First reported case of COVID-19 induced permanent third-degree atrioventricular (AV) block in a young patient.

SARS-CoV2 virus, COVID-19, was first reported in Wuhan, China in 2019. The most common symptoms of COVID-19 are dry cough, fever, and diarrhea that occur within 2-14 days of exposure. Primary infection from COVID-19 develops in the respiratory tract. Cardiovascular disease has become a more prominent manifestation of COVID-19 infection, however very little is known regarding the impact of COVID-19 on the cardiac conduction system. We present a young patient with COVID-19 who developed a permanent third-degree Atrioventricular (AV) heart block. This report is the first documentation of COVID-19 induced permanent third-degree heart block in a young male.

Very low risk of ST-elevation and non-ST-elevation myocardial infarction in patients with chest trauma.

BACKGROUND: The goal of this study was to evaluate any association between blunt chest trauma and occurrence of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction. METHODS: Data from the National Inpatient Sample (NIS) database from 2010-2014, of patients over the age of 40, hospitalized for blunt chest trauma (ICD 959.11), with STEMI or NSTEMI, was used in this study. We performed a chi-squared test to analyze this association. We also performed a multivariant analysis adjusting for race, gender, and age. RESULTS: We found that there is not an increased risk of STEMI/NSTEMI following blunt chest trauma, P > 0.05. We also found no correlation between STEMI or NSTEMI and chest trauma after adjusting for race, gender, and age. For STEMI after adjustments in 2010 (P=0.52), 2011 (P=0.19), 2012 (P=0.60), 2013 (P=0.88), and 2014 (P=0.14). For NSTEMI adjustments in 2010 (P=0.03), 2011 (P=0.06), 2012 (P=0.01), 2013 (P=0.21), and 2014 (P=0.03). CONCLUSION: Both ST-elevation myocardial infarction and non-ST-elevation myocardial infarction were not significantly associated with blunt chest trauma.

Higher Heart Rate Is Independently Associated With Abnormal Body Mass Index in a J Shape Pattern.

BACKGROUND: High heart rate (HR) is independently associated with higher cardiovascular mortality and usually occurs in sedentary persons. Inactivity can also lead to obesity. The purpose of this study was to evaluate the associations between body mass index as an independent marker of high HR. METHOD: Data generated from screening echocardiography, for the prevention of sudden death at the Anthony Bates Foundation, was used. Data from 1340 subjects, with documented HR and body mass index, between the ages 19-79 years with a mean age of 32 years, were studied. We correlated the presence of a high HR >90 beats per minute (bpm) with different body mass index (BMI) categories. RESULTS: High HR was significantly associated with higher BMI categories and underweight subjects in adults suggesting a J shape association. A total of 22.7% of participants with an HR of more than 90 bpm had BMI >40 kg/m 2 , versus 19.0% of patients with BMI of 35-40 kg/m 2 versus 13.5% of subjects with BMI of 30-35 kg/m 2 versus 12.2% of subjects with BMI of 25-30 kg/m 2 -29.9 kg/m 2 , versus in 10.3% of subjects with BMI between 18.5 and 25 kg/m 2 , P < 0.01) Furthermore, increased HR was also more prevalent in underweight patient (17.4% in subjects with BMI < 18.5 kg/m 2 ). CONCLUSION: High HR is strongly associated with obesity and underweight suggesting that maintaining a normal weight is associated with most positive effect on the cardiovascular system.

Presence of physical symptoms in healthy adolescence found to be associated with female gender, obesity, tachycardia, diastolic hypertension and smoking.

BACKGROUND: The goal of this study was to evaluate any association between physical symptoms and abnormal clinical history in adolescence undergoing screening echocardiography performed by Anthony Bates Foundation. METHOD: The Anthony Bates Foundation has been performing screening echocardiography across the United States for the prevention of sudden death since 2001. We performed uni- and multivariate analysis to evaluate any association between physical symptoms with gender, smoking, obesity, heart rate, and hypertension. RESULTS: We found a strong association between symptoms and the female gender (33% vs. 17.5% of males, P < 0.001). Furthermore, obesity (46.5% vs. 22.5%, P < 0.001), smoking (46.2% vs. 22.5%, P = 0.04), heart rate > 90 (34.8 vs. 22.8%, P = 0.001), and diastolic blood pressure > 90 (34.9% vs. 23.4%, P = 0.03) were all associated with symptoms. Increased systolic pressure was not associated with physical symptoms (24.3% vs. 21.9%, P = 0.4). Using multivariate analysis, female gender, diastolic blood pressure and obesity remained independently associated with physical symptoms. (Female gender: OR: 2.2, CI: 1.7-2.9, P < 0.001, obesity: OR: 2.5, CI 1.2-5.05, P = 0.009, and high diastolic blood pressure: OR: 2.08, CI 1.1-3.7, P = 0.01). CONCLUSION: Physical symptoms are associated with smoking, female gender, obesity, tachycardia, and high diastolic blood pressure but not systolic pressure in adolescence undergoing routine screening echocardiography.