OSP Journal of Cardiology

Objective: The aim of this study is to present the case of a 41-year-old asymptomatic male endurance athlete who underwent a competitive sports preparticipation screening examination, which revealed the presence of a huge thoracic vascular malformation with multiple fistulous communications between coronary arteries, bronchial arteries, and the pulmonary artery.

Coronary artery-pulmonary artery fistulas (CAFs) are rare cardiac anomalies. Most of them originate from the right coronary artery (RCA), while fistulas originating from the left anterior descending artery (LAD) or multiple arteries are less common. CAFs are often asymptomatic and are found incidentally during routine cardiac imaging. With this short paper, the author presents the case of a 41-year-old asymptomatic male endurance athlete who underwent a competitive sports preparticipation screening examination, which revealed the presence of a huge thoracic vascular malformation with multiple fistulous communications between coronary arteries, bronchial arteries, and the pulmonary artery.

Introduction: Coronavirus Disease-2019 (COVID-19) had discovered in Wuhan, and Mar 11, 2020, World Health Organization (WHO) declared it an outbreak pandemic. This study aims to investigate the clinical characteristics, morbidities, management, and outcomes of COVID-19 Infected patients admitted to the intensive care unit (ICU) with or without cardiac disease in Somalia.
Method:  We conducted a retrospective observational study of laboratory 48 confirmed patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) admitted to an ICU from April23 to Jun 28, 2020.

Results: 48 patients of COVID-19 infected patients with and without cardiac disease, the mean age was 62.15±13.9 years, ranging from 19 to 80 years. 64.6% were male, while diabetic-(58.3%) and hypertension-(31.2%) were the most common comorbidities. The most clinical presentations were dyspnea-(79.2%) and fever-(63.3%). Among diseased cardiac patients, 46.7%administered invasive mechanical ventilation was, while 29.2% received noninvasive ventilation, higher than those without cardiac disease. In addition, of 30 patients with cardiac disease, 20-(66.7%) have COVID-19 complications, while 10-(55%) of 18 patients with no cardiac disease have COVID-19 complications. According to the outcome, 18-(60%) out of 30 COVID-19-infected patients with cardiac disease patients in the ICU died compared to those with non-cardiac disease, about 11-(61.1%) patients.

Conclusion: This study identified that the patients suffering from cardiac diseases were more severe than those without cardiac conditions, according to the need for invasive ventilation, complications, and outcome.

Objective:  Femoral Artery Pseudoaneurysm was caused at the puncture site of the right groin after diagnostic coronary angiography. Manual compression for 48 hours was administrated but failed then balloon tamponade was attempted for hemostasis at the aneurysmal site but hemostasis was not achieved. Next, using contralateral anterograde approach was use to cross the wire from the neck of the pseudoaneurysm and ipsilateral retrograde approach by direct puncture of the pseudoaneurysm was tried. A 0.014-inch guidewire was crossed from the neck of the pseudoaneurysm to the external iliac artery. The wire was replaced with a 0.035-inch guidewire. A star close device was inserted and was deployed at the neck of the pseudoaneurysm. Final angiography revealed completion of hemostasis.

BRASH Syndrome is a newly defined cause of severe bradycardia that can manifest in a number of ways. This syndrome can easily arise in the setting of polypharmacy and does so in the context of some of the most frequently prescribed medications in current practice. This case demonstrates how this syndrome can occur with medication initiation and lead to a critical status.

The aim of this commentary is to draw attention to a plausible interrelationship between a lingering morbidity, myocardial and systemic inflammation, and to the imaging modalities to detect and monitor such inflammation, in patients with Takotsubo Syndrome (TTS). Although TTS is portraited as a stress-related affliction, whose pathophysiology is still elusive, systemic and myocardial inflammation appears to be a prominent accompaniment.

The author uses his developed GH-Method: math-physical medicine approach to investigate a more detailed contribution analysis of three lifestyle management sub-categories with nine elements on his risk probability percentages of having cardiovascular disease (CVD) or stroke.  

Listed below is his annualized risk probability percentage based on Lifestyle of having CVD or stroke:

A 39-year-old African American male with history of methamphetamine abuse and schizoaffective disorder, presented to the hospital from a homeless shelter for altered mentation. The patient had prior involuntary psychiatric facility admissions and was reportedly non-compliant with medications. From records available, he had no cardiac history. He was a current one pack per day tobacco smoker. Paliperidone was listed as a home medication, however, it was unclear if he was taking any medication. Due to his altered condition, no further history was elucidated.

India is considered as the capital of cardiometabolic conditions. Multiple studies have highlighted the early age of onset of Coronary Artery Disease (CAD) in the Indian population. Ethnicity and family history have been the primary drivers for this young age of onset that so far has been loosely defined as <45 years or as early as <35 years. We present a young normotensive Indian patient in visibly good health who came into the emergency room with chest pain. He was treated with primary angioplasty post diagnosis of Acute Inferior Wall myocardial infarction. This is the only case reported, from India, to our knowledge of a young 25- year old patient with CAD without any previous family history of CAD or any known risk factors. Increasing cardiovascular events especially in patients without family history such as ours indicates the need to institute population level screening programs and increase awareness of healthy lifestyle among the youth.

Septic arthritis in children is a serious orthopedic condition that can cause functional impairment or death through its complications. Complications are frequent and serious, in particular infective endocarditis in sepsis. We report in this paper a rare case of a 7-year-old child who had septic arthritis of the neglected ankle, complicated by severe sepsis and infectious mitral endocarditis on native valve.

Although clinical symptomatology and electrocardiogram (ECG) findings of acute pericarditis have been well described, the diagnosis can still be perplexing in some instances. We report here a case of early acute pericarditis which was taken to the cardiac catheterization lab for coronary angiography with suspected acute myocardial infarction (MI). The ECG initially showed regional ST elevation, but later became diffuse. The case demonstrates that in the earliest phase of pericarditis, ST-elevations may be regional, making it difficult to distinguish from an acute MI.  We present the ECG recordings which show this progression. Other factors which may help in differentiating pericarditis from acute MI are also discussed.