Juniper Publishers Journal of Cardiology and Cardiovascular Therapy

Abstract Hypertensive Cardiomyopathy (HTN-CM) is a structural cardiac disorder generally accompanied by concentric or eccentric Left Ventricular Hypertrophy (LVH) associated with diastolic or/and systolic dysfunction in patients with persistent systemic hypertension. It occurs in the absence of other cardiac diseases capable of causing myocardial hypertrophy or cardiac dysfunction. Long standing arterial hypertension (HTN) leads to structural and functional myocardial abnormalities resulting in myocardial ischemia, fibrosis, and hypertrophy. HTN-CM is predominantly a disease of impaired relaxation rather than impaired contractility, although subtle myocardial systolic abnormalities could be detected recently by Global Longitudinal Systolic Strain (GLS) Speckle Tracking Echocardiography (STE). Importantly, the accompanying LVH is itself a risk factor for mortality and morbidity and is considered an independent predictor for Sudden Cardiac Death (SCD). Therefore, early d...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract A 30-year-old female with a long-standing history of transfusion-dependent red cell aplasia and non-compliance with treatment was admitted with a new complain of shortness of breath. Workup revealed heart failure with reduced ejection fraction (LVEF 15%) with very high ferritin levels. A cardiac MRI was done due to suspicion of cardiac hemochromatosis, and it showed myocardial iron overload with severe biventricular dysfunction. The patient was stabilized, started on iron chelators and subsequently optimized for discharge, with plans for eventual orthotopic heart transplant after she had shown improved compliance. Two weeks later she was readmitted due to CHF exacerbation and cardiogenic shock. She went into V-fib arrest multiple times soon after being admitted. Patient's family decided not to continue with resuscitation efforts due to futility. This case undermines the im...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Hypertension is one the major preventable causes of death and morbidity. The prevalence of hypertension is approximately 30-35% at studies conducted in countries. Today; the role played by hypertension in the development of heart failure and coronary heart disease and the benefits of primary prevention with effective treatment have been clearly demonstrated. The significance of treatment of hypertension in terms of secondary prevention has also been established in patients with heart failure and coronary heart disease. By the current guidelines, hypertension treatment goals has been individualized and specific patient groups have also been amide to provide the highest benefit from therapy. Early identification and effective treatment of hypertension therefore has vital importance for both primary and secondary prevention. Keywords: Hypertension; Coronary artery disease; Heart f...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Case Report A 58-year-old man was admitted to the hospital with asymptomatic hypertensive urgency. His medical history was significant for heart failure and complete heart block with a dual chamber pacemaker first implanted in 1985. Although he had more leads added over time, his previous leads were never removed. Examination revealed a left-sided generator and an old right-sided device with purulent eroded wires. He also had mild pedal edema. A chest radiograph ( Figure 1A ) demonstrated a complicated lead arrangement with wires connecting the generator on the left and the old generator pocket site on the right, an atrial lead (yellow arrow) in the correct position, and multiple ventricular leads (green and red arrows) passing through the tricuspid area (oval). Gated chest computed tomography showed a misplaced, abandoned lead piercing one of the tricuspid leaflets (Red arrow in Figur...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Peripheral arterial disease (PAD) is the chronic and progressive deterioration of lower extremity arterial blood flow due to systemic atherosclerosis. Currently, PAD is considered not only a disorder of lower extremity circulation and but also a predictorofincreased mortality and morbidity. In prevalence surveys conducted in Turkey, the frequencyof PAD was found up to 20-30%, increasing with advancing age. The diagnosis of PAD can easily be made by the ankle brachial index measurement. The incidence of coronary artery disease and congestive heart failure is higherin individuals with PAD. In addition, in patients with coronary artery disease or congestive heart failure, cardiovascular mortality and all - cause mortality increases in the presence of PAD. In conclusion, PAD is a systemic disease and should be treated systematically and effectively in addition to interventional thera...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Prenatal diagnosis of pulmonary atresia with intact ventricular septum (PAIVS) was useful for planning delivery. It was hypothesized that it can be of benefit on postnatal outcome. The objective of this study was to compare the outcome of prenatal versus postnatal diagnosis of PAIVS in terms of mortality and morbidity. This is a retrospective study of the outcome of all cases of PAIVS presenting in utero and in the postnatal life during the period between January 2011 and December 2016 in a tertiary referral center. Twenty -eight patients with PAIVS were included in this study and distributed equally within two groups prenatal and postnatal. The main outcome measure was survival rate in first 12 months of postnatal life in a clinically well doing status. Three mortalities was the outcome in postnatal group compared to one mortality in the prenatal group. On the other hand, mo...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Keywords Keywords: Hypertension; Disparities; Treatment; Research; Education; Knowledge gap Objectives A. Provide a review of current hypertension management best-practices. B. Assess and bridge any existing knowledge gap among providers regarding the understanding of current data related to the treatment of hypertension in specific populations. C. Understand strategies for individualizing the treatment of hypertension, given existing controversies and disparate treatment guidelines. D. Share recent clinical trial data on the use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers as monotherapy and combination therapy in hypertensive African Americans. Introduction/Background About 1 of 3 U.S. adults has high blood pressure. Only about half of these people have their high blood pressure under control [...