Global Cardiology Science & Practice最新文献

{"title":"Impact of coronary artery calcium scores on cardiovascular risk and preventive therapies: A systematic review and meta-analysis.","authors":"Hussam Al Hennawi, Muhammad Salman Sabri, Muhammad Khuzzaim Khan, Nikhil Duseja, Rida Asim, Robert A Watson","doi":"10.21542/gcsp.2025.48","DOIUrl":"10.21542/gcsp.2025.48","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery calcium (CAC) scoring is a key noninvasive method for detecting subclinical atherosclerosis and refining cardiovascular risk assessment. It enhances traditional risk models and plays an expanding role in preventive cardiology. This systematic review and meta-analysis aimed to evaluate the relationship between CAC presence and cardiovascular outcomes, as well as its impact on the initiation and continuation of preventive pharmacologic and lifestyle interventions among asymptomatic and symptomatic individuals without known coronary artery disease (CAD).</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic search was conducted through February 2025 across PubMed, Scopus, Google Scholar, Cochrane Central, and ClinicalTrials.gov. Eligible studies included randomized controlled trials and observational research comparing outcomes and behaviors between individuals with a CAC score of zero and those with a score above zero.</p><p><strong>Results: </strong>Fifty-three observational studies involving 210,672 asymptomatic and 32,477 symptomatic participants were analyzed. Over an average follow-up of 8.6 years, the presence of CAC was significantly associated with increased risks of major adverse cardiovascular events (OR: 5.58), all-cause mortality (OR: 3.90), myocardial infarction (OR: 4.01), and revascularization (OR: 11.90). CAC presence also correlated with greater odds of initiating and continuing preventive therapies such as aspirin, lipid-lowering, and blood pressure medications, as well as adopting healthier lifestyle changes like increased physical activity and improved diet.</p><p><strong>Conclusion: </strong>CAC is a robust, independent marker of future cardiovascular risk and a strong catalyst for clinical intervention. Its use in risk stratification can enhance personalized prevention strategies in both asymptomatic and symptomatic populations.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202548"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diverticulum of the left ventricular apex manifested by recurrent chest pain.","authors":"Husam Katib, Sarah Alem, Nawfal Alkhafaji, Hamza Yousaf, Manoj Sharma","doi":"10.21542/gcsp.2025.52","DOIUrl":"10.21542/gcsp.2025.52","url":null,"abstract":"<p><p>A left ventricular diverticulum at the apex is a rare cardiac anomaly in adults, often detected incidentally due to its asymptomatic nature. Noninvasive imaging modalities, such as echocardiography, provide initial diagnostic clues, but advanced techniques like cardiac magnetic resonance (CMR) imaging or contrast-enhanced computed tomography (CT) are often required for confirmation. This report describes a case of a patient presenting with recurrent chest pain, ultimately diagnosed with a left ventricular apical diverticulum through a stepwise imaging approach.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202552"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiological distribution and mortality factors in pericardial effusion: Insights from a large cohort study.","authors":"Pooja Vyas Kothari, Kunal Parwani, Kewal Kanabar, Iva Patel, Payal Tripathi, Paritosh Nilesh Kotak, Khushboo Chouhan Parmar","doi":"10.21542/gcsp.2025.54","DOIUrl":"10.21542/gcsp.2025.54","url":null,"abstract":"<p><strong>Background: </strong>Pericardial effusion represents a potentially life-threatening clinical entity arising from diverse pathophysiological processes, with etiological prevalence demonstrating substantial geographic and ethnic variation. Despite this recognized heterogeneity, epidemiological data characterizing the distribution of pericardial effusion etiologies in Indian populations remain limited.</p><p><strong>Methods: </strong>This observational cohort study enrolled 695 consecutive patients presenting with moderate-to-large pericardial effusion at a tertiary cardiac care center. Comprehensive demographic and etiological data were systematically collected, with prospective follow-up extending over a 24-month period.</p><p><strong>Results: </strong>The 695 patients exhibited a male predominance (55.68%). Etiological analysis revealed tuberculosis as the most frequent cause (32.52%), followed by malignancy (30.6%), idiopathic effusion (19.14%), hypothyroidism (7.77%), chronic kidney disease (5.75%), connective tissue disorders (3.16%), and pyogenic infections (1.0%). Among malignancy-associated effusions, pulmonary carcinoma accounted for 47.41% of cases. In patients presenting with cardiac tamponade, malignancy was identified in 47.12% and tuberculosis in 29.15%. Over the 24-month follow-up period, malignancy was responsible for 78.76% of observed mortality. Kaplan-Meier survival analysis demonstrated that patients with malignancy-associated effusion exhibited the poorest prognosis, followed sequentially by those with chronic kidney disease and tuberculosis.</p><p><strong>Conclusion: </strong>Tuberculous pericarditis emerged as the predominant etiology of pericardial effusion in this cohort. However, malignancy, particularly pulmonary carcinoma, constituted the principal cause of mortality, followed by chronic kidney disease and tuberculosis. Kaplan-Meier survival analysis underscored the adverse prognostic impact of malignancy-associated pericardial effusion, highlighting the critical importance of prompt diagnostic evaluation and therapeutic intervention.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202554"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapy-induced cardiotoxicity in drug-resistant tuberculosis patients: A systematic review and meta-analysis.","authors":"Lies Dina Liastuti, Kelvin Kohar, Haifa Mayang Lestari, Armalya Pritazahra","doi":"10.21542/gcsp.2025.53","DOIUrl":"10.21542/gcsp.2025.53","url":null,"abstract":"<p><strong>Background: </strong>Drug-resistant tuberculosis remains a major public health challenge with substantial associated morbidity and mortality. Management requires complex, individualized treatment regimens. Emerging evidence suggests that contemporary antituberculosis agents for drug-resistant disease carry significant cardiotoxicity risk. This study aims to evaluate the cardiovascular toxicity of current therapeutic regimens in patients with multidrug-resistant, pre-extensively drug-resistant, and extensively drug-resistant tuberculosis.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted following the PRISMA guidelines. A comprehensive literature search was performed across five databases (PubMed, Cochrane Library, Scopus, ProQuest, and Springer) through May 5, 2024. Methodological quality was assessed using NHLBU study quality assessment tools for controlled intervention studies. Statistical analyses were conducted using a random-effects model with the DerSimonian-Laird method, with results reported as pooled estimates with 95% confidence intervals.</p><p><strong>Results: </strong>Eight studies comprising 9,506 patients with multidrug-resistant, pre-extensively drug-resistant, and extensively drug-resistant tuberculosis were included. Bedaquiline without delamanid was associated with the greatest QTc prolongation [pooled mean difference: 21.9 ms (95% CI [10.24-33.62])] and highest prevalence of clinically significant QTc prolongation [21.2% (95% CI [8.6-22.8]%)]. Treatment discontinuation rates were similar for bedaquiline monotherapy and bedaquiline-delamanid combination therapy [8% (95% CI [2-18]%) vs. 8% (95% CI [0-21]%)].</p><p><strong>Conclusion: </strong>Drug resistant tuberculosis treatments were associated with cardiotoxicity concerns, evidenced by its QT prolongation, clinically significant arrhythmia, and treatment discontinuation.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202553"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peak atrial longitudinal strain as a predictor of postoperative atrial fibrillation in isolated coronary artery bypass grafting: Insights from a single-centre study in Indonesia.","authors":"Ahmad F Lubis, Andre P Ketaren, Abdul H Raynaldo, Anggia C Lubis, Teuku B Haykal, Tengku W Ardini, Joy W Purba, Nizam Z Akbar","doi":"10.21542/gcsp.2025.58","DOIUrl":"10.21542/gcsp.2025.58","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a frequent complication in patients undergoing coronary artery bypass grafting (CABG) and contributes to increased morbidity and mortality. Identifying accurate preoperative predictors for POAF remains a clinical challenge.</p><p><strong>Objectives: </strong>This study aimed to evaluate the predictive value of preoperative peak atrial longitudinal strain (PALS) for POAF in patients undergoing isolated CABG.</p><p><strong>Methods: </strong>This prospective cohort study was conducted from May to October 2024. A total of 58 adult patients undergoing isolated CABG were consecutively enrolled. PALS measurement was performed preoperatively using speckle tracking echocardiography. Patients were followed for 30 days postoperatively to monitor POAF occurrence. Statistical analyses in this study included ROC curve, Kaplan-Meier, and Cox regression.</p><p><strong>Results: </strong>Of the 58 patients, 30 patients had PALS <28% and 28 patients had PALS ≥28%. The incidence of POAF was significantly higher in the low PALS group (53.3% vs 10.7%, <i>p</i> = 0.001). Multivariate analysis showed that low PALS, high BMI, and on-pump CABG were independent predictors of POAF. We also revealed that the combination of low PALS and on-pump CABG technique conferred the highest risk of POAF. Kaplan-Meier analysis reinforced that the cumulative incidence of POAF was higher in patients with low PALS and those undergoing on-pump CABG.</p><p><strong>Conclusion: </strong>Preoperative PALS < 28% is a strong predictor of POAF in patients undergoing isolated CABG. PALS assessment and surgical technique can optimize risk stratification and POAF prevention strategies.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202558"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery bypass grafting following Ross procedure in a patient with familial hypercholesterolemia.","authors":"Jessica B Briscoe, Shivani Shirodkar, AlleaBelle Bradshaw, Michelle Carvajal, Jennifer S Lawton, Hamza Aziz","doi":"10.21542/gcsp.2025.49","DOIUrl":"10.21542/gcsp.2025.49","url":null,"abstract":"<p><p>Patients with familial hypercholesterolemia and concurrent aortic valve disease are at exceptionally high risk of requiring repeat interventions due to coronary disease, in addition to management of valvular pathology. For effective management, it is important for these patients to have a multidisciplinary approach to their care with surgical and interventional cardiology input. In this report, we present a case of a 33-year-old female patient with a history of familial hypercholesterolemia and congenital aortic stenosis status post-Ross procedure who presents with unstable angina. We discuss the challenges and factors to consider in the management of this unique patient population.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202549"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure with preserved ejection fraction: the impact of right heart failure on risk mortality in hospitalized COVID-19 patients: Cohort study.","authors":"Rocío N Sánchez Santillán, Arturo Orea-Tejeda, Dulce González-Islas, Celemi Vigil-López, Luz M Jimenez Gallardo, Nadia Hernandez López, Benigno Valderrabano Salas, Alvaro Montañez Orozco, Tomas Peña Espinosa, Laura P Arcos Pacheco","doi":"10.21542/gcsp.2025.47","DOIUrl":"10.21542/gcsp.2025.47","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is a clinical syndrome characterized by signs and symptoms of structural and/or functional alterations accompanied by impaired expulsion of blood or ventricular filling. COVID-19 contributes to circulatory failure and frequently induces or facilitates pulmonary artery thrombosis. HF can be a risk factor as well as a complication of COVID-19.</p><p><strong>Aims: </strong>The purpose of this study was to evaluate the association between HFpEF isolate and RHF + HFpEF on mortality according to sex in hospitalized patients caused by COVID-19.</p><p><strong>Methods: </strong>A prospective cohort study was performed on hospitalized COVID-19 patients from February 2021 to October 2022. Patients ≥18 years with COVID-19 and an echocardiogram during their hospitalization were included. We excluded patients with HIV, shock, and with missing data.</p><p><strong>Results: </strong>A total of 105 patients were included in this study. The median age was 64 years (50-76), 32% (<i>n</i> = 37) of the subjects were women. Patients with \"HFpEF + RHF\" were found to have an increased risk of death (HR 5.58; 95% CI 1.26-24.6, <i>p</i> = 0.023) compared to those with HFpEF alone. A comparison of all patients with HFpEF vs \"HFpEF + RHF\" according to sex, revealed that women and men with \"HFpEF + RHF\" had greater mortality than those with HFpEF alone, (<i>p</i> = 0.0129, <i>p</i> = 0.081), respectively.</p><p><strong>Conclusion: </strong>Heart failure is an important condition associated with poor prognosis irrespective of the cause of hospitalization. COVID-19 causes damage to the heart and is associated with \"RHF and HFpEF\". Furthermore, there were found an increased incidence of \"RHF and HFpEF\" in women.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202547"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year versus three-year outcomes of DK-Crush versus Culotte for left main bifurcation lesions: A systematic review and meta-analysis of RCTs.","authors":"Arga Setyo Adji, Intan Komalasari, Diski Saisa, Atiyatum Billah, Nadhifa, Antonius Dwi Saputra, Derren David Homenta Rampengan, Yudi Her Oktaviano","doi":"10.21542/gcsp.2025.46","DOIUrl":"10.21542/gcsp.2025.46","url":null,"abstract":"<p><strong>Background: </strong>The long-term comparative effectiveness of the Double Kissing (DK) Crush and Culotte stenting techniques for left main bifurcation lesions (LMBLs) remains a subject of clinical debate. This meta-analysis aimed to evaluate and compare the one-year and three-year clinical outcomes of the DK Crush and Culotte techniques in patients with LMBLs.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, MEDLINE, Cochrane, ScienceDirect, and Google Scholar databases up to June 2025. Three randomized controlled trials (RCTs) comprising 1,188 patients with LMBLs were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel fixed-effects model to assess one- and three-year outcomes, including target vessel revascularization (TVR), major adverse cardiac events (MACE), myocardial infarction (MI), cardiac death (CD), and coronary artery bypass grafting (CABG).</p><p><strong>Results: </strong>Across all studies, DK Crush demonstrated significantly improved outcomes compared with the Culotte technique for several endpoints. At the one-year follow-up, DK Crush was associated with a significantly lower rate of target vessel revascularization (RR = 0.42, 95% CI: 0.24-0.75, <i>p</i> = 0.003) and major adverse cardiac events (RR = 0.45, 95% CI: 0.29-0.71, <i>p</i> = 0.0006). There were no significant differences between the two techniques in cardiac death (RR = 0.83, 95% CI: 0.32-2.12, <i>p</i> = 0.70), myocardial infarction (RR = 0.60, 95% CI: 0.26-1.39, <i>p</i> = 0.24), or coronary artery bypass grafting (RR = 2.42, 95% CI: 0.43-13.69, <i>p</i> = 0.32). At the three-year follow-up, DK Crush maintained its superiority, showing significantly reduced rates of TVR (RR = 0.37, 95% CI: 0.24-0.58, <i>p</i> < 0.0001), MACE (RR = 0.47, 95% CI: 0.34-0.65, <i>p</i> < 0.0001), and MI (RR = 0.43, 95% CI: 0.21-0.89, <i>p</i> = 0.02). However, no statistically significant differences were observed in cardiac death (RR = 0.81, 95% CI: 0.45-1.46, <i>p</i> = 0.47) or CABG (RR = 2.25, 95% CI: 0.46-11.03, <i>p</i> = 0.32).</p><p><strong>Conclusion: </strong>The DK Crush technique demonstrated superior clinical efficacy compared with the Culotte technique, with significantly lower rates of TVR, MACE, and MI at both one and three years. Although no significant differences were observed in cardiac death or CABG, DK Crush appeared to provide more favorable long-term vessel patency and reduced risk of repeat revascularization. Further large-scale randomized trials are warranted to validate these findings and strengthen the evidence supporting DK Crush as the preferred strategy for complex left main bifurcation lesions.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202546"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant saphenous vein graft aneurysm and associated constrictive pericarditis in a patient with prior CABG.","authors":"Emily L Larson, Binuri Hapuarachchy, Hamza Aziz","doi":"10.21542/gcsp.2025.57","DOIUrl":"10.21542/gcsp.2025.57","url":null,"abstract":"<p><strong>Background: </strong>Saphenous vein graft aneurysms (SVGA) are a rare but significant complication following coronary artery bypass grafting. They can lead to life-threatening conditions including rupture, fistula formation, and compression of adjacent thoracic structures. Current consensus calls for intervention, either surgically or percutaneously, with no agreed upon threshold for observation measures only. This case describes the clinical course of a patient with a known SVGA a decade prior to their current presentation with constrictive pericarditis.</p><p><strong>Case presentation: </strong>The patient developed a large SVGA after undergoing coronary artery bypass grafting. The SVGA was monitored for over a decade without intervention. The patient then developed worsening symptoms of volume overload and was found to have developed a constrictive left-sided pericarditis due to the SVGA compressing left-ventricular inflow. Two pericardiectomies were performed, with debridement of the SVGA and excision of calcified pericardial plaques. Although the constriction was addressed, the patient was unable to recover and ultimately died.</p><p><strong>Discussion: </strong>This report characterizes an SVGA causing constrictive pericarditis following coronary artery bypass grafting. This case demonstrates the need for appropriate and timely intervention in managing vein graft aneurysms and preventing fatal complications. We recommend annual echocardiography with dedicated evaluation for constriction to guide the need for intervention in patients with SVGA.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 5","pages":"e202557"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management challenges in Heyde syndrome: A case report of recurrent gastrointestinal bleeding and aortic stenosis in an octogenarian.","authors":"Muhammad Salman Sabri, David Glass, Aheed Javaid, John Dudzinski","doi":"10.21542/gcsp.2025.36","DOIUrl":"10.21542/gcsp.2025.36","url":null,"abstract":"<p><p>Heyde syndrome is defined by the triad of aortic stenosis, gastrointestinal bleeding from angiodysplasias, and acquired von Willebrand disease. Management of aortic stenosis in Heyde syndrome poses a unique clinical challenge, particularly in elderly patients with multiple comorbidities. We present the case of an 87-year-old woman with severe anaemia secondary to gastrointestinal bleeding, moderate-to-severe aortic stenosis, and confirmed acquired von Willebrand disease. Despite endoscopic intervention and medical management, the patient continued to experience recurrent bleeding and haemodynamic instability. Although aortic valve replacement is known to mitigate bleeding risk by correcting shear stress-induced von Willebrand factor abnormalities, the patient's frailty, atrial fibrillation, and preference for conservative management complicated decision-making. This case highlights the complexities and therapeutic dilemmas in managing aortic stenosis in Heyde syndrome, particularly balancing the risks and benefits of surgical intervention versus conservative treatment in a vulnerable population.</p>","PeriodicalId":12669,"journal":{"name":"Global Cardiology Science & Practice","volume":"2025 4","pages":"e202536"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13070244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}