosphates by their action at muscarinic and nicotinic receptors can have a myriad of presenting symptoms. Here we describe a fatal case of phorate (organophosphorus) toxicity manifesting with hypothermia and cardiotoxicity....

 Open Access DOI:10.23937/2378-2951/1410004

Allograft Inflammatory Factor-1 Induction during Ischemia Reperfusion Injury: A Rat Model of LAD Occlusion

D. Olga McDaniel, Lance Majors, Taolin Fang, Feng Zhang and Larry S. McDaniel

Article Type: Research Article | First Published: October 29, 2014

The emerging role of the innate immune response in organ transplantation heightens the significance of molecular markers released from the donor organ due to ischemia/reperfusion injury (IRI) during organ procurement. These molecules are prime activators of innate immunity. Allograft inflmmatory factor-1 (AIF- 1) has been implicated in the regulation of inflmmation and organ rejection. To verify expression level of AIF-1 in cardiac tissues, we developed a rat model of IRI, in which the left ante...

 Open Access DOI:10.23937/2378-2951/1410003

Prevalence of Hypertension and its Relationship with Adiposity among Rural Elderly Population in India

Nimmathota Arlappa, Avula Laxmmaiah, Nagalla Balakrishna, Rachakula Harikumar, Kodavanti Mallikharjuna Rao and GNV Brahmam

Article Type: Research Article | First Published: October 02, 2014

Background: The world has witnessed the demographic transition in which there is increased proportion of elderly (≥ 60 years) population. This increased longevity is associated with the burden of chronic noncommunicable diseases. Objective: To assess the prevalence of hypertension and its relationship with adiposity among the elderly in rural India. Subjects and methods: A community based cross-sectional study was carried out among 3133 elderly (Men: 1677; Women: 1456). Height, weight,...

 Open Access DOI:10.23937/2378-2951/1410002

Cardiology and the New Decade

Amy Hase

Article Type: Editorial | First Published: September 29, 2014

Greetings to all readers as we move in to the era of science and technology. Let us hope to witness several exciting developments in the field of cardiology that would pave way to the cure of many cardiological disorders in this new era. This year the International Journal of Clinical Cardiology is debuting in field of open access. We hope to bring to you some of scientific excitements. There had been much progress in the field of Heart Transplantation Surgery. Doctors and Researcher from all ac...

 Open Access DOI:10.23937/2378-2951/1410001

Treatment of Dyslipidemia in Diabetics

Wilbert S. Aronow

Article Type: Editorial | First Published: September 01, 2014

Dyslipidemia in diabetics should be treated with lifestyle measures. Statins are the only lipid-lowering drugs that have been demonstrated to lower the incidence of cardiovascular events and mortality in patients with diabetes mellitus. This review article will discuss the treatment of dyslipidemia in diabetics and the current guidelines supporting the use of statins in the treatment of diabetics....


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ClinMed Journals Index Copernicus Values

Clinical Medical Image Library: 93.51

International Journal of Critical Care and Emergency Medicine: 92.83

International Journal of Sports and Exercise Medicine: 91.84

International Journal of Womens Health and Wellness: 91.79

Journal of Musculoskeletal Disorders and Treatment: 91.73

Journal of Geriatric Medicine and Gerontology: 91.55

Journal of Infectious Diseases and Epidemiology: 91.55

Clinical Medical Reviews and Case Reports: 91.40

International Archives of Nursing and Health Care: 90.87

International Journal of Ophthalmology and Clinical Research: 90.80

International Archives of Urology and Complications: 90.73

Journal of Clinical Nephrology and Renal Care: 90.33

Journal of Family Medicine and Disease Prevention: 89.99

Journal of Clinical Gastroenterology and Treatment: 89.54

Journal of Dermatology Research and Therapy: 89.34

International Journal of Clinical Cardiology: 89.24

International Journal of Radiology and Imaging Technology: 88.88

Obstetrics and Gynaecology Cases - Reviews: 88.42

International Journal of Blood Research and Disorders: 88.22

International Journal of Diabetes and Clinical Research: 87.97

New Issues


International Journal of Clinical Cardiology

ISSN: 2378-2951 | ICV: 89.24



Obstetrics and Gynaecology Cases - Reviews

ISSN: 2377-9004 | ICV: 88.42



Journal of Hypertension and Management

ISSN: 2474-3690 | ICV: 87.69



International Journal of Diabetes and Clinical Research

ISSN: 2377-3634 | ICV: 87.97



Journal of Infectious Diseases and Epidemiology

ISSN: 2474-3658 | ICV: 91.55