The detection and quantification of coronary artery calcification (CAC) significantly improves cardiovascular risk prediction in asymptomatic patients. Many have advocated for expanded CAC testing symptomatic patients based on data demonstrating that the absence quantifiable with possible angina makes obstructive disease (CAD) subsequent adverse events highly unlikely. However, widespread use may be limited by high background prevalence its low specificity CAD, necessitating additional...

<h3>Importance</h3> Human immunodeficiency virus (HIV) infection is associated with increased cardiovascular disease (CVD) events. Endothelial dysfunction (EDF) involved in CVD pathogenesis; however, EDF onset after HIV acquisition and the potential for reversibility antiretroviral therapy (ART) have not been evaluated to date. <h3>Objective</h3> To evaluate endothelial function noninvasive reactive hyperemia index (RHI) patients early at baseline ART initiation. <h3>Design, Setting,...

A 58-year-old man presented with a chief complaint of tongue indentations and discomfort. Otolaryngology treated him for oral thrush counselling to avoid biting. In addition, the patient reported dyspnoea described as decrease in tolerance his physical activities. Due continued increase size worsening dyspnoea, he underwent tissue biopsy findings consistent amyloidosis. Further evaluation bone marrow revealed underlying multiple myeloma. Echocardiography abnormal ventricular wall thickness,...

BACKGROUND:While takotsubo cardiomyopathy (TC) is a rare cardiomyopathy, recurrent (rTC) even more so, occurring in only 4% of patients with TC. Treatment based on expert opinion and includes standard heart failure treatment using beta blockers (BB) angiotensin-converting enzyme inhibitors (ACEI). We present case rTC demonstrating how selective serotonin reuptake inhibitor (SSRI) cognitive behavioral therapy (CBT) can successfully prevent recurrence. CASE REPORT:A 64-year-old woman presented...

Effusive-constrictive pericarditis (ECP) is a rare clinical entity resulting from accumulating pericardial fluid within stiff, non-compliant pericardium. There are number of etiologies for ECP, which include malignancy, radiation, post-surgical causes, infectious, and collagen disorders. Clinically, ECP often presents as right-sided heart failure, or in advanced cases, cardiac tamponade. Symptoms may persist despite treatment with pericardiocentesis, warrant consideration pericardiectomy...

We sought to assess the prognostic value of coronary computed tomography angiography (CCTA) among military health care system beneficiaries. identified 1,125 consecutive symptomatic patients without known artery disease (CAD) referred for 64-slice CCTA (2006–2010) at a single center. CAD was assessed as none, <50%, or ≥50% (obstructive) stenosis. A combined endpoint major adverse events (death, myocardial infarction [MI], revascularization >90 days after CCTA) by Kaplan–Meier and Cox...

The public health concerns from Chagas disease warrant improved cardiovascular imaging efforts, and in this report, we review a military service member presenting with electrocardiographic cardiac magnetic resonance (CMR) findings that recognized dilated cardiomyopathy. We present an updated staging classification incorporating CMR to increase diagnosing cardiomyopathies.

In the appropriate clinical context, ST-segment elevation on electrocardiogram (ECG) necessitates prompt evaluation for coronary artery occlusion requiring reperfusion with percutaneous intervention. Conversely, etiology of may be representative an alternative diagnosis other than myocardial infarction. We report case a patient history primary bone sarcoma who presented further large pericardial effusion identified outpatient echocardiogram and was found to have ECG in absence any...

People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. However, there is scant evidence the changes that occur shortly after seroconversion. In this study we describe evaluations asymptomatic US Air Force members who were diagnosed infection evaluated San Antonio Military Medical Center between September 1, 2015 30, 2016.Patients (n = 50) predominantly male (96%), mostly African American (60%), a...

Introduction: Noninvasive stress myocardial imaging studies are commonly utilized to evaluate patients with chest pain. While coronary computed tomographic angiography (CTA) is highly accurate for the diagnosis of artery disease (CAD), its comparative effectiveness versus on downstream resource utilization undefined. Hypothesis: We assessed hypothesis that CTA may be associated lower as compared imaging. Methods: randomized 240 adults without prior CAD who were clinically referred (single...

Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic (NAFL) to steatohepatitis (NASH) and has been linked cardiovascular sub-clinical cardiac remodeling. This paper presents retrospective study biopsy-proven NAFL NASH examine the differences in subclinical remodeling.Patients were recruited an institutional repository patients with liver-biopsy-confirmed NAFLD. Patients transthoracic echocardiogram (TTE) within 12 months biopsy included. The parameters...

Abstract Background Up to 20% of resting echocardiograms obtained are suboptimal leading further downstream testing and delays in diagnosis. Contrast enhanced echocardiography is well established endorsed for use by the American Society Echocardiography (ASE) clinical scenarios when 2 or more adjacent wall segments not visualized; however, varied institutional protocols practices place limit such due increased time personnel needed obtain imaging. Methods The purpose this study was...

Abstract Objective People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD) and development of subclinical echocardiographic abnormalities. The pathogenicity induced cardiotoxicity has been described however the time to abnormalities after acquisition remains unclear. In this study we describe evaluations asymptomatic US Air Force members who were diagnosed infection. Results Patients (n=50) predominantly male (96%), mostly black (60%), a mean age 28 years. At...

Introduction: Coronary CT angiography (CCTA) can safely disposition low to intermediate risk chest pain (CP); however, there is conflicting data with respect cumulative radiation exposure when compared usual care over short follow-up intervals. Objectives: We report the effective dose from index and downstream testing in symptomatic patients evaluated for ED either CCTA or define various sources of patient quantify a year half follow-up. Patients Methods: initial prospectively collected,...

Introduction: Cardiovascular complications of coronavirus disease 2019 (COVID-19) infection, including myocarditis, have been widely reported. Research question/hypothesis: What was the incidence and clinical implications viral myocarditis resulting from COVID-19 infection in hospitalized United States active-duty service members (US ADSM)? Goal/aims: Report US ADSM who suffered associated myocarditis. Methods: This retrospective observational cohort study Joint Trauma Service Registry...

It is rare that a left atrial appendage thrombus will grow to the extent it can prolapse into ventricle. We report case of large prolapsing diagnosed by 3D echocardiography in patient presenting with transient ischemic attack.