Burden and predictors of thirty-day readmission in patients with NSTEMI: a retrospective analysis of the 2020 NRD database.

Background: Non-ST-segment elevation myocardial infarction (NSTEMI) is an entity which was defined as a type of a coronary syndrome with positive cardiac biomarker of myocardial necrosis with no ST-segment elevation in ECG. Currently, the centers for Medicare and Medicaid services (CMS) Hospital readmission reduction program assistance risk-adjusted 30-day readmission rates for five major clinical entities which includes acute myocardial infarction.

Methods: We performed this retrospective study to look into the current burden and predictors of NSTEMI readmission.

Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis: A pilot study.

Background: Infective endocarditis (IE) is a life-threatening infection with an annual mortality of 40%. Embolic events reported in up to 80% of patients. Vegetations of > 10 mm size are associated with increased embolic events and poor prognosis.

Atrioventricular Synchrony Restoration Aided by a Temporary Permanent Pacemaker in Right Ventricular Infarction and Complete Heart Block.

Pacemakers are effective treatments for a variety of bradyarrhythmias. Cardiac pacemakers generally consist of a pulse generator and one or more leads. The conventional temporary transvenous ventricular cardiac pacemaker utilizing a passive fixation lead is commonly associated with multiple complications such as increased infection rate, lead dislodgement, venous thrombosis, longer duration of hospital stay, and atrioventricular (AV) dyssynchrony.

Cardiovascular Remodeling in Chronic Mineralocorticoid Excess.

Primary hyperaldosteronism typically leads to resistant hypertension, hypokalemia, and metabolic alkalosis. Excess aldosterone secretion by the adrenal glands may lead to heart failure with preserved ejection fraction. Potassium-sparing diuretics and aldosterone antagonists directed to lower excess aldosterone levels may help treat the associated heart failure and lead to control of blood pressure, resulting in improved outcomes.

Cardio-Thyrotoxicosis Syndrome: A Review of Thyrotoxic Cardiovascular Disease.

Thyrotoxicosis, an endocrine disorder characterized by elevated serum thyroid hormone levels of tri-iodothyronine (T3) and/or thyroxine (T4), can impact cardiovascular health in several ways. The cardiovascular system is often severely targeted by the thyrotoxic state, and the term "Cardio-thyrotoxic syndrome" has been proposed to encompass the various cardiovascular disease states resulting from thyrotoxicosis. In this review, we discuss various cardiovascular disorders resulting from the effects of thyrotoxicosis.

Bradycardia-Induced Torsades de Pointes in Atrioventricular Block.

Bradycardia is known to prolong QT interval. Persistent bradycardia and high-grade atrioventricular (AV) block may lead to persistently prolonged QTc interval with a risk for life-threatening ventricular arrhythmias, which needs addressing the underlying cause. We present the case of a patient with persistent sinus bradycardia with a high-grade AV block leading to persistently prolonged QTc without any reversible etiology that resulted in torsades de pointes.

Anomalous aortic origin of right coronary artery from left coronary cusp: a management conundrum: a case report.

Background: Coronary artery anomalies are characterized by an abnormality in the course or origin of three main coronary arteries. There needs to be more scientific evidence to promptly treat coronary artery anomalies with poorly understood prognostic implications, especially anomalous aortic origin of the right coronary artery from the left coronary cusp.

Case Presentation: A 58-year-old Caucasian female presented multiple times over 6 months with atypical chest discomfort and palpitations.

Dilated Cardiomyopathy: Beware of Diet Drugs Slimming the Heart.

There have been rare reports of dilated cardiomyopathy from chronic use of phentermine/topiramate, although very limited data are available. Phentermine is an atypical amphetamine analog that has been contraindicated in patients with a history of cardiovascular disease. We present a case of nonischemic dilated cardiomyopathy in the setting of chronic phentermine/topiramate use, which is the most likely cause of her dilated cardiomyopathy.

Yamaguchi syndrome - An updated review article of electrocardiographic and echocardiographic findings.

Apical hypertrophic cardiomyopathy (ApHCM) is thought to be an uncommon variant of hypertrophic cardiomyopathy (HCM). This article is a literature review focusing on the characteristic electrocardiogram (EKG) and 2D echocardiogram findings as currently there are no specific ACC/AHA/ESC guidelines set as diagnostic criteria for ApHCM.

Atrioventricular Block: An Unusual Presentation of Overactive Thyroid.

The clinical features of hyperthyroidism are varied, but bradyarrhythmia and atrioventricular (AV) block are typically not reported in hyperthyroid patients. We present here a case of primary hyperthyroidism with symptomatic high-grade AV block as the sole presenting feature of hyperthyroidism without any obvious precipitating factors for thyroid disease or AV block. This case highlights a rare presentation of high-grade AV block with the risk of progression to complete AV block as a complication of an untreated overactive thyroid.

Left Pulmonary Artery Aneurysm: A Post-stenotic Pulmonary Aneurysm Related to Pulmonary Valve Stenosis.

Aneurysms of the pulmonary artery are uncommon vascular pathologies that are associated with congenital structural cardiac anomalies, pulmonary hypertension, vasculitis, neoplasm, iatrogenic, and infection. PAAs are commonly asymptomatic and accidentally diagnosed, however, if symptomatic, clinical features are generally non-specific and depend on the etiology of PAA. CT pulmonary angiography remains the gold standard imaging modality and other diagnostic imaging tests include transthoracic echocardiography and right heart catheterization.

Serratia endocarditis, uncommon organism, with significant complications.

Serratia marcescens is an aerobic, Gram-negative bacillus predominantly seen in patients with intravenous drug use, immunosuppression, previous antibiotic exposure, and indwelling catheterization. Gram-negative organism causing infective endocarditis (IE) is rare. Serratia marcescens IE is uncommon and is reported to be seen in 0.

ST elevation myocardial infarction - national trend analysis with mortality differences in outcomes based on day of hospitalization.

Background: Patientswho present with acute ST elevation myocardial infarction (STEMI) need emergent revascularization. Our study aims to investigate the outcomes in patients with STEMI admitted during weekends versus weekdays.

Methods: We conducted a retrospective analysis of the nationwide inpatient sample database.

Anomalous Interarterial Right Coronary Artery: Approach to a High-Risk Course.

Congenital coronary anomalies can be an incidental finding in the adult population. Implications of an anomalous coronary artery vary depending on its course and the anomaly. An interarterial course of an anomalous coronary artery is considered malignant with a high risk of sudden cardiac death.

Critical Stenosis in Left Anterior Descending Artery: Beware of T- Wave Inversions.

Wellens' syndrome (WS) is a pattern on an electrocardiogram (ECG) characterized by biphasic T waves or deeply inverted T waves in leads V2-V3 with a recent clinical history of angina. Wellens' pattern on the ECG is particular for critical left anterior descending artery (LAD) stenosis. Wellens' sign and WS have been used interchangeably in the literature.

Anomalous Origin of the Left Circumflex Coronary Artery: Approach in Acute Coronary Syndrome.

Coronary artery anomalies are congenital and relatively uncommon. Anomalous origin of the left circumflex artery from the right is a relatively common congenital coronary variant and is usually considered benign in itself. The presence of an anomalous coronary artery may pose challenges in engaging the anomalous vessel, and prompt recognition of an anomalous coronary artery is important to allow for appropriate coronary interventions.

Left Main Coronary Artery Disease: The Forgotten Lead of Electrocardiogram Is Predictive.

An ST segment depression in eight or more leads along with ST segment elevation in lead aVR or V1, especially occurring during ischemic symptoms, has a very high predictive accuracy of left main or three-vessel disease, or tight proximal left anterior descending (LAD) coronary artery stenosis. We describe a classic case of a patient who presented with ST elevation in the lead aVR with diffuse ST segment depression during anginal symptoms and was found to have severe disease in the distal left main, ostial circumflex, and left anterior descending artery on an emergent coronary angiogram.

Brugada Sign in a Cardiac Transplant Donor.

Brugada syndrome (BrS) is a rare entity represented by the Brugada sign on an electrocardiogram (EKG) and is associated with sudden cardiac death (SCD). There is little data to guide the management of donor Brugada syndrome in the setting of cardiac transplantation. A 31-year-old male sustained out-of-hospital cardiac arrest secondary to polysubstance use and was found asystole.

Empowering Patients: Promoting Patient Education and Health Literacy.

Patients are generally keen to understand and obtain more information about their medical conditions. There exists a need to develop updated and thorough yet concise patient education handouts and to encourage healthcare providers (HCPs) to use uniform patient education methods. A thorough review of literature on patient education material was performed prior to starting the study.

Building Body With Anabolics Is Weakening the Heart: Anabolic Steroid Induced Cardiomyopathy.

Anabolic steroid (AS) use is common in young males, with several reports of various adverse cardiovascular events in the users of AS. We present a unique case of a young male with no other risk factors who developed dilated cardiomyopathy secondary to abuse of AS. The exact mechanism by which AS leads to cardiomyopathy is not very well understood.

Cardiovascular Morbidity in Ankylosing Spondylitis: A Focus on Inflammatory Cardiac Disease.

Ankylosing spondylitis (AS) is associated with an increase in cardiovascular (CV) morbidity when compared to the general population. The increased risk of CV involvement in AS is likely multifactorial including inflammation accelerating atherosclerosis and the cardiac inflammation itself in the form of aortitis and conduction anomalies. Establishing indisputable evidence linking AS and CV disease is challenging due to AS being relatively rare and it affects 1:1,000 and all studies analyzing the association between AS and CV disease involve a small sample size making long-term outcome measurements limited.

Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019.

Hydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and anti-inflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory syndrome coronavirus 2, with several speculated mechanisms. The purpose of this review is to elaborate on the mechanisms surrounding hydroxychloroquine.