Acute Myocarditis and Heart Failure Associated with Multisystem Inflammatory Syndrome in Adults: A Rare Sequela of Coronavirus 2 Infection.

During the current pandemic, acute coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provokes overwhelming inflammatory response leading to a wide range of clinical presentations including, a rare multisystem inflammatory syndrome and cardiac injury. Not only during the acute phase of the disease but a delayed immunologic response to SARS-CoV-2 infection among people with hyperinflammatory illness several weeks postacute phase of the infection is recently recognized. We report a young adult male who presented with acute myocarditis and heart failure associated with laboratory evidence of hyperinflammatory syndrome 5 weeks after a full recovery from COVID-19 infection. We believe that health-care providers need to be aware and recognize this syndrome as a rare sequela of COVID-19 infection.

A Case Report of Severe Dehydration Associated With Acute Kidney Injury Causing Acute ST-Segment Elevation Myocardial Infarction.

The initial electrocardiogram finding in the setting of acute myocardial infarction typically shows either persistent ST-segment elevation or non-ST-segment elevation. In young adults, when coronary angiography is performed, can further classify the patient with an occluded vessel and those with non-occluded coronary arteries. In these subgroups, myocardial infarction can be explained on the basis of coronary artery thrombosis, embolization, spontaneous coronary artery dissection, myocardial bridging, coronary aneurysms, ectasia, anomalous origin of coronary arteries coronary microvascular dysfunction, and vasospasm, or a combination of these factors. We describe a 37-year-old male with a history of chest pain and electrocardiographic evidence of acute myocardial infarction who worked many hours under the sun before being presented to the emergency department. The initial laboratory tests showed evidence of acute kidney injury. He underwent a rescue coronary angiogram due to failed initial medical reperfusion therapy with Tenecteplase, which revealed occluded of the distal left anterior descending (LAD) artery with a minor lesion in proximal LAD and right coronary artery. Our patient experienced acute myocardial infarction owing to severe dehydration. This case is important as it highlights that severe dehydration can be considered one of the triggering factors for acute myocardial infarction in young men who are at risk. Proper hydration could be a preventive measure.

Caffeinated Energy Drink Induced Ventricular Fibrillation: The Price for Overexcitement.

An otherwise healthy 32-year-old man had an in-hospital cardiac arrest with ventricular fibrillation after a few days of consuming 48 cans of alcohol-mixed energy drinks (EDs) (250-mL per can ). He had collapsed shortly after presenting to the emergency room with complaints of lack of sleep and palpitations. Normal cardiac rhythm was restored by biphasic direct current (D/C) shock. EDs generally contain mainly caffeine, taurine, and other ingredients. Especially in high doses, caffeine can cause palpitations and ventricular arrhythmias.

Hospitalized heart failure patients with preserved vs. reduced ejection fraction in Dubai, United Arab Emirates: a prospective study.

AIMS: To compare the baseline characteristics, pharmacological treatment, and in-hospital outcomes across hospitalized heart failure (HF) patients with preserved LVEF (HF-PEF) and those with reduced LVEF (HF-REF). METHOD AND RESULTS: This was a prospective analysis of consecutive patients admitted with decompensated HF at two government hospitals in the United Arab Emirates, from 1 December 2011 to 30 November 2012. Multivariate factors of HF-PEF vs. HF-REF included elevated systolic blood pressure [odds ratio (OR) 1.02; 95% confidence interval (CI) 1.01­1.03], heart rate (OR 0.98; 95% CI 0.97­0.99), age (OR 1.02; 95% CI 1.01­1.04), female sex (OR 2.38; 95% CI 1.41­4.03), angina or myocardial infarction (OR 0.42; 95% CI 0.25­0.71), AF (OR 1.82; 95% CI 1.05­3.15), COPD or asthma (OR 2.80; 95% CI 1.47­5.35), Charlson Comorbidity Index score (OR 0.75; 95% CI 0.64­0.88), and anaemia (OR 2.97; 95% CI 1.64­5.38). In-hospital outcomes were similar between the two groups. However, patients with HF-PEF were less likely to be prescribed HF medication, and used more anticoagulants and fewer antiplatelet medications. CONCLUSION: These results suggest that patients with HF-PEF are older, more often female, and have higher prevalence of respiratory diseases and AF. Compared with developed countries, hospitalized HF patients in the Middle East are 10 years younger and have a higher prevalence of diabetes mellitus, and the majority have HF-REF.

Acute coronary syndrome registry from four large centres in United Arab Emirates (UAE-ACS Registry).

OBJECTIVE: To identify the characteristics, treatments and hospital outcomes of patients diagnosed as having acute coronary syndrome (ACS) in the United Arab Emirates (UAE). DESIGN: A 3-year prospective registry. SETTING: Four tertiary care hospitals in three major cities of UAE from December 2003 to December 2006. PATIENTS: 1842 eligible consecutive patients with suspected ACS. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Characteristics, treatments and in-hospital outcomes were recorded. RESULTS: The mean age was 50.8±10.0 years, and 93.1% were male. More than half (51%) had ST elevation myocardial infarction (STEMI). The smoking rate was 46.4%, and diabetes was present in 38.9%. Only a minority (17.3%) used the ambulance services. For patients with STEMI, the median symptom to hospital time was 127 (IQR 60-256) min, and the median diagnostic ECG to thrombolysis time was 28 (IQR 16-50) min. Reperfusion in STEMI was in 81.4% (64.8% thrombolysis and 16.6% primary percutaneous coronary intervention). During hospitalisation, only a minority of the patients did not receive antiplatelets, anticoagulants, beta-blockers, ACE inhibitors and statin therapy. In-hospital complications were not common in our registry cohort. In-hospital mortality was 1.68%. CONCLUSIONS: ACS patients in UAE are young but have higher risk factors such as smoking and diabetes. Almost half present as STEMI. Only a minority use ambulance services.