European Cardiology Congress July 01-02, 2019 Panorama Hotel Prague, Milevská 7, 140 63 Praha 4, Czechia

Biography:

Cesare Saponieri has been an active Electrophysiologist for the last 25 years in Brooklyn, NY. He has completed his research on Sudden Cardiac Death, has published many articles and presented at many international conferences. He also has an active private practice and thousands of patients who call him their doctor.

Abstract:

We present a 62-year female with history of hypertension, who presented with recurrent multiple syncopal episodes. The patient has had full syncope-with loss of consciousness, multiple times at work and during relaxing activities. Patient would have no pre-syncopal aura and would find herself on the floor every time. A full neurologic evaluation was negative. On presentation, the patient had a physical exam positive for left arm BP 180/120 and right arm BP 120/80. Her ECG showed normal sinus rhythm, 61 bpm, no abnormalities. Her echocardiogram showed a normal ejection fraction of 60%, with trace mitral regurgitation. A previously placed implantable loop recorder showed no evidence of arrhythmia, even during the syncopal episodes. At this point, the differential diagnosis was wideneded and a CT angiogram of the chest and neck was ordered. The CT showed a hemodynamically significant blockage between the right carotid artery and the right vertebral artery. There was also delayed contrast filling the distal right subclavian artery. This constellation of findings is consistent with the diagnosis of subclavian steal syndrome (SSS). A vascular surgery and interventional cardiology consults were ordered, and a definitive treatment plan will be based on a team approach to this patient.

Biography:

Tamilarasu Kaliappan has completed his MBBS, MD at Dr. MGR Medical University, Chennai, India. He has obtained his Diplomate in National Board in Cardiology at Amrita University, Kochi, India. He has been elected as Fellow in American College of Cardiology (FACC) in 2015. He is currently working as an Associate Professor in the Department of Cardiology, PSG Institute of Medical Science and Research, Coimbatore, India. He is a Life Member in Cardiology Society of India (CSI).

Abstract:

Introduction: Infective endocarditis is a microbial infection of endocardial surface of the heart and vegetation is the characteristic lesion of the disease. Left atrial mural endocarditis is a condition of rare diagnosis and it may be difficult to find vegetation by standard views in transthoracic echocardiography (TTE). Identifying the mural vegetation not only helps to diagnose infective endocarditis, but also predicts the risk for developing embolism.

Aim: The main aim of this study is to find the prevalence of embolism in patients with left atrial mural endocarditis.

Method: A retrospective, observational study was done from the year 2012 to 2018, in which total of 53 patients with definite diagnosis of infective endocarditis were identified. After the IHEC approval, the data of these patients were collected and analyzed.

Results: Results showed that out of 53 patients five (9.4%) patients had mural
vegetation with culture positive infective endocarditis. Among five (9.4%) patients with mural vegetation, three (5.6%) presented with stroke and two (3.7%) developed stroke during hospital stay. Though mural vegetation is not common, but if present it may predict a propensity for embolism. Our results indicate that in patients with left atrial mural endocarditis, the propensity of embolism is more.

Biography:

Regina Elena M Bisnar is currently undergoing her Cardiology Fellowship at The Medical City in the Philippines. She was graduated from the Ateneo School of Medicine and Public Health in 2013 and finished her Internal Medicine training in 2017.

Abstract:

Ventricular septal rupture is a rare complication especially in the era of reperfusion, carrying a poor prognosis without intervention. Surgical repair is still the definitive treatment but carries a high morbidity and mortality risk. We are presented with a 54/M with a one week history of shortness of breath. He had a ST elevation MI of the anteroseptal wall two weeks prior and was managed medically. He presented with a BP of 80/50 mmHg and HR 90-147 bpm in atrial fibrillation. A grade 2/6 holosystolic murmur, left parasternal border was noted. TTE showed dilated left ventricle with an aneurysmal apex and depressed systolic function. A thallium rest-redistribution MPI showed a large transmural MI involving the apex and apical to basal anterior and anteroseptal walls and apical to midventricular inferior walls. Perfusion recovery showed viable basal anterior, anteroseptal, lateral, basal inferior and inferoseptal segments. Coronary angiogram showed that the LAD has an 80% proximal stenosis with TIMI 1 flow. PCI was done with TIMI 2 flow. One week after discharge, he developed heart failure symptoms and repeat TTE showed ventricular septal rupture with an echo-drop out of 1 cm and Qp:Qs of 2:1 with predominantly left-to-right shunt. Patient refused open heart surgery so a transcatheter septal closure was done. A Cocoon VSD Occluder (Vascular Innovations Co., Ltd., Nonthaburi, Thailand) with a diameter of 24 mm and a wing size of 26 mm successfully closed the defect. Repeat TTE revealed decreased Qp:Qs to 1.4:1 with residual left-to-right shunt. Patient was asymptomatic on follow-up.

Biography:

Waleed Abdou Ibrahim Hamed has completed his MD degree from Menoufia University. He is Assistant Professor of Cardiology in Faculty of Medicine, Menoufia University. He has published more than 30 papers in different cardiology journals and conferences.

Abstract:

Background & Objectives: Chemerin, leptin and psoriasin are proinflammatory
and immune-modulatory proteins associated with psoriasis and displayed higher circulating levels. Their relation to atherosclerosis in psoriatic patients has been investigated in numerous studies with wide-ranging results. Therefore, the present study aimed to assess plasma levels of chemerin, leptin and psoriasin and evaluate their relationship with carotid intima-media thickness (CIMT) and epicardial fat thickness (EFT) as potential predictors for subclinical atherosclerosis in psoriasis patients.
Patients & Methods: The study included 50 psoriatic patients and 40 age and gender matched healthy controls. Clinical severity of psoriasis was evaluated by psoriasis area and severity index (PASI). Fasting blood glucose and lipid profile were estimated. Plasma levels of high sensitivity-CRP (hs-CRP), chemerin, leptin and psoriasin were measured by ELISA. CIMT and EFT were assessed by ultrasonography and echocardiography, respectively.
Results: Plasma levels of hs-CRP, chemerin, leptin and psoriasin as well as CIMT and EFT were significantly elevated in psoriasis patients compared to controls (P<0.001). CIMT and EFT were significantly positively correlated with PASI, plasma hs-CRP, chemerin, leptin and psoriasin (P<0.001). Moreover, significant positive correlation was demonstrated between PASI and plasma hs-CRP, chemerin, leptin and psoriasin (P<0.001). Multiple linear regression analyses showed that chemerin, leptin and psoriasin were independently correlated with CIMT and EFT and exhibited high significance for predicting their values.
Conclusion: It can be concluded that chemerin, leptin and psoriasin might represent an important link between psoriasis and atherosclerosis. Measurements of plasma chemerin, leptin and psoriasin along with CIMT and EFT seem to be valuable potential markers of subclinical atherosclerosis in patients with
psoriasis.

Biography:

Abstract:

Scientific knowledge was gathered along centuries, and it is subject to revision
and refinement as new data are found. This is also true for the field of medicine. However, some natural therapies were forgotten because of rapidly increasing synthetic drugs. As new research results are published, it is seen that lots of therapies recommended in the historical medical books have scientific basis. In this report, information about use of apple in heart disease in the historical books are presented: “The Canon by Avicenna” (d.1037): “If palpitation affects the whole body, blood is extracted from left basilic vein and recommend patient drink apple extract and ……….”; “Kitab al-Saydana” by Al-Biruni (d.1048): “Syrian apple has cardio tonic properties ……….”; “Edviye-i Mufrede” (1389) by Ishak Bin Murad, (for palpitation): “…….. Recommend patients eat apples, pears and quinces.………” A book by Hayatizade Mustafa Feyzi (d.1693): “Apple strengthens and refreshes the heart, but eating excess apples is harmful for the nerves……” As it can be seen, there are indications in the historical medical books for beneficial effects of apple for cardiac functions and for palpitation. Confirming these information, there are some reports in the literature. Two epidemiological studies have shown that eating apples is associated with the reduction of the occurrence of cardiovascular diseases. Beside there is an experimental study indicating protective effect of apple against ventricular arrhythmias. Information from the old medicinal books and results of new researches put together indicates that apple is a promising research subject for heart diseases.

Biography:

Abstract:

Mexico is a country with many inequalities, which are very notable, amongst other things, in high tech healthcare. Congenital heart diseases require in average $5,000 USD per child for a surgical treatment. Given that our average per capita income is quite low, only as few as 10% of the population can afford such healthcare, and even though 98% of the population have some sort of social security service, these are saturated, and patients may have to wait up to two years to be able to have surgery. And more so, over two million people have no access to medical services. So, we must turn to social enterprises and non-profit associations to be able to cope with this problem, and still are left with many patients without proper care. There are several areas within the country that do not have extracorporeal pump machines for open heart surgery, so they must perform surgeries without them, such as corpectomy or pulmonary banding, some of which are palliative surgeries. Many of the patients we attend arrive relatively late, considering their state. For example, we operate tetralogies of Fallot after two years of age, or anomalous pulmonary venous connections after three months. All these because of lack of planning; we have the resources and the infrastructure, but we do not yet find a way to properly manage these deficits. And so, we have so far eight nonprofit associations performing surgical procedures in congenital heart diseases throughout the country. Amongst all of them, over 1,000 children a year have been operated on, just a small percentage of all that we calculate are still awaiting surgery. Every year, more that 22,000 new children with congenital heart diseases are born, and we try to shorten the list. The first non-profit was founded in 1995, and the newest one barely this year. And all of them need mainly two things: Patients, and economical resources. We need pediatricians to redirect patients to the specialists as soon as possible and to begin medical treatment in case these referrals are not entirely feasible, and paediatric cardiologist to be familiar with all governmental, profit and nonprofit options for the patient’s benefit. We intend with this paper to share our experiences and our results in case some other countries may find it useful, as well as to urge the need for pediatric alertness, the need for resources (both human and economic), as well as an early referral, to be able to help all he children awaiting surgery to improve their quality of life.