World Journal of Cardiovascular Diseases

Journal Information
ISSN / EISSN : 2164-5329 / 2164-5337
Published by: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 687
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Coumba Thiam, Boubacar Sonfo, Massama Konaté, Mahan Ameri Abba Diall, Asmaou Keita, Mariam Sako, Youssouf Camara, Hamidou Oumar Bâ, Ibrahima Sangaré, Mamadou Touré, et al.
World Journal of Cardiovascular Diseases, Volume 12, pp 209-215; https://doi.org/10.4236/wjcd.2022.124021

Abstract:
Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the CHU-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.
Chris Nadège Nganou-Gnindjio, Bâ Hamadou, Ludovic Kadji, Jules Thierry Elong, Daryl Tcheutchoua Nzokou, Honoré Kemnang Yemele, Alain Patrick Menanga, Samuel Kingue, Jacqueline Ze Minkande
World Journal of Cardiovascular Diseases, Volume 12, pp 199-208; https://doi.org/10.4236/wjcd.2022.124020

Abstract:
Background: Venous thromboembolic disease (VTE) is a clinical entity whose two clinical manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a frequent and severe disease in Cameroon, thus constituting a significant public health problem. We aimed to describe VTE management in the Yaoundé Emergency Center, in particular the use of thrombolysis. Methods: This was a retrospective study on patients hospitalized at the Yaoundé Emergency Center for DVT and/or PE from January 1, 2015, to December 31, 2020. We collected clinical signs, paraclinical signs, risk factors of VTE, and management methods from each patient. Results: We recruited 106 participants. Dyspnea was the most frequent symptom; PE was the most common form of VTE in eight patients on 10. Obesity and high blood pressure were the main cardiovascular risk factors. The main clinical signs were oedema and pain in the limb for DVT, dyspnea, and tachycardia for PE. Heparinotherapy was the most commonly used management modality. Thrombolysis was performed in 7.5% of participants, especially in the case of hypotension or massive PE. Conclusion: In VTE management, thrombolysis remains the least used therapeutic modality in our context. Heparinotherapy remains the basis of the therapy.
Farid Khan, Keyoor Patel, Muhammad Imran Ali
World Journal of Cardiovascular Diseases, Volume 12, pp 191-198; https://doi.org/10.4236/wjcd.2022.124019

Abstract:
Background: Tricuspid valve thrombus with concomitant bilateral pulmonary embolism (PE) and right heart strain poses a significant risk of hemodynamic instability and increased mortality. Case Report: We report the unique case of a female who presented with dyspnea and tachycardia, and was subsequently found to have a structure attached to the tricuspid valve. Concomitantly, she also had bilateral upper extremity deep venous thrombosis (UEDVT) and bilateral sub-massive PE. Thorough clinical assessment, and diagnostic and risk stratification tools were applied to guide the management and disposition. Tricuspid valve thrombus resolved after unfractionated heparin therapy followed by oral anticoagulation as seen on repeat transthoracic echocardiography. We think the readership will benefit from our experience of managing an uncommon and critical clinical presentation of tricuspid valve thrombus in the setting of extensive venous thromboembolism. Conclusion: Careful clinical assessment, risk stratification tools, and close monitoring are needed to guide the management of tricuspid valve thrombus with concomitant bilateral PE and UEDVT.
Jinguo Zhu
World Journal of Cardiovascular Diseases, Volume 12, pp 168-190; https://doi.org/10.4236/wjcd.2022.123018

Abstract:
The SARS-CoV-2 has infected over 194,909,000 cases and over 4,170,000 deaths in the world before the end of July 2021. The virus attacks human alveoli and induces severe lung injury (COVID-19 disease) and spreads rapidly. The mechanisms of COVID-19 disease are unclear. To better understand this disease, This review analyzes the SARS-CoV-2 biological characteristics, insights the effect of alveolar epithelium and its adjacent microvascular endothelium, investigates human host cells immune response and immunothrombosis. Explains clinical manifestations of COVID-19 associated lung injury. It may be helpful for development management strategies for COVID-19 associated pulmonary damage.
Domenico Sarandria, Nicola Sarandria
World Journal of Cardiovascular Diseases, Volume 12, pp 152-159; https://doi.org/10.4236/wjcd.2022.123016

Abstract:
This is an essay focused on discussing parts of the current state of knowledge and research in the field of Omega 3, Inflammation and cardiovascular diseases prevention. For a long time, Omega 3 has been considered a health-promoting and beneficial substance for well-being and longevity. New studies have shed new light on the role of omega 3 in cardiovascular diseases prevention and anti-inflammatory effects.
Ngardjibem Djita, Ibrahima Sory Sylla, Aissatou Barry, Murielle Ahodakin, Djibril Sylla, Elhadj Yaya Balde, Mamadou Bachir Bah, Houzeiph Abdou Lassissi, Alpha Kone, Sana Soumra, et al.
World Journal of Cardiovascular Diseases, Volume 12, pp 160-167; https://doi.org/10.4236/wjcd.2022.123017

Abstract:
Introduction: Cardiac amyloidosis is a rare and under-diagnosed disease. The objective of this study was to collect cases of cardiac amyloidosis in patients hospitalized in the cardiology department of the Centre Hospitalier Intercommunal Alençon-Mamers (CHICAM). Patients and Methods: This was a retrospective descriptive study of the records of patients diagnosed with cardiac amyloidosis. The study took place in the cardiology department of the CHICAM over 12 months (from January 1, 2020 to December 31, 2020). We included the files of patients in whom the diagnosis of cardiac amyloidosis was confirmed on the basis of clinical, echocardiographic, biological, scintigraphic and cardiac MRI evidence. Results: Seven patients were included. The mean age was 86.71 years. Six men for one woman. Most of the patients were in heart failure. There was one case of periorbital ecchymosis. Troponinemia was increased in three patients, NTproBNP was always high with a mean of 1000 ng/L. Cardiac echography showed a hyperbright septum in four cases, concentric hypertrophy of the left ventricle with a mean interventricular septum in diastole of 13.85 mm. Six cases were senile transthyretin amyloidosis (TTR), one case was mutated transthyretin amyloidosis (TTRm). Two cases of death were noted. Conclusion: Cardiac amyloidosis has a poor prognosis due to delayed diagnosis.
Mohamed Sanhoury, Samar Elsayed, Abdallah Mostafa Almaghraby, Mahmoud Hassanein, Asmaa Alkafafy
World Journal of Cardiovascular Diseases, Volume 12, pp 140-151; https://doi.org/10.4236/wjcd.2022.123015

Abstract:
Background: Acute heart failure (AHF) is a life-threatening condition that necessitates urgent evaluation and treatment with an urgent need for hospital admission. Among the available imaging modalities, echocardiography is the method of choice due to its feasibility and cost-effectiveness. Lung ultrasonography in emergency department, critical and cardiac care units is becoming popular. The present study aimed to assess the value of the focused echocardiography and lung ultrasound protocol for guiding treatment and its effect on the hospitalization period in AHF patients admitted to the CCU, 6 months re-hospitalization and mortality. Methods: This study included 40 consecutive patients admitted to the Cardiology and Angiology department after disposition from the emergency department at Alexandria main university hospital in Egypt with the diagnosis of (AHF). Patients were divided into 2 groups, 20 patients received the standard treatment while the other group received a modification of medication doses according to daily imaging changes. All patients were followed up for 6 months to assess the 6 months HF rehospitalization and death rates. Results: Group II patients had a significantly shorter duration of hospitalization; 6.45 ± 2.01 days compared to 9.10 ± 3.82 days among group I patients (P = 0.02). There was no significant difference between the two groups regarding the 6 months rehospitalization and death rates. Conclusion: The focused echocardiography and lung ultrasound-guided therapy for AHF patients resulted in a shorter duration of hospitalization without increased adverse events.
Joseph Berger, Martin Sayegh, Anish D. Thomas, Cara Sherman, Vikas Agrawal, Jay V. Doshi
World Journal of Cardiovascular Diseases, Volume 12, pp 228-235; https://doi.org/10.4236/wjcd.2022.124023

Abstract:
We present a case of ictal asystole in an 81-year-old female, with no prior history of epileptic activity, or cardiac history suggestive of arrhythmia, who suffered several seemingly unrelated epileptic and asystolic episodes prior to finally having a witnessed seizure followed by an asystolic event. Following this event, all atrioventricular (AV) nodal blockers, and medications with potential seizure threshold lowering activity were stopped, and anti-epileptic medication was optimized. Due to the wishes of the patient’s family, no invasive interventions were pursued.However, the patient continued to be medically treated with anti-epileptic therapy and had no further asystolic events. Unfortunately, the patient’s overall clinical status deteriorated, and she subsequently passed during her hospital stay after being made do not resuscitate and do not intubate (DNR/DNI) by the family and then subsequently comfort care. Prior to her passing, however, she had remained free of epileptic events for 10 days and free of asystolic events for 21 days.
Pramote Porapakkham, Pornwalee Porapakkham
World Journal of Cardiovascular Diseases, Volume 12, pp 216-227; https://doi.org/10.4236/wjcd.2022.124022

Abstract:
Background: Mitral valve repair in secondary mitral regurgitation is still uncertain as the chance of recurrence is approximately 30 percent after solely undersized annuloplasty. Some procedures adding to the subvalvular level are proposed to alleviate the recurrent rate. This study was to evaluate the clinical and echocardiographic outcomes of papillary muscle relocation plus undersized ring in secondary mitral regurgitation (2nd MR). Methods: Medical records of moderate to severe 2nd MR with tethering depth of more than 1 cm patients who underwent papillary muscle relocation plus undersized ring from 2014 to 2020 were reviewed. Clinical and echocardiographic parameters before and after operation were analyzed. Results: Thirty-two patients were included during the 6-year period. There was no perioperative mortality. Two patients died at one year from ischemic stroke and car accidents with overall 5-year survival of 93.7%. All patients were in NYHA class I and II with MR grading as trivial or mild at a median follow-up of 33 months. Postoperative mean tenting depth, area and posterior leaflet angle decreased remarkably from 1.18 cm, 2.61 cm2 and 46.5 degree to 0.65 cm, 1.22 cm2 and 28.6 degree, respectively (p 0.001, 0.02, and 0.01). Moreover, left ventricular function and remodeling were also notably improved (EF; 38.2% vs 49.1%: p = 0.018, LVEDD; 62.8 vs 54.6 mm: p = 0.005, LVESD; 50.2 vs 42.4 mm: p = 0.01). Conclusions: Papillary muscle relocation combined with undersized annuloplasty improved mid-term clinical outcomes. Apart from reduction of recurrent MR rate, restoration of mitral configuration and reverse LV remodeling could be the effect of adding subvalvular correction in this pathology.
Solange Flore Mongo Ngamami, Armel Landry Batchi-Bouyou, Trésor Mavie Eouolo Ndona, Christian Michel Kouala Landa, Eric Gibrel Kimbally Kaky, Jean Joseph Ekwa Sima, Bertrand Fikahem Ellenga Mbolla, Méo Stéphane Ikama
World Journal of Cardiovascular Diseases, Volume 12, pp 94-110; https://doi.org/10.4236/wjcd.2022.122010

Abstract:
Infectious endocarditis (IE) is a relatively rare but serious condition. We report 3 cases of infectious endocarditis complicated by peri-annular and/or septal abscess. The patients aged 24, 25 and 28 were all male. Global heart failure was observed in 2 cases. Atrioventricular block was noted in 2 cases (complete syncopation: 1 time; 2nd degree Mobitz 2 1 time). Transthoracic echocardiography made it possible to diagnose abscess in all cases (aortic and septal peri-annulus: once, septal only: twice). The aortic insufficiency was grade 2 in all cases, mitral insufficiency grade 2 in 1. The front door was found once, with a dental location. Blood cultures were negative in all cases. A bi-probabilistic antibiotic therapy made it possible to control the infectious process in all the patients. Cardiac surgery, indicated in all cases, was performed in 1 case, consisting of flattening the abscesses and then placing a pacemaker in the patient with complete syncopal atrioventricular block. The outcome of all patients was favorable. Return to permanent sinus rhythm, associated with complete left bundle branch block, was noted at the 4th year of development in the pacemaker wearer. The other 2 patients are still awaiting medical evacuation.
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