Journal of Cardiovascular Emergencies Feed

The Value of Optical Coherence Tomography Parameters in Estimating Non-Critical Lesions in Patients with Acute Myocardial Infarction

Fri, 27 Mar 2026 00:00:00 GMT

Background Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Accurate assessment of coronary lesion severity is essential for guiding revascularization. Fractional flow reserve (FFR) is the gold standard for functional evaluation of coronary stenoses, but data on intracoronary hemodynamic assessment in patients with acute myocardial infarction are limited. Optical coherence tomography (OCT) provides high-resolution intravascular imaging and may offer additional insights into lesion severity. Aim To investigate the correlation between OCT-derived measurements and FFR values in patients with acute myocardial infarction. Methods The study included 114 patients with acute myocardial infarction (STEMI or NSTEMI) undergoing primary percutaneous coronary intervention (PCI) of the culprit lesion. Intermediate stenoses in non-culprit vessels (151 lesions) were evaluated during staged procedures with OCT and FFR. Minimal luminal area (MLA) and percent luminal area stenosis (PAS) were analyzed in relation to FFR values. Results OCT-derived parameters showed good correlation with FFR values. In multivariable logistic regression, MLA and PAS were independent predictors of FFR <0.80. The optimal cut-off values were 2.08 mm2 for MLA and 76.85% for PAS. Conclusions OCT-derived parameters may help identify functionally significant non-culprit lesions in patients with acute myocardial infarction and can complement physiological assessment in clinical practice.

Risk Factors Associated with In-hospital Poor Outcomes in Patients with Acute Limb Ischemia

Fri, 27 Mar 2026 00:00:00 GMT

Background Acute limb ischemia (ALI) is a vascular emergency characterized by a sudden reduction in limb perfusion, most commonly resulting from thromboembolism or thrombosis at the site of an atherosclerotic plaque. This study aimed to analyze and identify risk factors associated with major amputation and in-hospital mortality in patients with ALI. Material and methods We retrospectively analyzed 177 patients diagnosed with upper or lower limb ALI admitted to the Vascular Surgery Clinic between January 2019 and December 2024. Data collected from electronic medical records included demographic variables, cardiovascular comorbidities, chronic kidney disease, diabetes mellitus, malignancies, preoperative laboratory parameters (within the first 12 h of admission), type of surgical intervention, and anesthesia type. Results Patients with lower limb ischemia were significantly older than those with upper limb involvement (p = 0.041). Lower limb ischemia was also associated with a higher prevalence of ischemic heart disease (p = 0.030), chronic heart failure (p = 0.013), and peripheral arterial disease (p < 0.001). Laboratory findings revealed lower red blood cell counts (p = 0.034), hemoglobin (p = 0.010), and hematocrit (p = 0.011), along with higher creatine kinase (p = 0.013), neutrophil (p = 0.017), and monocyte levels (p = 0.034) in patients with lower limb ALI. While surgical intervention types did not differ significantly, lower limb ALI patients underwent local anesthesia less frequently (p < 0.001) and general anesthesia more frequently (p < 0.001). Univariate analysis identified peripheral arterial disease (OR: 2.45, p = 0.046) as a predictor of major amputation, while chronic heart failure (OR: 2.77, p = 0.033), prior myocardial infarction (OR: 3.85, p = 0.024), and diabetes mellitus (OR: 3.23, p = 0.012) were significantly associated with in-hospital mortality. Conclusions These findings highlight the critical role of aggressive cardiovascular risk factor management in patients with ALI to improve outcomes following surgical revascularization.

Coronary Computed Tomography Angiography in Non-ST Elevation Acute Coronary Syndromes: Present Evidence and Potential Advances

Fri, 27 Mar 2026 00:00:00 GMT

Coronary computed tomography angiography (CCTA) has evolved significantly over the past decade, expanding from stable coronary artery disease (CAD) assessment to diverse cardiovascular applications. However, its role in non-ST-elevation acute coronary syndromes (NSTE-ACSs) remains incompletely defined despite excellent diagnostic accuracy. This review synthesizes current evidence on the performance of CCTA in NSTE-ACS, examining diagnostic capabilities, advanced plaque characterization, clinical outcomes, and knowledge gaps requiring future investigation. CCTA demonstrates high negative predictive value (>90%) for ruling out obstructive CAD in NSTE-ACS, particularly in low-to-intermediate risk patients. Despite this diagnostic performance, contemporary evidence reveals a persistent disconnect between anatomical accuracy and clinical benefit, with CCTA-guided strategies failing to demonstrate improvements in major adverse cardiovascular events or reductions in healthcare costs when compared to standard invasive approaches. Advanced plaque characterization techniques offer potential refinement in risk stratification. Pericoronary adipose tissue analysis via fat attenuation index correlates with vulnerable plaque features and inflammatory markers in NSTE-ACS populations. Critical evidence gaps persist regarding optimal patient selection algorithms, timing strategies across risk stratification, and cost-effectiveness analyses. Future research must prioritize outcome-driven investigations demonstrating that CCTA-guided management improves clinical endpoints, prospective validation of advanced imaging biomarkers, and integration into personalized algorithms to bridge the gap between diagnostic capability and meaningful clinical impact.

A Rare Cause for Congestive Heart Failure after Myocardial Infarction: A Giant Left Ventricle Pseudoaneurysm

Fri, 27 Mar 2026 00:00:00 GMT

Introduction Left ventricular pseudoaneurysm (LVP) is a rare complication of myocardial infarction associated with very high mortality. Patients with LVP may present with heart failure, ventricular arrhythmias, or even cardiac tamponade. If left untreated, the risk of rupture may reach up to 45% within the first year. Case presentation We present the case of a 76-year-old patient with a recent myocardial infarction, diabetes, renal failure, stroke, and tetraparesis, admitted to the Neurology Department of the Clinical Rehabilitation Hospital in Cluj-Napoca. A cardiology consultation was requested for sudden-onset dyspnea, palpitations, and deterioration of the general condition. Clinical examination showed SpO2 79% and HR 100/min, without cardiac murmurs. Echocardiography revealed mildly reduced LVEF, a giant posterior LVP, dilated right heart chambers with signs of right ventricular overload, and bilateral pleural effusion. CT angiography excluded pulmonary embolism and confirmed the presence of LVP. The symptoms were interpreted as acute heart failure. Surgical closure was considered, but the Heart Team decided on conservative management due to the extremely high perioperative risk. During hospitalization, the patient developed multiple complications and eventually died following pseudoaneurysm rupture and cardiac arrest. Conclusion Left ventricular pseudoaneurysm is a rare but life-threatening complication of myocardial infarction that requires early diagnosis and prompt management. This case highlights the challenges of treating patients with multiple comorbidities and very high surgical risk, in whom the lack of definitive treatment options may lead to a fatal outcome.

Sustained Atrial Fibrillation Induced by Commotio Cordis-Like Event in a Pediatric Patien

Fri, 27 Mar 2026 00:00:00 GMT

Introduction Commotio cordis (CC), or concussion of the heart, is typically characterized by a sudden impact to the chest wall precipitating ventricular fibrillation arrest. There have been very few documented cases of atrial fibrillation (AF) resulting from this mechanism. A relative consensus exists in the crucial nature of the timing of a blow at the vulnerable ventricular repolarization in the cardiac cycle, with suggestion of the impact occurring during atrial repolarization, triggering paroxysmal atrial fibrillation. Case Presentation We present the case of a 17-year-old male patient who sustained two significant chest wall blows over the course of 8 months with initial electrocardiogram evidence of both atrial and ventricular irritability, subsequently developing AF, which did not spontaneously resolve. Conclusions Although the focus of CC has been management of immediate and lethal ventricular arrhythmias, atrial arrhythmias such as atrioventricular block, atrial flutter, or AF can occur from abnormal depolarization or occult damage to the conduction system. Detection of these rhythms may be delayed due to lack of initial collapse. Clinicians in the emergency department need to consider the possibility of late complications even in patients who do not exhibit immediate ventricular arrhythmia.

Patent Foramen Ovale – from Diagnosis to Treatment. A Literature Review

Fri, 27 Mar 2026 00:00:00 GMT

Patent foramen ovale (PFO) is a common congenital cardiac anomaly, present in approximately 25% of the general population, representing a persistent interatrial communication. This review summarizes current evidence on the clinical manifestations, diagnostic approaches, and management strategies for PFO in accordance with the most recent international guidelines. In patients with high-risk anatomical features or cryptogenic stroke, PFO closure may be indicated. The decision to close a PFO is based on careful risk stratification and comprehensive imaging, typically including contrast-enhanced transesophageal echocardiography. Several randomized controlled trials have demonstrated the efficacy of percutaneous closure devices, and PFO closure is currently considered an effective strategy for secondary prevention of cryptogenic stroke in carefully selected patients aged 18 to 60 years.

The Impact of Connective Tissue Disorders on Patients with Thoracic Aortic Pseudoaneurysms

Wed, 31 Dec 2025 00:00:00 GMT

Introduction We sought to review the clinical presentation, etiologies, diagnostic methods, surgical techniques, and long-term outcomes of patients with thoracic aortic false aneurysms (TAFA) treated at our institution. Although connective tissue disorders (CTDs) are recognized risk factors for aortic aneurysms, their role in the development and management of false aneurysms is less well established. The aim of this study was to compare cohorts of patients with and without CTD. Methods A total of 116 patients were diagnosed with a thoracic aortic pseudoaneurysm between January 1996 and August 2024 at our institute. Genetic screening confirmed a CTD in 18 patients. Follow-up was obtained for all patients through echocardiographic or computed tomography assessment. Results In all cases, TAFA developed after prior cardiovascular surgery. In the CTD cohort, the most common initial diagnosis was aortic dissection (72%), and the most frequent primary operation was the Bentall procedure (88%). Ten patients with CTD were indicated for reintervention (surgical reoperation, endoluminal graft implantation, or occluder implantation). Conclusion One-year survival was higher in patients without CTD (98%) than in those with CTD (89%); however, ten-year survival was higher in the CTD cohort (89% vs. 68%). After surgical reoperation, secondary TAFA recurrence was lower in patients without CTD (16% vs. 22%), although recurrence occurred sooner in this group. Operative mortality was 11.1% in patients with CTD and 5.1% in those without CTD.

Implementation of Artificial Intelligence for Predicting Atrial Fibrillation – A Review

Wed, 31 Dec 2025 00:00:00 GMT

Atrial fibrillation is the most common heart arrhythmia globally, leading to life-threatening complications, reduced quality of life, a high financial burden, and significant healthcare resource utilization. Artificial intelligence is increasingly being integrated into medicine, enhancing clinicians’ ability to screen for, diagnose, and treat various conditions. In recent years, artificial intelligence models have been successfully applied to predict atrial fibrillation by analyzing 12-lead electrocardiogram waveforms, imaging features derived from computed tomography, cardiac magnetic resonance imaging, and echocardiography, as well as other clinical risk factors. The aim of this study is to synthesize current evidence, highlight emerging trends, and identify future directions in this field.

Peripheral Vascular Access Complications After Percutaneous Procedures: A Single-Center Experience

Wed, 31 Dec 2025 00:00:00 GMT

Background The Seldinger technique is a fundamental method for percutaneous vascular access in cardiovascular interventions, including extracorporeal membrane oxygenation, transcatheter aortic valve implantation, percutaneous coronary intervention, and coronary angiography. Despite its critical role in hemodynamic monitoring, drug delivery, and device placement, peripheral vascular access is associated with complications such as pseudoaneurysm, hematoma, arteriovenous fistula, thrombosis, and bleeding, which may adversely impact clinical outcomes. Aim of the Study This study aimed to evaluate the incidence, risk factors, and management strategies of severe vascular complications requiring surgical intervention following peripheral vascular access in cardiovascular procedures. Materials and Methods A retrospective analysis was conducted on 81 patients treated at the Emergency Institute for Cardiovascular Diseases and Transplantation Târgu Mureş between 2017 and 2024 for vascular complications after percutaneous interventions. From a total of 23,370 procedures, including 592 cases of transcatheter aortic valve implantation, 73 patients with femoral artery complications were analyzed. Demographic data, comorbidities, procedural history, complication type, and surgical management were recorded. Results The cohort had a mean age of 65.7 ± 13.3 years; 60.2% were male, and 87.6% were over 50 years of age. Frequent comorbidities included cardiopathies (97.5%), anemia (67.1%), peripheral arterial disease (32.8%), and coagulopathies (28.7%). Previous vascular interventions were significantly associated with increased complication risk (p < 0.001). Pseudoaneurysm was the most prevalent complication (43.8%), followed by hematoma and arteriovenous fistula. Arterial suturing constituted the primary surgical management (67.1%). Conclusions Femoral artery access in cardiovascular interventions carries a measurable risk of severe complications, particularly in older patients with comorbidities and prior vascular procedures. Pseudoaneurysm represents the most frequent adverse event. Optimal outcomes require meticulous patient selection, procedural planning, and early recognition of complications, supported by advanced imaging, closure devices, and prompt surgical intervention when necessary.

Hypertensive Emergencies – Updated Insights into Guidelines, Mechanisms, and Emerging Challenges

Wed, 31 Dec 2025 00:00:00 GMT

Hypertensive emergencies are critical conditions characterized by severe blood pressure (BP) elevations causing acute target organ damage. Despite advancements in hypertension management, these emergencies remain a significant clinical challenge, affecting 1–2% of hypertensive patients and often arising from poor disease control. This review integrates updated guidelines, emerging evidence, and treatment strategies to optimize outcomes. Pathophysiological mechanisms, including failure of autoregulation and renin–angiotensin–aldosterone system activation, contribute to endothelial dysfunction and microvascular injury. Effective management requires rapid, yet cautious BP reduction to prevent further organ damage while preserving perfusion. Intravenous antihypertensive agents, such as labetalol and nicardipine, are emphasized for their safety and efficacy. Comparative studies highlight nicardipine’s superior efficacy in achieving rapid BP control, whereas labetalol offers versatility with fewer cardiac side effects. In specific scenarios, such as ischemic stroke or preeclampsia, treatment is tailored to underlying conditions, reflecting guideline recommendations. Long-term outcomes depend on sustained BP control and the prevention of hypertensive-mediated organ damage. Emerging biomarkers provide insights into disease progression and potential therapeutic targets. Despite progress, research gaps remain in precision medicine and healthcare equity. Future efforts should focus on personalizing treatment and integrating advanced diagnostics to reduce morbidity and mortality in hypertensive emergencies.

Previous Cardiovascular and Cerebrovascular Events Increase Risk of Depression or Anxiety Disorder in Patients with Chronic Limb-Threatening Ischemia

Wed, 31 Dec 2025 00:00:00 GMT

Background Chronic limb-threatening ischemia (CLTI), the most severe type of peripheral arterial disease (PAD), is characterized by rest pain, ischemic ulcers, or gangrene. It is associated with high rates of amputation, hospitalization, and mortality. Depression affects between 16% and 35% of patients with PAD, while anxiety disorders are present in approximately 24.4% to 29%. Aim of the study: This study aims to identify and analyze the risk factors associated with the presence of anxiety or depressive disorders in patients with CLTI. Material and Methods In this monocentric, retrospective, observational study, all patients with CLTI admitted to the Vascular Surgery Clinic of the Târgu Mureş County Emergency Clinical Hospital from January 2020 to December 2023 were included. Demographic data, comorbidities, risk factors, and laboratory data were collected from the hospital’s electronic database. Additionally, cardiovascular events (history of myocardial infarction or angina pectoris) and cerebrovascular events (including stroke or transient ischemic attack) were documented, along with the presence of depression or anxiety disorders. Results A total of 113 patients with CLTI were enrolled, with a mean age of 70.54 ± 8.96 years. Of the entire cohort, 14 patients (12.39%) were diagnosed with depression or anxiety disorder. Based on the presence of depression or anxiety disorder, no significant differences were observed concerning demographic data, comorbidities, and risk factors, except for cardiovascular events (35.71% vs. 11.11%; p = 0.013) and cerebrovascular events (64.29% vs. 12.12%; p < 0.001). Regarding laboratory findings, only blood urea nitrogen levels were higher in patients with depression or anxiety disorder (p = 0.023). In the univariate analysis, cardiovascular events (OR 4.44; p = 0.020) and cerebrovascular events (OR 13.05; p < 0.001) were linked to depression or anxiety. Conclusions: A history of cardiovascular and cerebrovascular events was strongly linked to an increased risk of depression or anxiety in patients with CLTI. This emphasizes the close connection between vascular disease and mental health, indicating that neurological and cardiac conditions might worsen psychological distress in this at-risk group.

The Association of Coronary Artery Calcium Score with Heart Failure – a Literature Review

Wed, 31 Dec 2025 00:00:00 GMT

One of the main principles of cardiovascular disease prevention is early intervention. Heart failure represents an end stage of most cardiovascular diseases and is a consequence of persistent damage caused by conditions such as coronary artery disease, hypertension, or valvular heart disease. Since its introduction, the coronary artery calcium (CAC) score has proven to be a comprehensive, reproducible, and accessible measure to quantify atherosclerotic burden. This review aimed to assess the prognostic value of the CAC score in patients with heart failure and its association with heart failure-related mortality. We searched the PubMed, Web of Science, and Google Scholar databases for studies examining the relationship between the CAC score and heart failure. After an initial selection of 32 articles, 23 were deemed eligible for inclusion. Based on the findings of these studies, the CAC score can be considered a useful tool for assessing heart failure risk, either alone or in combination with other parameters, across diverse populations, thereby supporting earlier initiation of pharmacological therapy.

Challenges in the Comprehensive Management of Hypertrophic Cardiomyopathy in Children: Case Report

Tue, 23 Sep 2025 00:00:00 GMT

Hypertrophic cardiomyopathy (HCM) is a myocardial disease characterized by abnormal thickening of the ventricular myocardium. It is most commonly inherited as an autosomal dominant disorder caused by mutations in sarcomere or sarcomere-associated protein genes. We report the case of a 15-year-old female with HCM and a strong family history (mother, sister, and maternal grandfather). Despite this background, her diagnosis was made incidentally following the onset of cardiac symptoms. Genetic testing confirmed a pathogenic MYH7 mutation. Based on elevated risk scores (HCM-Risk Kids = 8.6%, Primacy Risk Score = 13.09), she was considered at high risk for sudden cardiac death and underwent implantation of an implantable cardioverter-defibrillator (ICD) for primary prophylaxis. This case highlights the importance of a comprehensive approach to pediatric and adolescent HCM, including family history, genetic testing of at-risk relatives, early diagnosis, and multidisciplinary management. It also emphasizes the urgent need for systematic family screening of first-degree relatives using echocardiography and electrocardiography. Although genetic testing confirmed the diagnosis in our patient, it could not be extended to relatives due to financial limitations. Expanding access to genetic screening at a national level should be a priority. Future research should focus on optimizing genetic testing protocols and improving quality-of-life interventions for young patients with HCM and ICDs.

Neo-Femoral Artery Reconstruction with Autologous Bifurcated Great Saphenous Vein Graft in an 88-Year-Old Patient with a Large Infected Pseudoaneurysm

Tue, 23 Sep 2025 00:00:00 GMT

We present the case of an 88-year-old patient with multiple cardiovascular comorbidities who, on the first day after transcatheter aortic valve implantation (TAVI), developed sudden severe pain in the right lower extremity. Urgent computed tomography angiography (CTA) of the abdominal aorta and lower limbs revealed a patent right common iliac artery with thrombotic occlusion of the external iliac and femoral arteries. A transfemoral thromboembolectomy using a Fogarty catheter was performed at the iliofemoral axis, supplemented by local endarterectomy and patch angioplasty. Over the following three weeks, two additional interventions were required to evacuate an inguinal hematoma and secure hemostasis at the patch level. Three months later, the patient returned to the emergency department with severe groin pain and active bleeding from the wound. CTA revealed a large infected pseudoaneurysm of the common femoral artery, measuring approximately 4 × 2.5 cm. Reconstruction of the neo-femoral artery was carried out using an autologous bifurcated great saphenous vein graft, combined with a proximal sartorius muscle flap. At six months, CTA demonstrated patent femoral arteries without thrombus or hematoma and complete tissue healing.

The Link Between Periostin Serum Levels and Cardiovascular Risk in Patients with Acute Coronary Syndrome and Concomitant Periodontal Disease

Tue, 23 Sep 2025 00:00:00 GMT

Background Acute coronary syndrome (ACS) is a leading cause of death, with significant disparities in risk factors and outcomes. The relationship between periodontal disease (PD), periostin (PN), and cardiovascular disease is complex, with both conditions sharing inflammatory pathways and risk factors. This study investigates the link between PN serum levels and cardiovascular risk factors in patients with ACS and concomitant PD. Methods This case–control study involved 92 patients with ACS and PD admitted to the County Emergency Clinical Hospital of Târgu Mureș, Romania. Patients were divided into low PN (LP) and high PN (HP) groups based on a median PN level of 30.63 ng/ml. Clinical data, lipid profiles, and biomarkers were compared between groups. Results Patients in the LP group had significantly higher total HDL cholesterol and triglyceride levels, and significantly lower LDL cholesterol levels compared to the HP group. Linear regression analysis showed a positive correlation between serum PN and LDL cholesterol (p < 0.0001) and a negative correlation between PN and HDL cholesterol (p < 0.0001). There were no statistically significant differences in apolipoprotein B, serum uric acid, creatinine, or blood glucose levels between the groups. However, patients in the HP group had a significantly higher prevalence of ST-elevation myocardial infarction (p < 0.05). Conclusion In patients with ACS and PD, PN levels correlate with lipid profiles, particularly LDL and HDL cholesterol, and are associated with the type of myocardial infarction. These findings suggest PN may play a role in the complex interplay between PD, ACS, and cardiovascular risk, warranting further research to clarify its potential as a biomarker.

Unpredictable Cause of Renal Infarction in a Young Person – a Case Report

Tue, 23 Sep 2025 00:00:00 GMT

Introduction Renal artery occlusion is a rare but life-threatening condition that can cause renal infarction and long-term functional impairment if diagnosis and treatment are delayed. It is commonly linked to systemic thromboembolic events, and in certain cases the origin of the thrombus is uncertain. This report presents a case of renal thromboembolism caused by a paradoxical embolism in a young patient. Case presentation We report the case of a 32-year-old male patient who presented to the emergency department with severe right lumbar pain irradiating to the right thigh and abdomen. The patient had recently experienced a dislocation of the right patella, which had been immobilized without anticoagulation therapy. Clinical and imaging investigations showed almost complete occlusion of the right renal artery, thus causing infarction of two-thirds of the right kidney. A patent foramen ovale with coexisting deep vein thrombosis suggested a paradoxical embolism as the etiology. With catheter-directed thrombolysis and thrombectomy, improvement was obtained through a multidisciplinary approach to care with interventional cardiology, vascular surgery, and nephrology. Conclusion Although uncommon, renal artery thrombosis should be considered in patients with flank pain and thromboembolic history. Long-term anticoagulation and follow-up are essential to prevent recurrence.

Allergic Acute Coronary Syndrome Without Identifiable Triggers – Kounis Syndrome Type I Associated with Chronic Spontaneous Urticaria. Case Report and Review of the Literature

Tue, 23 Sep 2025 00:00:00 GMT

Introduction Kounis syndrome is a complex clinical entity at the intersection of acute coronary syndromes and allergic reactions. Case presentation We report the case of a 55-year-old woman with hypertension, autoimmune thyroiditis, and recurrent allergic complaints who was admitted with ST-elevation myocardial infarction and found to have myocardial infarction with non-obstructive coronary arteries (MINOCA), likely due to coronary vasospasm. During hospitalization, she developed cutaneous symptoms and was subsequently diagnosed with chronic spontaneous urticaria. Retrospectively, the diagnosis of Kounis syndrome type I was established. Conclusions Reporting cases with subtle or absent allergic manifestations is essential to improve diagnostic accuracy and guide appropriate management, particularly given the potential for recurrence.

Acute Myocardial Infarction Following Blunt Thoracic Trauma in a Young Patient

Tue, 01 Jul 2025 00:00:00 GMT

IntroductionCoronary artery dissection caused by trauma is a rare but serious condition that can lead to acute coronary syndrome. The dissection may result from various mechanisms, including thrombus formation and intramural hematoma, leading to intraluminal occlusion. This report presents a case of acute myocardial infarction secondary to right coronary artery dissection in a traumatic context. Case PresentationWe report the case of a 30-year-old male patient who presented to the emergency department with constrictive chest pain after sustaining direct blunt thoracic trauma caused by a pig. Clinical and imaging findings were suggestive of an acute coronary event. Coronary angiography and optical coherence tomography confirmed an acute occlusion of the right coronary artery due to dissection with intramural hematoma. A drug-eluting stent was placed to restore vessel patency. The patient had a favorable outcome, with improved ventricular function at discharge compared to admission. ConclusionAlthough uncommon, coronary artery dissection should be considered in patients presenting with acute chest pain following thoracic trauma. Prompt diagnosis and timely interventional treatment are essential to improving prognosis and minimizing long-term impairment of ventricular function.

High Values of the Leukocyte Glycemic Index Are Associated with Symptomatic Systemic Atherosclerotic Disease in Young Patients

Tue, 01 Jul 2025 00:00:00 GMT

BackgroundPeripheral artery disease (PAD), traditionally affecting older adults, is increasingly diagnosed in younger patients, highlighting the need for early, non-invasive biomarkers such as the leukocyte glycemic index (LGI) that reflect the inflammatory mechanisms driving atherosclerosis. The aim of this study was to determine whether the LGI can be associated with the presence of symptomatic atherosclerotic disease on patients under 45 years. MethodsWe conducted a retrospective observational study, enrolling all patients under the age of 45 years who were admitted to the Department of Vascular Surgery of Targu Mures County Emergency Clinical Hospital between January 2019 and May 2024. Patients were categorized into two groups based on the presence or absence of systemic atherosclerosis. ResultsPatients with systemic atherosclerosis had a higher incidence of cerebrovascular events (p = 0.006) and ischemic heart disease (p = 0.038), as well as elevated counts of white blood cells (WBCs) (p = 0.003), platelets (p = 0.038), neutrophils (p = 0.002), monocytes (p = 0.024), lymphocytes (p = 0.01), and LGI (p = 0,006). At the receiver operating characteristics analysis, we observed a significant correlation between the baseline values of the LGI and systemic atherosclerosis (p = 0.004). The area under the curve (AUC) was determined to be 0.707, with an optimal cut-off value established at 0.683, resulting in a sensitivity of 79.2% and a specificity of 60.6%. Additionally, elevated baseline values for platelets (OR 2.18; p = 0.017), WBCs (OR 2.06; p = 0.020), neutrophils (OR 2.75; p = 0.004), lymphocytes (OR 2.47; p = 0.021), monocytes (OR 2.03; p = 0.021), and LGI (OR 2.90; p = 0.024) were also identified as predictive factors of systemic atherosclerosis. ConclusionsElevated values of LGI are associated with the presence of symptomatic atherosclerotic disease in patients under 45 years.

Incidence and Risk Factors for Early Postoperative Arrhythmias in Congenital Heart Disease – Systematic Review

Tue, 01 Jul 2025 00:00:00 GMT

Postoperative arrhythmias are commonly seen in pediatric cardiac intensive care units and are linked to higher rates of both morbidity and mortality in children with congenital heart disease. However, the incidence of early postoperative arrhythmias in the pediatric population is unclear, varying from 7.3% to 48% in the literature. We searched the PubMed, Embase, and Web of Science databases from 2000 to 2025 with the aim to perform a systematic review of the existing literature on the incidence and risk factors of early arrhythmias following heart surgery. A total of 16 cross-sectional observational studies, including 5,563 patients who underwent surgery for congenital heart disease and 901 patients who developed early postoperative arrhythmias, met the inclusion criteria. Patients developing early postoperative dysrhythmias were younger, with a lower body weight, and the duration of cardiopulmonary bypass was significantly longer. Other incriminated risk factors for the occurrence of early postoperative arrhythmias were hemodynamic instability, complexity of the surgical procedure, and higher vasoactive-inotropic scores. Pediatric patients with congenital heart disease who undergo cardiac surgery face increased morbidity and mortality due to the risk associated with the multifactorial complication of early postoperative arrhythmias. The reported incidence of these arrhythmias varies greatly among different studies and a better understanding of risk factors and pathophysiological mechanisms would improve postoperative outcomes for this notably exposed population.