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Background Ebstein's anomaly is a rare congenital heart disease characterized by apical displacement of the septal and posterior tricuspid valve leaflets. It is commonly associated with other defects such as patent foramen ovale or accessory atrioventricular pathways. Case summary We describe a case of an Ebstein anomaly diagnosed in an adult in his 50s in association with a septal defect between the left ventricle and right atrium (Gerbode defect). The diagnosis was confirmed on magnetic resonance imaging. A third anomaly was noted on coronary angiography, consisting of an aberrant origin of the right coronary artery from the left sinus of Valsalva. The patient was paucisymptomatic until he developed typical atrial flutter. Catheter ablation was employed after first arrhythmia recurrence and the patient is to date in good clinical condition. Conclusion The association of Ebstein's anomaly–Gerbode defect is extremely rare, and to our knowledge, this is the first case that presents in addition an anomalous coronary artery. Both structural defects were without haemodynamic significance, and there was no proof of myocardial ischaemia. As the case illustrates, congenital disorders, even when in conjunction, can have a silent clinical course and multimodality imaging is sometimes necessary for a complete and final diagnosis. [ABSTRACT FROM AUTHOR]

The escalation of global obesity is driving research to understand environmental influences on this process, particularly during vulnerable developmental stages such as childhood and adolescence. Efforts include the development of various structured data collection tools. We aimed to adapt a series of previously validated questionnaires from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the Child Feeding Questionnaire, and elements from the World Health Organization Childhood Obesity Surveillance Initiative (COSI) in order to assess local lifestyle patterns among Romanian high school students and their families that may predispose them to obesity. To this goal, an expert committee was formed as part of a research partnership to oversee the questionnaire's translation and adaptation. It consisted of education and school management specialists, clinical research professionals, language experts, and public health experts. The adapted questionnaires were then applied to 114 students enrolled in the 9th and 10th grades attending a high school situated in Sibiu, and their parents. The variables measured were investigated for correlations with overweight and obesity and, as a secondary objective, academic performance. The study revealed several critical findings, including suboptimal sleep durations and physical activity levels among students, a significant amount of screen time, and correlations between weight status and physical activity, sedentary time, and maternal weight status and education levels. The adapted questionnaires proved to be effective tools in capturing the multifaceted factors implicated in adolescent obesity, providing a foundation for targeted interventions and broader public health strategies to address this issue. [ABSTRACT FROM AUTHOR]

Background: Hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) are common heart muscle disorders that are caused by pathogenic variants in sarcomere protein genes. In this study, we describe a variant in the MHY7 gene, segregating in a family having three different phenotypes of cardiomyopathies. MYH7 encodes for the myosin heavy-chain β (MHC-β) isoform involved in cardiac muscle contractility. Method and results: We present the case of a family with four members diagnosed with HCM and four members with DCM. The proband is a 42-year-old man diagnosed with HCM. He has an extended family of eight siblings; two of them are diagnosed with HCM and are implantable cardioverter–defibrillator (ICD) carriers. One of the siblings died at the age of 23 after suffering a sudden cardiac arrest and DCM of unknown etiology which was diagnosed at autopsy. Another brother was diagnosed with DCM during a routine echocardiographic exam. Genetic testing was performed for the proband and two of his siblings and a niece of the proband, who suffered a cardiac arrest at the age of nine, all being MYH7 mutation positive. For all four of them, cardiac imaging was performed with different findings. They are ICD carriers as well. Conclusions: Our results reveal three variants in phenotypes of cardiomyopathies in a family with MYH7 mutation associated with high SCD risk and ICD needed for primary and secondary prevention. [ABSTRACT FROM AUTHOR]

The use of Amiodarone as a first-line antiarrhythmic agent in secondary prophylaxis of sudden cardiac death is limited by its well-known toxicity. The side effects depend on the age of the patient, the dosage and the duration of the treatment. We hereby present the case of a 62-year old female patient, with obesity and hypertension, with a history of malignant rhythm disorders and a long and effective, but unsupervised treatment with Amiodarone. After a period of 7 years, the patient is hospitalized with severe acute respiratory insufficiency, initially diagnosed as a high risk pulmonary thromboembolism. Although the specific treatment, including the thrombolytic one, improved the respiratory and hemodynamic status of the patient, it did not have the estimated result. The repeated imaging showed parenchymal aspects, not farmable in the initial diagnosis, corresponding to pulmonary fibrosis. The treatment with Amiodarone was replaced with corticotherapy, resulting in a noticeable alleviation of respiratory status. [ABSTRACT FROM AUTHOR]

Minimally invasive techniques are increasingly used in cardiac valve surgery, with satisfactory results to date. The present study is important because it is an attempt to address these problems at the level of a single center, on a population of patients from 2018, who have benefited from the approach of the valvular pathologies through minimally invasive novel techniques. In this retrospective study, data were collected, in 2018 and 2019, in an observational, nonintervention study, for patients with minimally invasive cardiac valve surgery in 2018. There were 93 cases with minimally invasive valve surgery during 2018. There was only one death regarding the 30-day-follow up. In the group of patients who had minimally invasive valve surgery, in this particular center, in 2018, we conclude that the hybrid approach is safe. [ABSTRACT FROM AUTHOR]

Introduction. Nicorandil, a vasodilator with strong coronary and peripheral vascular activity is current used as an antianginal agent, but its effect in heart failure (HF) patients has not been fully established. Therefore, we examined impact of nicorandil in outcomes of ischemic HF patients. Materials and methods. HF patients with ischemic etiology were prospectively registered and divided into 2 groups based on oral administration of nicorandil: nicorandil group (n = 6) and non-nicorandil group (n=6). Patients were randomly assigned to be treated with or without oral nicorandil, 10 mg twice daily for 5 days. BNP values were measured at admission and at 5th day. Patients undergo ecocardiography exam and 6 minutes walk test. Results: Echocardiographic measurements showed no statistical relevant differences between groups. The mean distance at the 6minute walk test has higher in the nicorandil group (396 meters) versus non-nicorandil group (320 meters) and BNP levels after 5 days were decreased significant in the nicorandil group. Conclusion: Nicorandil is potentially effective for treatment in patients with ischemic heart failure. [ABSTRACT FROM AUTHOR]

Introduction. Adherence to guidelines treatment in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate characteristics of HF in patients with ischemic heart disease (IHD), and to assess the adherence to current HF guidelines. Materials and methods. There were included patients admitted to the Cardiology Clinic with decompensate HF and IHD. Guideline Adherence Indicator was calculated as the number of drugs taken per number of drugs indicated; beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers and diuretics. Results: 98/111 patients entered the analysis. HF class II was prevalent in 51%, class III in 38,7% and class IV 9.18%,; 29/98 patients were diagnosed with HFREF (29%). A high prevalence of arterial hypertension and PCI was found. Global adherence indicator was 73%, HFPEF patients had a lower indicator. Conclusions. Pharmacotherapy was fairly well implemented in HFREF patients, worse in patients with more preserved ejection fraction. [ABSTRACT FROM AUTHOR]