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Decreased physical activity is associated with cardiovascular, metabolic and mental health disease. While decreases in physical activity during the COVID-19 pandemic have been described in the general population, there is a paucity of data regarding children with underlying cardiovascular disease. We hypothesized there would be a decrease in physical activity at the onset of the COVID-19 pandemic. Performed a single-center, retrospective cohort study of children aged 80% of dates from February 3, 2020 through June 30, 2020. Patients with significant neurologic/neuromuscular disease were excluded. We identified 144 patients with a median age of 15.4 years. 47% were female. 34% had congenital heart disease, 20% had cardiomyopathy, 19% had an inherited arrhythmia syndrome and 5% had atrioventricular block without congenital heart disease. 47% of patients had an implantable loop recorder, 29% had a permanent pacemaker and 24% had an implantable cardioverter-defibrillator. We observed a significant decrease in device-measured physical activity from baseline (February 3–March 9), with up to a 21% decrease in physical activity during mid-March through early May. Activity levels returned to pre-pandemic levels in June. Physical activity sharply declined in children with cardiac rhythm management devices at the onset of the COVID-19 pandemic. These data highlight the importance of finding strategies to maintain physical activity during the current pandemic and future public health crises.

Objectives To evaluate safety, feasibility, and benefit of cardiac rehabilitation (CR) in patients with peripheral arterial disease (PAD) who undergo revascularization. Methods We conducted a prospective, non-randomized, pilot study to assess the feasibility, safety, and benefit of CR in PAD patients after revascularization compared to standard of care (controls). CR feasibility was assessed by the ability to complete 36 sessions. Safety was defined as the absence of adverse cardiovascular events during CR. Quality of life (QoL) assessment was performed using SF-36 form (Medical Outcomes Study 36-Item Short-Form Health Survey) and PAD-specific quality of life questionnaire (VascuQOL6). Other endpoints included incidence of claudication during 6-minute walk test (6MWT), mean distance, and number of laps walked. All outcome data were collected before and after CR completion. Standard statistical tests were used for comparisons. Results This study enrolled 20 subjects (CR group = 10). Mean age was 60.70 (±7.13) and 63.1 (±9.17) years in CR and controls, respectively ( p-value > 0.05). Fifty percent and 60% were female in CR and control group, respectively. All subjects completed 36 CR sessions without adverse events. The increase in mean distance walked during 6MWT was higher in the CR group compared to control group (63.7 m vs. 10.5 m, p = 0.043). Change in mean number of laps walked was higher in the CR group (3.5 vs. –1.1; p Conclusion CR is safe, feasible, and improves walking ability in ambulatory patients with PAD after arterial revascularization.

Objectives Oral steroids are routinely administered in the United States for prophylaxis of iodinated contrast media hypersensitivity (ICMH). We studied the impact of short-term steroid use in diabetic patients with ICMH undergoing nonemergent coronary angiography. Methods We retrospectively analyzed records of diabetic patients with and without ICMH who underwent nonemergent coronary angiography at our center. Primary study endpoint was 30-day major adverse cardiac events (MACE) and secondary endpoints were pre- and postprocedure fasting blood glucose (FBG), highest in hospital blood glucose, pre- and postprocedure systolic blood pressure (SBP), and use of intravenous insulin and antihypertensive medications. Results A total of 88 diabetics with ICMH (study group) and 76 diabetics without ICMH (control group) undergoing angiography were enrolled. Demographics and hemoglobin A1c values were similar in both groups. Preprocedural FBG was significantly higher in the study group. The study group had significantly higher post angiography FBG (239.93 + 96.88 mg/dl vs. 156.6 + 59.88 mg/dl) and greater use of intravenous (IV) insulin (67.27% vs. 32.43%). Further, those who received steroids had significantly higher systolic SBP postprocedure (146.16 + 25.35 mmHg vs. 130.8 + 21.59 mmHg), a higher incidence of severe hypertension and use of IV antihypertensive medications (80.95% vs. 19.05%) periprocedurally. There were no differences in 30-day MACE between groups. Conclusion Short-term steroid use for ICMH results in a significant increase in surrogate markers for adverse clinical events after coronary procedures. Study findings highlight the need for better periprocedural management of these patients and to limit steroid prophylaxis to those with only true ICMH.

Graphical abstract, Highlights • Traumatic RV pseudoaneurysm is a rare diagnosis. • Optimal management of RV pseudoaneurysm remains unknown. • The authors describe a novel percutaneous treatment approach for RV pseudoaneurysm.

Cardiac adverse events, while infrequent, are the primary complications to electroconvulsive therapy (ECT). Acute myocardial infarction is a rare complication of ECT. Here, we report a case of a 49-year-old male with no known cardiac history and with intermediate cardiac risk who developed an Anterolateral ST elevated myocardial infarction after a course of ECT. His risk factors for coronary artery disease included hyperlipidemia and tobacco dependence. Coronary angiography demonstrated a complete occlusion of the proximal left anterior descending artery. The hemodynamic changes during ECT will also be discussed, which contribute to the associated cardiac complications.

Summary: Background: Fibromuscular dysplasia (FMD) primarily involves medium-sized arteries, though the entire spectrum of vascular involvement is not fully understood. We hypothesized that larger arteries may also be affected, albeit sub-clinically. Patients and methods: We measured the cross-sectional diameter of the thoracic aorta, abdominal aorta, common iliac arteries (CIA) and common carotid arteries (CCA) in FMD subjects and compared them to matched controls. We retrospectively analyzed records of FMD subjects (n = 74) and of age- and sex- matched controls (n = 74) that underwent computed tomography of the neck, chest or abdomen. Cross-sectional diameters of the thoracic and abdominal aorta, CIA and CCA were measured in a standardized manner by two trained physicians. Results: The FMD group had a significantly greater diameter of the CIA and CCA bilaterally. The measurements (mm) in FMD and control groups were as follows: Right CIA: 10.85 + 1.75 vs. 10.23 + 1.36, p = 0.04, left CIA: 11.01 + 1.93 vs. 10.15 + 1.38, p = 0.007, right CCA: 7.70 + 0.81 vs. 6.80 + 1.10, p

Pregnancy is contraindicated in patients with Left Ventricular Assist Device (LVAD). A 24 year old female with history of substance abuse and LVAD implantation presented to the ER with chest pain. Urine pregnancy test was positive and obstetric ultrasound confirmed pregnancy with gestational age (

Studies assessing direct oral anticoagulants (DOAC) in patients with atrial fibrillation (AF) have excluded those with bioprosthetic heart valves (BPHV). Data on the safety and efficacy of DOACs is limited in this population We queried the electronic medical records (EMR) of our institution for

Acute aortic dissection is the most feared complication in patients with Marfan syndrome (MS). However, there is paucity of real world data on in-hospital management outcomes. We investigated in-hospital management, outcomes and mortality in patients with MS and aortic dissection. We used the

Background: Percutaneous coronary intervention (PCI) followed by transcatheter valve replacement is an alternative for patients with severe aortic stenosis (SAS) and coronary artery disease (CAD). In many, the coronaries are calcific and best treated with rotational or orbital atherectomy (RA or OA

We investigated recent trends in-hospital outcomes and mortality in patients admitted with primary diagnosis of acute myocarditis. We performed a secondary analysis of the NIS (2008 to 2012) for patients with primary diagnosis of acute myocarditis. Various demographic/clinical parameters, including