BACKGROUND Establishing a correlation between left ventricular global longitudinal strain (LV-GLS) with transthoracic echocardiography (TTE), and the severity and outcomes of patients infected with COVID-19 offers several advantages in patient care and management. This study aims to explore the utility of measuring the LV-GLS to predict outcomes in hospitalized patients infected with COVID-19. METHODS This was a retrospective cohort study of COVID-19 patients in a tertiary care center who had a TTE with GLS measurements from April 2021 to May 2021. Comparisons between parameters of left ventricular function (GLS and LVEF) were performed using the t-test or Mann-Whitney U test for continuous variables and the χ2 test or Fisher exact test for categorical variables. Kaplan-Meier survival analysis was used to estimate mortality and length of hospital stay. Log-rank test was used to assess the association of GLS on in-hospital mortality. RESULTS A total of 124 participants were included in the study. 73.2% (90/123) had a decreased GLS; average GLS was -19.2% [-27.6 to -4.7]. A significant model was created using GLS as a main factor with pre-selected co-variates with a Wald χ2 (2, N = 121) = 7.932 (p = .020). Co-variates were average GLS magnitude (HR = 0.897 [95% CI 0.808 to 0.997], p = .0.043) and presence of severe complications (HR = 2.630 [95% CI of 1.087 to 6.362], p = 0.032). CONCLUSION A model considering severe complications showed that among patients admitted for COVID-19 an abnormal average global longitudinal strain predicts increased in-hospital mortality.
背景:通过经胸超声心动图(TTE)建立左心室整体纵向应变(LV-GLS)与COVID-19感染患者的严重程度和结局之间的相关性，为患者护理和管理提供了多项优势。本研究旨在探讨测量LV-GLS对COVID-19感染住院患者预后的预测作用。方法:本研究是一项回顾性队列研究，研究对象是2021年4月至2021年5月在三级医疗中心接受TTE和GLS测量的COVID-19患者。左室功能参数(GLS和LVEF)的比较对连续变量采用t检验或Mann-Whitney U检验，对分类变量采用χ2检验或Fisher精确检验。Kaplan-Meier生存分析用于估计死亡率和住院时间。采用Log-rank检验评估GLS与住院死亡率的关系。结果本研究共纳入124名受试者。73.2%(90/123)患者GLS下降;平均GLS为-19.2%[-27.6 ~ -4.7]。以GLS为主要因子，预先选择协变量，建立显著性模型，其Wald χ2 (2, N = 121) = 7.932 (p = 0.020)。共变量为平均GLS强度(HR = 0.897 [95% CI 0.808 ~ 0.997]， p = 0.043)和是否存在严重并发症(HR = 2.630 [95% CI 1.087 ~ 6.362]， p = 0.032)。结论考虑严重并发症的模型显示，在COVID-19住院患者中，全球平均纵向应变异常预示着住院死亡率的增加。
{"title":"Left Ventricular Global Longitudinal Strain as a Predictor for Poor Outcomes in Patients Hospitalized for COVID-19 Infection","authors":"Juan Armando D. Diaz, R. Lapitan","doi":"10.31762/ahj2332.0203","DOIUrl":"https://doi.org/10.31762/ahj2332.0203","url":null,"abstract":"BACKGROUND Establishing a correlation between left ventricular global longitudinal strain (LV-GLS) with transthoracic echocardiography (TTE), and the severity and outcomes of patients infected with COVID-19 offers several advantages in patient care and management. This study aims to explore the utility of measuring the LV-GLS to predict outcomes in hospitalized patients infected with COVID-19. METHODS This was a retrospective cohort study of COVID-19 patients in a tertiary care center who had a TTE with GLS measurements from April 2021 to May 2021. Comparisons between parameters of left ventricular function (GLS and LVEF) were performed using the t-test or Mann-Whitney U test for continuous variables and the χ2 test or Fisher exact test for categorical variables. Kaplan-Meier survival analysis was used to estimate mortality and length of hospital stay. Log-rank test was used to assess the association of GLS on in-hospital mortality. RESULTS A total of 124 participants were included in the study. 73.2% (90/123) had a decreased GLS; average GLS was -19.2% [-27.6 to -4.7]. A significant model was created using GLS as a main factor with pre-selected co-variates with a Wald χ2 (2, N = 121) = 7.932 (p = .020). Co-variates were average GLS magnitude (HR = 0.897 [95% CI 0.808 to 0.997], p = .0.043) and presence of severe complications (HR = 2.630 [95% CI of 1.087 to 6.362], p = 0.032). CONCLUSION A model considering severe complications showed that among patients admitted for COVID-19 an abnormal average global longitudinal strain predicts increased in-hospital mortality.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88687381","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}
Joseph Lawrence Ponciano, Jeannica Kriselle Lerios-Dela Pena
Presented is a case of a 68-year-old Filipino, female, a known case of Myasthenia Gravis, post-thymectomy maintained on pyridostigmine, with a history of hypertension and Mitral Valve Prolapse who was admitted for acute heart failure symptoms. Diagnostics revealed a torn chordae tendineae of the mitral valve and the patient was subsequently advised to undergo mitral valve replacement due to acute decompensation. Pre operative coronary evaluation showed angiographically normal coronary arteries while CT aortogram showed no distinct evidence of aortic aneurysm, stenosis, dissection or severe calcification of thoraco-abdominal aorta and iliac-femoral vessels. The patient underwent minimally invasive mitral valve replacement with a bioprosthetic valve, however suddenly experienced ptosis and respiratory depression while at the recovery room which were attributed to stress from surgery and missed doses of Pyridostigmine while undergoing surgery. She was closely monitored at the Intensive Care Unit and her symptoms gradually resolved upon resumption of Pyridostigmine. Despite the unanticipated respiratory depression and ptosis, the patient was able to complete 5 days of phase I cardiac rehabilitation post operatively and was discharged well and improved. The case reported may be the first locally documented ruptured chordae tendineae with coinciding Myasthenia Gravis who underwent minimally invasive valve replacement with successful treatment outcomes.
{"title":"Successful Minimally Invasive Mitral Valve Replacement in a Post-thymectomy Patient with Myasthenia Gravis: A Case Report","authors":"Joseph Lawrence Ponciano, Jeannica Kriselle Lerios-Dela Pena","doi":"10.31762/ahj2332.0202","DOIUrl":"https://doi.org/10.31762/ahj2332.0202","url":null,"abstract":"Presented is a case of a 68-year-old Filipino, female, a known case of Myasthenia Gravis, post-thymectomy maintained on pyridostigmine, with a history of hypertension and Mitral Valve Prolapse who was admitted for acute heart failure symptoms. Diagnostics revealed a torn chordae tendineae of the mitral valve and the patient was subsequently advised to undergo mitral valve replacement due to acute decompensation. Pre operative coronary evaluation showed angiographically normal coronary arteries while CT aortogram showed no distinct evidence of aortic aneurysm, stenosis, dissection or severe calcification of thoraco-abdominal aorta and iliac-femoral vessels. The patient underwent minimally invasive mitral valve replacement with a bioprosthetic valve, however suddenly experienced ptosis and respiratory depression while at the recovery room which were attributed to stress from surgery and missed doses of Pyridostigmine while undergoing surgery. She was closely monitored at the Intensive Care Unit and her symptoms gradually resolved upon resumption of Pyridostigmine. Despite the unanticipated respiratory depression and ptosis, the patient was able to complete 5 days of phase I cardiac rehabilitation post operatively and was discharged well and improved. The case reported may be the first locally documented ruptured chordae tendineae with coinciding Myasthenia Gravis who underwent minimally invasive valve replacement with successful treatment outcomes.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91008754","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}
INTRODUCTION A single coronary artery is extremely rare. Patients with this coronary anomaly are usually asymptomatic and is commonly an incidental finding among imaging diagnostics. CASE REPORT We report a case of 56-year-old hypertensive, diabetic Filipino female on thrice-weekly maintenance hemodialysis who had a single origin coronary artery on invasive coronary angiography after she developed STEMI in cardiogenic shock along the course of her admission for an elective below knee amputation. Advised revascularization via coronary artery bypass grafting, however refused. She was eventually discharged against medical advice upon stabilization. She refused further renal replacement therapy; she succumbed two weeks later. LEARNINGS Single coronary artery is a rare condition associated with increased risk of sudden cardiac death. A multidisciplinary team in place is ideal to determine the best management strategy to employ. Guideline-directed medical therapy with aggressive risk factor control offers benefit. KEYWORDS Single coronary artery. SCA. Cardiogenic shock. ST-elevation myocardial infarction. STEMI.
{"title":"Single Coronary Artery: An Unwonted Incidental in a 54-year-old Chronic Kidney Disease Filipino Female with ST Elevation Myocardial Infarction in Cardiogenic Shock","authors":"Renato C. Ong, Jr., Charles Tadeo O. Galang","doi":"10.31762/ahj2332.0201","DOIUrl":"https://doi.org/10.31762/ahj2332.0201","url":null,"abstract":"INTRODUCTION A single coronary artery is extremely rare. Patients with this coronary anomaly are usually asymptomatic and is commonly an incidental finding among imaging diagnostics. CASE REPORT We report a case of 56-year-old hypertensive, diabetic Filipino female on thrice-weekly maintenance hemodialysis who had a single origin coronary artery on invasive coronary angiography after she developed STEMI in cardiogenic shock along the course of her admission for an elective below knee amputation. Advised revascularization via coronary artery bypass grafting, however refused. She was eventually discharged against medical advice upon stabilization. She refused further renal replacement therapy; she succumbed two weeks later. LEARNINGS Single coronary artery is a rare condition associated with increased risk of sudden cardiac death. A multidisciplinary team in place is ideal to determine the best management strategy to employ. Guideline-directed medical therapy with aggressive risk factor control offers benefit. KEYWORDS Single coronary artery. SCA. Cardiogenic shock. ST-elevation myocardial infarction. STEMI.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76312533","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}
Significant paravalvular leak is a serious complication of surgical valve replacement. Approximately 1–5% of PVLs can lead to serious clinical consequences, including congestive heart failure and/or haemolytic anaemia. Surgical intervention was the standard care of treatment for this for years. We describe a case of aortic paravalvular leak, managed with transcatheter closure. Keywords Paravalvular leak, vascular plug, trans catheter closure
{"title":"Device Closure of Aortic Paravalvular Leak","authors":"R. Bhardwaj, Sachin Sandhu, Shivani Rao","doi":"10.31762/ahj2332.0102","DOIUrl":"https://doi.org/10.31762/ahj2332.0102","url":null,"abstract":"Significant paravalvular leak is a serious complication of surgical valve replacement. Approximately 1–5% of PVLs can lead to serious clinical consequences, including congestive heart failure and/or haemolytic anaemia. Surgical intervention was the standard care of treatment for this for years. We describe a case of aortic paravalvular leak, managed with transcatheter closure. Keywords Paravalvular leak, vascular plug, trans catheter closure","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78572511","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}
INTRODUCTION The renin-angiotensin-aldosterone system (RAAS) is a crucial mechanism by which our bodies maintain blood pressure and fluid & electrolyte balance. Any disruption to this system may upset the carefully maintained equilibrium, leading to development of hypertension and cardiovascular (CV) diseases. Thus, RAAS has been a key therapeutic target in hypertension since the serendipity discovery of angiotensin converting enzyme inhibitors (ACEis) in the 1970s. The use of ACEis have also evolved over the decades, from a stand-alone blood pressure (BP) lowering agent to critical underpinnings of CV protection in high-risk patients following improved elucidation of its role.
{"title":"PART 1: RAAS Blockers – Are They All The Same?","authors":"Vijaya Ramasamy","doi":"10.31762/ahj2332.0101","DOIUrl":"https://doi.org/10.31762/ahj2332.0101","url":null,"abstract":"INTRODUCTION The renin-angiotensin-aldosterone system (RAAS) is a crucial mechanism by which our bodies maintain blood pressure and fluid & electrolyte balance. Any disruption to this system may upset the carefully maintained equilibrium, leading to development of hypertension and cardiovascular (CV) diseases. Thus, RAAS has been a key therapeutic target in hypertension since the serendipity discovery of angiotensin converting enzyme inhibitors (ACEis) in the 1970s. The use of ACEis have also evolved over the decades, from a stand-alone blood pressure (BP) lowering agent to critical underpinnings of CV protection in high-risk patients following improved elucidation of its role.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89168929","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}
Cardiac arrhythmia is one of the common complications among hospitalized COVID-19 patients. The incidence of arrhythmia in COVID-19 varies from 5.9% to 16.7%. This literature review to explore the epidemiology, risk factors, clinical manifestation, pathophysiology, outcomes, and management of hospitalized COVID -19 patients with cardiac arrhythmia. The literature search and review of the literature was performed on PubMed and Google Scholar from January 2020 to July 2021. Age, comorbidities, and COVID-19 disease severity may increase the risk to develop arrhythmia. Hypertension, coronary artery disease, heart failure, diabetes mellitus, and renal disease are more frequently observed patients with arrhythmia. The proposed pathophysiology of arrhythmia in COVID-19 are myocardial injury, hypoxia, cytokine storm, and drugs side effects. In addition, comorbidity, pre-existing scar or conduction defect, history of previous arrhythmia, electrolyte abnormalities may play a role in the pathophysiology of tachyarrhythmia and bradyarrhythmia. The in-hospital mortality, need of intensive care unit, need of mechanical ventilation or non-invasive ventilation, hypotension, and thromboembolic event were higher in hospitalized COVID-19 patients with arrhythmia. The general managements were to treat the underlying COVID-19 infection and to tackle the hemodynamic disturbances due to tachyarrhythmia or bradyarrhythmia. Cardiac arrhythmia is a common complication among hospitalized COVID-19 patients. Hospitalized COVID-19 patients with tachyarrhythmia or bradyarrhythmia had worse in-hospital outcomes compared with patients without arrhythmia.
{"title":"Review Article: Cardiac Arrhythmia among Hospitalized COVID-19 Patients","authors":"","doi":"10.31762/ahj2332.0103","DOIUrl":"https://doi.org/10.31762/ahj2332.0103","url":null,"abstract":"Cardiac arrhythmia is one of the common complications among hospitalized COVID-19 patients. The incidence of arrhythmia in COVID-19 varies from 5.9% to 16.7%. This literature review to explore the epidemiology, risk factors, clinical manifestation, pathophysiology, outcomes, and management of hospitalized COVID -19 patients with cardiac arrhythmia. The literature search and review of the literature was performed on PubMed and Google Scholar from January 2020 to July 2021. Age, comorbidities, and COVID-19 disease severity may increase the risk to develop arrhythmia. Hypertension, coronary artery disease, heart failure, diabetes mellitus, and renal disease are more frequently observed patients with arrhythmia. The proposed pathophysiology of arrhythmia in COVID-19 are myocardial injury, hypoxia, cytokine storm, and drugs side effects. In addition, comorbidity, pre-existing scar or conduction defect, history of previous arrhythmia, electrolyte abnormalities may play a role in the pathophysiology of tachyarrhythmia and bradyarrhythmia. The in-hospital mortality, need of intensive care unit, need of mechanical ventilation or non-invasive ventilation, hypotension, and thromboembolic event were higher in hospitalized COVID-19 patients with arrhythmia. The general managements were to treat the underlying COVID-19 infection and to tackle the hemodynamic disturbances due to tachyarrhythmia or bradyarrhythmia. Cardiac arrhythmia is a common complication among hospitalized COVID-19 patients. Hospitalized COVID-19 patients with tachyarrhythmia or bradyarrhythmia had worse in-hospital outcomes compared with patients without arrhythmia.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72379054","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}
A coronary artery fistula (CAF) is defined as a direct connection between a coronary artery with right heart chambers including the right atrium, right ventricle, coronary sinus, superior vena cava, or pulmonary arteries. Elective closure of coronary artery fistula by surgery or percutaneous transcatheter technique is generally accepted in the presence of symptoms. We report a case of successful percutaneous transcatheter device closure of coronary fistula, originating from the circumflex artery and draining into the coronary sinus.
{"title":"Device Closure of Left Circumflex Coronary Artery to Coronary Sinus Fistula","authors":"R. Bhardwaj, S. Asotra","doi":"10.31762/ahj2332.0303","DOIUrl":"https://doi.org/10.31762/ahj2332.0303","url":null,"abstract":"A coronary artery fistula (CAF) is defined as a direct connection between a coronary artery with right heart chambers including the right atrium, right ventricle, coronary sinus, superior vena cava, or pulmonary arteries. Elective closure of coronary artery fistula by surgery or percutaneous transcatheter technique is generally accepted in the presence of symptoms. We report a case of successful percutaneous transcatheter device closure of coronary fistula, originating from the circumflex artery and draining into the coronary sinus.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78734999","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}
MM Cheng-Co, RM Rivera, M. Alegre, S. Sawit, G. Martinez
Trivial to mild tricuspid regurgitation is commonly seen in patients with a normal right heart. It is usually asymptomatic and when severe enough may cause symptoms of right-sided heart failure such as ascites, edema and congestive hepatopathy. We present a case of a 46-year-old female who presented with progressive bipedal edema. Transthoracic echocardiography showed dilated right atrium and right ventricle with severe tricuspid regurgitation. Patient then underwent tricuspid valve replacement with a 29mm bioprosthetic valve. Final histopath report showed myxomatous degeneration of valve leaflets. Post-operatively, patient developed increasing shortness of breath and orthopnea. A repeat transthoracic echo revealed decompensation of right ventricle with decline in right ventricular systolic function. Patient was then given inotropic support with milrinone and norepinephrine and adequate diuresis with IV furosemide. She was gradually weaned off the inotropes. Prior to discharge, a repeat transthoracic echocardiogram done showed improvement of right ventricular systolic function and she was discharged on oral furosemide and spironolactone.
{"title":"Case of An Isolated Tricuspid Valve Regurgitation Presenting as Right Sided Heart Failure","authors":"MM Cheng-Co, RM Rivera, M. Alegre, S. Sawit, G. Martinez","doi":"10.31762/ahj2332.0301","DOIUrl":"https://doi.org/10.31762/ahj2332.0301","url":null,"abstract":"Trivial to mild tricuspid regurgitation is commonly seen in patients with a normal right heart. It is usually asymptomatic and when severe enough may cause symptoms of right-sided heart failure such as ascites, edema and congestive hepatopathy. We present a case of a 46-year-old female who presented with progressive bipedal edema. Transthoracic echocardiography showed dilated right atrium and right ventricle with severe tricuspid regurgitation. Patient then underwent tricuspid valve replacement with a 29mm bioprosthetic valve. Final histopath report showed myxomatous degeneration of valve leaflets. Post-operatively, patient developed increasing shortness of breath and orthopnea. A repeat transthoracic echo revealed decompensation of right ventricle with decline in right ventricular systolic function. Patient was then given inotropic support with milrinone and norepinephrine and adequate diuresis with IV furosemide. She was gradually weaned off the inotropes. Prior to discharge, a repeat transthoracic echocardiogram done showed improvement of right ventricular systolic function and she was discharged on oral furosemide and spironolactone.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82258318","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}
Permanent pacemaker is the mainstay treatment indicated for bradycardia caused by sinus node dysfunction. However, heart failure may appear in patients with chronic right ventricle pacing, this is known as Pacing-Induced Cardiomyopathy (PICM). There is no internationally accepted definition for diagnosis of PICM. Studies show the prevalence of PICM is 9% in the first year and increases in proportion to the duration of PPM implantation, but varies widely according to diagnostic criteria used. PICM causes a higher all-cause death, hospital admission, and cardiac death. Therefore, detecting risk factors may be an important part of the prevention and early treatment of PICM. Once PICM develops, several therapy options are available but Cardiac Resynchronization Therapy with biventricular Pacemaker is currently the forefront of treatment. But insight into other more novel therapeutic options such as; His bundle pacing and Left Bundle Branch Pacing shows promising results as an alternative treatment option in the near future.
{"title":"Pacing Induced Cardiomyopathy: Diagnosis and Management","authors":"Sidhi Laksono, Irwan Surya Angkasa, Cliffian Hosanna","doi":"10.31762/ahj2332.0302","DOIUrl":"https://doi.org/10.31762/ahj2332.0302","url":null,"abstract":"Permanent pacemaker is the mainstay treatment indicated for bradycardia caused by sinus node dysfunction. However, heart failure may appear in patients with chronic right ventricle pacing, this is known as Pacing-Induced Cardiomyopathy (PICM). There is no internationally accepted definition for diagnosis of PICM. Studies show the prevalence of PICM is 9% in the first year and increases in proportion to the duration of PPM implantation, but varies widely according to diagnostic criteria used. PICM causes a higher all-cause death, hospital admission, and cardiac death. Therefore, detecting risk factors may be an important part of the prevention and early treatment of PICM. Once PICM develops, several therapy options are available but Cardiac Resynchronization Therapy with biventricular Pacemaker is currently the forefront of treatment. But insight into other more novel therapeutic options such as; His bundle pacing and Left Bundle Branch Pacing shows promising results as an alternative treatment option in the near future.","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83100360","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}
Jose Jonas Del Rosario, J. Ng, Priscilla Mae C. Rosales
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (COVID 19), also known as COVID 19, was first detected in 2019 as a result of a cluster of pneumonia cases in China. It is known to cause respiratory illness in a majority of cases, however myocardial involvement can be seen in 7% of cases, with even a smaller number in pediatric populations. CASE PRESENTATION We are presented with a 14 year old male with confirmed COVID 19 infection that is followed by a fulminant myocarditis resulting in High grade AV Block and subsequent pacemaker insertion, which is the first reported case in the pediatric population. DISCUSSION Cardiac injury resulting from a recent COVID 19 infection can result to a fulminant myocarditis. This can present as arrhythmia, seen in 16.7% of cases. The mainstay of treatment is still maintaining hemodynamic stability and initiating immunomodulatory support, however, specifically in this case resulting in third-degree AV block, pacemaker insertion may also be required. CONCLUSION Although severe cardiac involvement in COVID 19 infection is rare, a fulminant myocarditis is possible for some patients. KEYWORDS COVID 19, Myocarditis, pacemaker, arrhythmia
{"title":"Myocarditis with Complete Heart Block in a Child With COVID-19 Infection","authors":"Jose Jonas Del Rosario, J. Ng, Priscilla Mae C. Rosales","doi":"10.31762/ahj2231.0201","DOIUrl":"https://doi.org/10.31762/ahj2231.0201","url":null,"abstract":"INTRODUCTION Severe acute respiratory syndrome coronavirus 2 (COVID 19), also known as COVID 19, was first detected in 2019 as a result of a cluster of pneumonia cases in China. It is known to cause respiratory illness in a majority of cases, however myocardial involvement can be seen in 7% of cases, with even a smaller number in pediatric populations. CASE PRESENTATION We are presented with a 14 year old male with confirmed COVID 19 infection that is followed by a fulminant myocarditis resulting in High grade AV Block and subsequent pacemaker insertion, which is the first reported case in the pediatric population. DISCUSSION Cardiac injury resulting from a recent COVID 19 infection can result to a fulminant myocarditis. This can present as arrhythmia, seen in 16.7% of cases. The mainstay of treatment is still maintaining hemodynamic stability and initiating immunomodulatory support, however, specifically in this case resulting in third-degree AV block, pacemaker insertion may also be required. CONCLUSION Although severe cardiac involvement in COVID 19 infection is rare, a fulminant myocarditis is possible for some patients. KEYWORDS COVID 19, Myocarditis, pacemaker, arrhythmia","PeriodicalId":72307,"journal":{"name":"ASEAN heart journal : Official journal of the ASEAN Federation of Cardiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79832315","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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