Highlights of Cardiovascular Disease Prevention Studies Presented at the 2022 American College of Cardiology Scientific Sessions.

PURPOSE OF REVIEW: Focused review highlighting select studies presented at the 2022 American College of Cardiology (ACC) Scientific Sessions. RECENT FINDINGS: Included studies assessed the impact of a low-sodium diet on heart failure outcomes (SODIUM-HF); outcomes of pregnant patients with chronic hypertension treated with antihypertensive therapies (CHAP); cardiovascular outcomes in patients with type 2 diabetes and renal impairment treated with sotagliflozin (SCORED); a safety and efficacy study investigating SLN360, a short interfering RNA targeting lipoprotein(a) (APOLLO); a supermarket and web-based intervention targeting nutrition for cardiovascular risk reduction (SuperWIN); a superiority trial comparing myocardial injury following very mild perioperative hypothermia versus aggressive warming after non-cardiac surgery (PROTECT); and 3-year efficacy outcomes of renal denervation on blood pressure reduction from the SPYRAL HTN-ON MED pilot study. Research presented at the 2022 ACC Scientific Sessions underscores the new potential and meaningful impact of cardiovascular disease prevention and management interventions.

Prevalence of Depression and Anxiety Among Medical Students and House Staff During the COVID-19 Health-Care Crisis.

OBJECTIVE: The objective of the study was to evaluate the prevalence of anxiety and depression among medical trainees during the initial wave of the COVID-19 pandemic. METHODS: This was a cross-sectional study of the prevalence of depression and anxiety among medical students, residents, and fellows at a medical university hospital in New York using self-reported PHQ-9 and GAD-7 screening tools administered via an anonymized survey. The study was conducted in April 2020. RESULTS: The authors received 438 responses (33.4% response rate). Nearly half (44.5%) were medical students and female (56.6%). The prevalence of positive screen for depression (45.3%) and anxiety (48.1%) was high. Many reported moderate to severe depression (17.2%) and anxiety (20.3%). Over half (57.3%) experienced significant mood changes and inability to concentrate, and 14.6% had reconsidered their choice of profession since the start of the pandemic. Those who had reconsidered their profession had higher PHQ-9 [8.1 (6.4) vs 4.4 (4.3), p < 0.0001] and GAD-7 scores [8.3 (6.1) vs 4.7 (4.6), p < 0.0001], indicating adverse mental health partly contributed to their reconsideration of choice of profession. Women were more likely to screen positive for anxiety (OR: 1.68) and medical students more likely to screen positive for anxiety (OR: 2.55) and depression (OR: 2.74). CONCLUSION: The COVID-19 pandemic has placed great strain on health-care resources, including the mental health of medical trainees.

A Review of Acute Myocardial Injury in Coronavirus Disease 2019.

In December 2019, an outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan, Hubei province, China, and it has spread rapidly across the world, causing the coronavirus disease 2019 (COVID-19) pandemic. Although SARS-CoV-2 infection predominantly results in pulmonary issues, accumulating evidence suggests the increased frequency of a variety of cardiovascular complications in patients with COVID-19. Acute cardiac injury, defined as elevated cardiac troponin levels, is the most reported cardiac abnormality in COVID-19 and strongly associated with mortality. In this article, we summarize the currently available data on the association of SARS-CoV-2 and COVID-19 with acute myocardial injury.

Hughes Stovin Syndrome, a Rare Form of Behcet's Disease Presenting as Recurrent Intracardiac Thrombus.

Hughes Stovin syndrome (HSS) is a particularly rare disease characterized by multiple pulmonary artery and/or bronchial artery aneurysms with concomitant peripheral venous thrombosis and is believed to be a cardiovascular variant of Behcet's disease. Intracardiac thrombus occurring as a thrombotic manifestation of HSS is an unusual presentation and represents a challenge in diagnosis and treatment. Here we report a 25-year-old male presenting with recurrent right-sided intracardiac thrombi, in whom pulmonary artery aneurysm was later detected in the clinical course corroborating the diagnosis of HSS and leading to appropriate initiation of immunosuppressive agents. The patient required multiple cardiac surgeries during the clinical course for cardiovascular complications associated with recurrent cardiac thrombus. Unfortunately, the patient was readmitted a year later for massive hemoptysis secondary to pulmonary arterial aneurysm rupture requiring left lower lobectomy. Our case highlights also the significant morbidity, complications, and treatment challenges associated with this potentially life-threatening syndrome, which is intensified in the presence of cardiac involvement.

A Rare Case of Lemierre's Syndrome Caused by Streptococcus Intermedius, Presenting as an Epidural Abscess.

Lemierre's syndrome is a rare but life-threatening condition characterized by an oropharyngeal infection typically secondary to Fusobacterium necrophorum resulting in septic thrombophlebitis of the internal jugular vein. Streptococcus intermedius is a particularly rare cause of Lemierre's syndrome with only a few cases reported in the literature. Here we describe a rare case of Lemierre's syndrome, caused by Streptococcus intermedius, likely secondary to an odontogenic infection, found to have a cervical epidural abscess with concomitant large retropharyngeal and prevertebral abscesses on presentation, in whom the clinical course was further complicated by an extensive cerebral venous sinus thrombosis. However, despite grave complications, early diagnosis and appropriate emergency management including intravenous antibiotics and surgical intervention led to a successful recovery, thus demonstrating that aggressive measures can potentially lead to a favorable outcome.