Heart Views最新文献

{"title":"Left Brachiocephalic Vein with Combined Retroaortic and Retroesophageal Courses - A Hitherto Undescribed Pattern with Potential Surgical Implication.","authors":"Arun Sharma, Mansi Verma, Vivek Jaswal, Manphool Singhal","doi":"10.4103/heartviews.heartviews_127_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_127_26","url":null,"abstract":"<p><p>We report a 3-year-old boy presenting with exertional dyspnea, where computed tomography revealed left brachiocephalic vein with two distinct anomalous posterior mediastinal pathways. Recognition of these rare systemic venous anomalies is essential for surgical planning and to avoid procedural complications.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"12"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167592","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 Two-vessel Circumflex Left Aortic Arch: An Extremely Rare Arch Configuration.","authors":"Arun Sharma, Mansi Verma, Vivek Jaswal, Manphool Singhal","doi":"10.4103/heartviews.heartviews_78_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_78_26","url":null,"abstract":"<p><p>We present the case of a 6-month-old male infant with a ventricular septal defect, in whom cardiac computed tomography revealed a rare association of a circumflex left aortic arch with bilateral brachiocephalic trunks. Recognition of this unusual arch configuration is crucial as it has significant implications for surgical planning.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"11"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170985","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 Diagnostic Dilemma: Urosepsis Mimicking ST-elevation Myocardial Infarction: A Case Report and Review of the Literature.","authors":"Mohamed Atta, Amr Ashour, Fadi Khazaal, Abdul Rahman Arabi, Mhd Baraa Habib","doi":"10.4103/heartviews.heartviews_18_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_18_26","url":null,"abstract":"<p><p>Acute coronary syndrome (ACS) remains a leading global cause of morbidity and mortality. Healthcare systems worldwide have established national guidelines to facilitate the timely identification and transfer of patients with ST-elevation myocardial infarction (STEMI) to centers capable of performing primary percutaneous coronary intervention (PCI). Typically, ST-segment elevation (STE) on an electrocardiogram (ECG) is indicative of STEMI, prompting early intervention. However, rare cases of STE have been documented in the setting of sepsis or septic shock, with subsequent coronary angiography or imaging revealing normal coronary arteries. There is limited information regarding the exact mechanisms responsible for STE in the context of sepsis. We report the case of a 79-year-old Indian female who presented with epigastric pain and vomiting. Her initial ECG showed STE in leads I, aVL, and V2, accompanied by markedly elevated cardiac biomarkers. In accordance with the national STEMI network protocol, she received prehospital dual antiplatelet therapy and intravenous heparin before hospital arrival and was transferred directly for primary PCI. She was initially managed as a case of ACS; however, coronary angiography demonstrated normal coronary arteries. Further evaluation led to the diagnosis of septic shock secondary to extended-spectrum beta-lactamase (ESBL)-producing <i>Escherichia coli</i> urosepsis, requiring mechanical ventilation, four concurrent vasopressors, and continuous venovenous hemodiafiltration, with complete clinical recovery. Notably, her ECG abnormalities resolved within 72 h following prompt management of the septic shock. While STEMI remains the most common cause of STE on ECG, sepsis and septic shock are rare but important differential diagnoses. The underlying pathophysiology may involve inflammatory myocardial injury, transient coronary vasospasm, or global hypoperfusion. This case highlights the critical importance of recognizing septic shock as a potentially life-threatening STEMI mimic, to avoid unnecessary invasive interventions and to guide appropriate, targeted management.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"9"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167550","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":"Dual-Drainage in Mixed Total Anomalous Pulmonary Venous Connection - A Rare Variant.","authors":"Tarishi Kabra, Mansi Verma, Anmol Bhatia, Akshay Kumar Saxena","doi":"10.4103/heartviews.heartviews_55_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_55_26","url":null,"abstract":"<p><p>Total anomalous pulmonary venous connection (TAPVC) is a rare congenital anomaly and mixed TAPVC with dual drainage is even rarer. We report the case of a 1-year-old male child presenting with progressive dyspnea, in whom computed tomography (CT) angiography revealed a complex mixed-type TAPVC with dual drainage into the coronary sinus and innominate vein. This case highlights the critical role of CT angiography in delineating complex pulmonary venous anatomy and guiding surgical planning to prevent residual shunting.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"10"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166555","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":"Diabetes Screening Age and the U.S. Preventive Services Task Force Guideline: Does One Size Fit All? Insights from the Middle East.","authors":"Mohammad Altermanini, Alaa Rahhal, Osama Alkhalaila, Emad Algorani, Mhd Baraa Habib, Ahmed Mahfouz, Awad Al Qahtani, Jassim Al Suwaidi, Abdulrahman Arabi","doi":"10.4103/heartviews.heartviews_5_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_5_26","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a major modifiable risk factor for coronary artery disease, and cardiovascular events can represent the first clinical manifestation of undiagnosed DM. Our study aims to determine the incidence of newly detected cardiovascular risk factors, including DM, prediabetes, dyslipidemia, hypertension, and smoking, among patients presenting with acute coronary syndrome (ACS) in Qatar.</p><p><strong>Methods: </strong>This cross-sectional observational study was included all patients admitted with ST-or non-ST-elevation myocardial infarction (MI) to Heart Hospital, Qatar, between March 1, 2015, and December 31, 2020. Data were extracted from electronic records, including newly diagnosed DM was defined as hemoglobin A1c (HbA1c) ≥6.5%; prediabetes as HbA1c 5.6%-6.4%; dyslipidemia as low-density lipoprotein (LDL) ≥3.3 mmol/L; and familial hyperlipidemia as LDL ≥4.9 mmol/L with a family history. Smoking and hypertension were also recorded.</p><p><strong>Results: </strong>Among 10,450 patients, the mean age of ACS was 51 ± 11 years, and 92.4% were male, 13.2% had newly diagnosed DM, and 21.2% met prediabetes criteria. Dyslipidemia, hypertension, and smoking were newly identified in 30.3%, 38.9%, and 27.3%, respectively. These findings suggest that ACS onset occurred at a markedly younger age compared to international cohorts.</p><p><strong>Conclusions: </strong>Undiagnosed cardiovascular risk factors, particularly DM and prediabetes, are highly prevalent and may be associated with earlier MI. Thus, early screening and preventive strategies should be more targeted and tailored to reflect the distinct cardiometabolic risk profiles of Middle Eastern populations.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"8"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170995","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":"Factors Associated with Mortality following Acute Coronary Syndrome According to Patient Satisfaction.","authors":"Sagar B Dugani, Sujaytha S Paknikar, Marlene E Girardo, Hanieh Sadat Tabatabaei Yeganeh, Samia Mora, Alawi A Alsheikh-Ali, Mohammad Zubaid","doi":"10.4103/heartviews.heartviews_16_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_16_26","url":null,"abstract":"<p><strong>Background: </strong>The factors associated with mortality following acute coronary syndrome (ACS) based on patient satisfaction are unknown. The objective was to describe and compare factors associated with 1-year mortality following ACS according to high versus low patient satisfaction with hospital stay, doctors, and nurses.</p><p><strong>Materials and methods: </strong>In a registry of 3565 patients presenting with ACS to 29 hospitals across 4 countries, we grouped patients by self-reported satisfaction with hospital stay reported at 1-month following ACS. The primary outcome was all-cause 1-year mortality following ACS, excluding patients with mortality before the initial 30-day follow-up. We examined associations of patient and hospitalization factors with risk of 1-year all-cause mortality in logistic regression models, unadjusted and adjusted for Global Registry of Acute Coronary Event (GRACE) risk score, reported as odds ratio (OR; 95% confidence interval).</p><p><strong>Results: </strong>In models adjusting for GRACE risk score, in the low satisfaction category, women, compared with men, had statistically similar odds of mortality (adjusted OR: 1.43 [0.99-2.04]). Lack of formal education (vs. any education) was associated with higher odds of mortality in the low satisfaction (aOR: 1.99 [1.33-3.04]; <i>P</i> < 0.01) and high satisfaction (aOR: 3.06 [1.93-5.00]; <i>P</i> < 0.001) categories (<i>P</i> _interaction = 0.30). Lack of employment (vs. employment) was associated with similar higher odds of mortality in the low satisfaction (aOR: 6.37 [2.83-18.25]; <i>P</i> < 0.001) and high satisfaction (aOR: 2.58 [1.40-5.21]; <i>P</i> < 0.01) categories (<i>P</i> _interaction = 0.08). Generally comparable results were obtained when analyzed by patient satisfaction with doctors and with nurses.</p><p><strong>Conclusions: </strong>Education and employment were major factors associated with higher 1-year mortality following ACS, independent of patient satisfaction, and may inform tailored educational and outreach interventions to reduce mortality.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"7"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167432","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 of Tricuspid Valve Regurgitation Consensus Recommendations.","authors":"Sondos Samargandy, Bander Alshuhri, Burkhard Mackensen, Fawaz Almutairi, Gilbert H L Tang, Lamia Alshengheti, Mohammad Alreshidan, Mohammed Al-Hijji, Zakariya Albinmousa","doi":"10.4103/heartviews.heartviews_94_26","DOIUrl":"https://doi.org/10.4103/heartviews.heartviews_94_26","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a prevalent condition historically associated with high mortality and underrecognition. While medical therapy remains common, standalone surgical interventions involve significant perioperative risks. This has led to the emergence of transcatheter tricuspid valve interventions (TTVI) as a vital alternative for high-risk patients. Initiated and led by the Gulf Interventional Society, a multidisciplinary panel of experts was brought together to develop the current evidence and formulate a regional consensus and evidence-based recommendations for the management of tricuspid valve regurgitation in the Gulf region. TR is classified into primary (10%) and secondary (90%) types, with secondary TR further divided into atrial and ventricular subtypes. Evaluation relies on multimodality imaging, with echocardiography as the cornerstone and cardiac magnetic resonance for right ventricular assessment. While medical therapy focuses on decongestion, it does not modify TR progression. Surgical repair remains the gold standard for low-to-intermediate risk patients, but early referral is critical to avoid futile procedures in advanced disease. TTVI options, including edge-to-edge repair and replacement, are expanding in the Gulf, though regional adoption is hampered by fragmented healthcare systems and late presentations. Effective TR management in the Gulf requires a transition toward patient-centered care, early identification by primary care physicians, and a multidisciplinary \"Heart Team\" approach. Integrating digital health tools and establishing regional registries are essential to improving clinical outcomes and survival.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"6"},"PeriodicalIF":0.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167555","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":"Clinical Effect of Renal Denervation on Resistant Hypertension in Obese and Nonobese Patients: Insights from Kuwait.","authors":"Yahya E Alansari, Abdullah Alawadi, Budour Almandeel, Nader Alasousi, Mohammad A Aljarallah, Ahmad Alsaber, Rajesh Rajan","doi":"10.4103/heartviews.heartviews_169_25","DOIUrl":"10.4103/heartviews.heartviews_169_25","url":null,"abstract":"<p><strong>Background: </strong>Renal denervation (RDN) has demonstrated blood pressure (BP) - lowering efficacy in resistant hypertension; however, response heterogeneity remains incompletely understood. Obesity is associated with sympathetic overactivity and may influence the BP response to RDN. We evaluated BP changes following Symplicity Spyral RDN in a real-world cohort stratified by obesity status.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study including patients with resistant hypertension who underwent radiofrequency RDN using the Symplicity Spyral system at Sabah Al-Ahmad Cardiac Center in Kuwait between March 2023 and August 2024. BP was assessed at baseline, immediate postprocedure, and at 6 months. The primary outcome was change in systolic and diastolic BP at 6 months and the comparison between obese and nonobese patients. Secondary outcomes included time to achieving BP targets and clinical predictors of target achievement.</p><p><strong>Results: </strong>A total of 50 patients underwent RDN (mean age: 61.7 years); 32 were obese, and 18 were nonobese. In the overall cohort, systolic BP (SBP) decreased from 163.7 ± 24.6 mmHg at baseline to 129.4 ± 13.5 mmHg at 6 months (<i>P</i> < 0.001), and diastolic BP decreased from 86.7 ± 16.6 mmHg to 75.9 ± 8.2 mmHg (<i>P</i> = 0.0004). Repeated measures analysis of covariance demonstrated significant SBP changes over time (<i>P</i> < 0.001) with no overall between-group difference by obesity status; however, a significant time × body mass index category interaction was observed for SBP (<i>P</i> = 0.038). Kaplan-Meier analysis showed a median time of 2 months to BP target achievement in both the groups. In multivariable logistic regression, dyslipidemia was independently associated with lower odds of BP target achievement (odds ratio: 0.17, 95% confidence interval: 0.03-0.80;<i>P</i>= 0.036).</p><p><strong>Conclusion: </strong>In this real-world cohort, Symplicity Spyral RDN was associated with significant BP reduction at 6 months in both obese and nonobese patients. Obesity status did not appear to diminish overall BP-lowering efficacy, although SBP response trajectory differed over time. In exploratory multivariable analysis, dyslipidemia was associated with lower odds of BP target achievement.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"3"},"PeriodicalIF":0.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018113","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":"Should Dual Pulse Oximetry Screening Be Used in Neonates? The Insights from the CHOOSE Study.","authors":"Neha Singh, Jaya Upadhyay, Monica Lazarus, Shishir Soni","doi":"10.4103/heartviews.heartviews_17_26","DOIUrl":"10.4103/heartviews.heartviews_17_26","url":null,"abstract":"<p><strong>Background: </strong>Critical congenital heart disease (CCHD) is a leading cause of neonatal morbidity and mortality. Early detection is crucial to prevent life-threatening complications. Pulse oximetry screening (POS) is a noninvasive method to identify hypoxemia indicative of CCHD, but the optimal timing for screening remains debated.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy of dual POS performed at 24-36 h and 48-72 h of life for early detection of CCHD in neonates.</p><p><strong>Methods: </strong>This prospective observational study was conducted over 20 months at a tertiary care neonatal intensive care unit (NICU) in India. A total of 1431 neonates, including term and preterm, underwent POS at two time points. Screening followed the modified American Academy of Pediatrics algorithm, with echocardiographic follow-up for positive screens. Sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated.</p><p><strong>Results: </strong>Of the enrolled neonates (<i>n</i> = 1431), dual screening identified 95 positives (6.64%): 11 CCHD, 38 noncritical CHD and 46 noncardiac hypoxemic conditions. Dual POS had higher sensitivity (73.33% vs. 60%) and NPV (99.7% vs. 99.54%), and a lower false-negative rate (26.66% vs. 40%). POS 2 detected 2 additional CCHDs missed by POS1. Among 1336 negatives, clinical follow-up found 4 CCHDs.</p><p><strong>Conclusion: </strong>Dual POS significantly improves CCHD detection over single screening while identifying treatable noncardiac hypoxemic conditions. This nurse-led protocol is feasible even in resource-constrained NICUs, warranting routine adoption alongside clinical examination to minimize missed diagnoses of CCHD.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"1"},"PeriodicalIF":0.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018127","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":"The Emerging Role of Artificial Intelligence in Cardiovascular Care: From Imaging to Predictive Analytics.","authors":"Taha Hatab, Maan Fares","doi":"10.4103/heartviews.heartviews_41_26","DOIUrl":"10.4103/heartviews.heartviews_41_26","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming cardiovascular medicine, evolving from theoretical promise to practical tools that improve diagnostic accuracy, streamline workflow, and enhance patient outcomes. Machine learning (ML) and deep learning systems now support automated image interpretation, disease detection, physiologic signal analysis, and individualized risk prediction. Large language models further reduce documentation burden and enable more efficient clinical communication. This review summarizes current applications of AI across cardiovascular care, with an example on the role of AI in predictive analytics in liver transplant candidates, an area where early risk identification may significantly alter outcomes. The article also explores emerging innovations, including the potential role of quantum computing, that may define the next era of cardiovascular medicine.</p>","PeriodicalId":32654,"journal":{"name":"Heart Views","volume":"27 ","pages":"4"},"PeriodicalIF":0.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018033","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}