COVID-19 has caused a global pandemic of anxiety, fear and uncertainty. National lockdowns, high mortality, social isolation, economic recession, job losses and food insecurity resulting from COVID-19 are potent drivers of increased stress levels, anxiety and depression, and have placed a substantial strain on healthcare and economic systems. Depression, anxiety and physical isolation are strongly linked to incident cardiovascular disease (CVD) as well as poorer outcomes in established CVD – including coronary artery disease, stroke and heart failure. Acute stress-related disorders such as post-traumatic stress disorder, have been robustly and independently associated with multiple phenotypes of CVD, particularly in the first year after the psychiatric diagnosis. Unprecedented psychological stress imposed by COVID-19 on the global population bears the potential to cause a parallel epidemic of mental health disorders and a subsequent surge in CVD, warranting strategic planning by healthcare services to mitigate its impact. This potential for a mental health crisis would require both large-scale psychosocial interventions, and incorporation of mental healthcare into disaster management plans. Anxiety and depression, as the dominant emotional responses to the outbreak, warrant adequate training of healthcare personnel and the optimal use of technological advances to deliver acute mental healthcare interventions which are time-limited and culturally sensitive.
{"title":"COVID-19 and impact of psychological stress on cardiovascular disease","authors":"T. Bana, J. Hoare, P. Letuka, N. Ntusi","doi":"10.24170/17-3-4374","DOIUrl":"https://doi.org/10.24170/17-3-4374","url":null,"abstract":"COVID-19 has caused a global pandemic of anxiety, fear and uncertainty. National lockdowns, high mortality, social isolation, economic recession, job losses and food insecurity resulting from COVID-19 are potent drivers of increased stress levels, anxiety and depression, and have placed a substantial strain on healthcare and economic systems. Depression, anxiety and physical isolation are strongly linked to incident cardiovascular disease (CVD) as well as poorer outcomes in established CVD – including coronary artery disease, stroke and heart failure. Acute stress-related disorders such as post-traumatic stress disorder, have been robustly and independently associated with multiple phenotypes of CVD, particularly in the first year after the psychiatric diagnosis. Unprecedented psychological stress imposed by COVID-19 on the global population bears the potential to cause a parallel epidemic of mental health disorders and a subsequent surge in CVD, warranting strategic planning by healthcare services to mitigate its impact. This potential for a mental health crisis would require both large-scale psychosocial interventions, and incorporation of mental healthcare into disaster management plans. Anxiety and depression, as the dominant emotional responses to the outbreak, warrant adequate training of healthcare personnel and the optimal use of technological advances to deliver acute mental healthcare interventions which are time-limited and culturally sensitive.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"146 1","pages":"282-286"},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74316640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Jankelow, P. Manga, M. Ntsekhe, Sajidah Khan, B. Cupido, Hopewell N. Ntsinjana, L. Zühlke, F. Smit
The South African Heart Association (SA HeartR) is an association of cardiologists, paediatric cardiologists, cardiac surgeons, as well as allied cardiac professionals, whose vision is to advance cardiovascular care for each of our country’s citizens and to be the scientific leaders in South African cardiac healthcare delivery, education and research. As such, we are ideally placed to advise the National Department of Health (NDoH) about the cardiac implications of the COVID-19 pandemic, as well as how we tackle non-communicable cardiovascular disease (NCD) going forward.
{"title":"SA Heart® Statement on COVID-19 and cardiovascular disease","authors":"D. Jankelow, P. Manga, M. Ntsekhe, Sajidah Khan, B. Cupido, Hopewell N. Ntsinjana, L. Zühlke, F. Smit","doi":"10.24170/17-3-4390","DOIUrl":"https://doi.org/10.24170/17-3-4390","url":null,"abstract":"The South African Heart Association (SA HeartR) is an association of cardiologists, paediatric cardiologists, cardiac surgeons, as well as allied cardiac professionals, whose vision is to advance cardiovascular care for each of our country’s citizens and to be the scientific leaders in South African cardiac healthcare delivery, education and research. As such, we are ideally placed to advise the National Department of Health (NDoH) about the cardiac implications of the COVID-19 pandemic, as well as how we tackle non-communicable cardiovascular disease (NCD) going forward.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"132 1","pages":"258-262"},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83745757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Smit, A. Oelofse, A. Linegar, L. Botes, E. Turton
South Africa face a significant shortage of ventilator-supported intensive care (ICU) beds during the peak phase of the COVID-19 pandemic, further exacerbated by severe ICU-staff shortages. It is also recognised that the mortality rate for ventilated patients might be as high as 88%. In the absence of a vaccine and proven effective pharmacotherapy, it is important to understand the pathophysiological processes causing progression. Early type-L COVID-19, associated with pulmonary thrombo-embolism, may be amenable to treatment with careful anti-coagulation and supplementary oxygenation strategies. This could attenuate the severe hyperventilation phase causing patient self-inflicted lung injury (P-SILI) that contributes to the development of type-H COVID-19 pneumonia. Type-H is an ARDS variant requiring intubation and ventilation and is associated with a very high mortality rate. Stepwise non-invasive positive pressure ventilation strategies (NIPPV) providing supplementary oxygen have shown benefit and, in the South African context, may be the only realistic strategy to deal with high numbers of patients during the early type-L phase of the disease. To address this, a mobile wall unit has been created that allows for stepwise supplementary oxygen therapy according to protocol – including NIPPV as well as standard ventilation. The unit can support modified wards, field hospitals or high care areas in existing facilities. It allows for NIPPV support within a hood system linked to scavenger lines addressing aerolisation. Standard humidification, flow regulators, vacuum systems, HFNC and CPAP systems, as well as monitoring equipment that are readily available in South Africa, can be linked to the system addressing availability issues.
{"title":"Supplemental oxygen therapy in COVID-19","authors":"F. Smit, A. Oelofse, A. Linegar, L. Botes, E. Turton","doi":"10.24170/17-3-4379","DOIUrl":"https://doi.org/10.24170/17-3-4379","url":null,"abstract":"South Africa face a significant shortage of ventilator-supported intensive care (ICU) beds during the peak phase of the COVID-19 pandemic, further exacerbated by severe ICU-staff shortages. It is also recognised that the mortality rate for ventilated patients might be as high as 88%. In the absence of a vaccine and proven effective pharmacotherapy, it is important to understand the pathophysiological processes causing progression. Early type-L COVID-19, associated with pulmonary thrombo-embolism, may be amenable to treatment with careful anti-coagulation and supplementary oxygenation strategies. This could attenuate the severe hyperventilation phase causing patient self-inflicted lung injury (P-SILI) that contributes to the development of type-H COVID-19 pneumonia. Type-H is an ARDS variant requiring intubation and ventilation and is associated with a very high mortality rate. Stepwise non-invasive positive pressure ventilation strategies (NIPPV) providing supplementary oxygen have shown benefit and, in the South African context, may be the only realistic strategy to deal with high numbers of patients during the early type-L phase of the disease. To address this, a mobile wall unit has been created that allows for stepwise supplementary oxygen therapy according to protocol – including NIPPV as well as standard ventilation. The unit can support modified wards, field hospitals or high care areas in existing facilities. It allows for NIPPV support within a hood system linked to scavenger lines addressing aerolisation. Standard humidification, flow regulators, vacuum systems, HFNC and CPAP systems, as well as monitoring equipment that are readily available in South Africa, can be linked to the system addressing availability issues.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"30 1","pages":"324-328"},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88513424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Global health simply refers to the health of populations in a global context. Global health has been defined as an “area of study, research and practice that focuses on improving health and achieving equity in health for all people worldwide”.(1) Scholarship in global health often focuses on worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders. Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day. Importantly, global health must not be confused with public health (defined as the science of protecting and improving the health of communities through education, policy making, health promotion and research for disease and injury prevention) or international health (defined as the branch of public health that focuses on lowand middle-income countries [LMICs] receiving foreign aid from high-income countries [HICs]). Table 1 shows the abbreviations.
{"title":"Cardiovascular disease and global health: a perspective from the global South","authors":"N. Ntusi","doi":"10.24170/17-2-4154","DOIUrl":"https://doi.org/10.24170/17-2-4154","url":null,"abstract":"BACKGROUND Global health simply refers to the health of populations in a global context. Global health has been defined as an “area of study, research and practice that focuses on improving health and achieving equity in health for all people worldwide”.(1) Scholarship in global health often focuses on worldwide health improvement, reduction of disparities, and protection against global threats that disregard national borders. Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day. Importantly, global health must not be confused with public health (defined as the science of protecting and improving the health of communities through education, policy making, health promotion and research for disease and injury prevention) or international health (defined as the branch of public health that focuses on lowand middle-income countries [LMICs] receiving foreign aid from high-income countries [HICs]). Table 1 shows the abbreviations.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"5 1","pages":"134-139"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86387583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developing a new electrophysiology service and training platform - narrowing the gap","authors":"Jane Moses, Anton Doubell","doi":"10.24170/17-2-4155","DOIUrl":"https://doi.org/10.24170/17-2-4155","url":null,"abstract":"","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"31 1","pages":"140-143"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75588465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ntshalintshali, N. Mhlana, F. Moosajee, Riyad Abousriwiel, K. George, R. D. Toit
South Africa (SA) has a high incidence of tuberculosis. Medical conditions mimicking tuberculosis often result in erroneous treatment with antitubercular therapy (ATT) before a definitive diagnosis is made. We report on 2 cases presenting with massive pericardial effusions secondary to Still’s disease (sJIA) and Adult onset Still’s disease (AOSD). Both cases were treated with ATT, with an alternative diagnosis only considered upon poor response to therapy and the development of ATT associated side effects. Our objective is to remind clinicians of other potential differential diagnoses in the clinical scenario of massive effusive pericarditis in a tuberculosis endemic region.
{"title":"A massive pericardial effusion in South Africa is not always due to tuberculosis","authors":"S. Ntshalintshali, N. Mhlana, F. Moosajee, Riyad Abousriwiel, K. George, R. D. Toit","doi":"10.24170/17-2-4153","DOIUrl":"https://doi.org/10.24170/17-2-4153","url":null,"abstract":"South Africa (SA) has a high incidence of tuberculosis. Medical conditions mimicking tuberculosis often result in erroneous treatment with antitubercular therapy (ATT) before a definitive diagnosis is made. We report on 2 cases presenting with massive pericardial effusions secondary to Still’s disease (sJIA) and Adult onset Still’s disease (AOSD). Both cases were treated with ATT, with an alternative diagnosis only considered upon poor response to therapy and the development of ATT associated side effects. Our objective is to remind clinicians of other potential differential diagnoses in the clinical scenario of massive effusive pericarditis in a tuberculosis endemic region.","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"17 1","pages":"204-207"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75891515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"South African Heart Journal 2019: A year in review","authors":"N. Ntusi","doi":"10.24170/17-1-4027","DOIUrl":"https://doi.org/10.24170/17-1-4027","url":null,"abstract":"","PeriodicalId":22462,"journal":{"name":"The Egyptian Heart Journal","volume":"75 1","pages":"2-5"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86769059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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