Background: Elderly patients and those with multiple concomitant disorders are nowadays qualified for cardiac surgery procedures, which is related to higher incidence of the postoperative complications. Aim: The aim of this study was a retrospective analysis of the perioperative factors potentially contributing to occurrence of cardiac incidents after cardiac surgery procedures. Methods: Data of 552 patients of the cardiac surgery clinic were collected and analyzed. Data concerning medical history, previous treatment, laboratory results, additional tests results, operation and hospitalization period were examined. Results: In the study population of 552 patients, cardiac complications were observed in 49.5% of them. Among cardiac complications, the most frequent were supraventricular tachycardia (30.1%) and atrial fibrillation (27.4%). Postoperative bradycardia occurred in 5.25% patients, half of whom required temporary cardiac pacing. Conclusions: The risk of incidence of cardiac complications after cardiac surgery procedures depends mostly on patient’s age, EuroSCORE Logistic (ESL) score, left ventricular ejection fraction, myocardial hypertrophy, presence of paroxysmal AF and coincidence of nephrological complications. The necessity of performing more than one heart defibrillation after removing aortic cross-clamp favors early postoperative bradycardia. Considering the outcomes of this study, continuing reperfusion at least until 1/3 of the aortic cross-clamp time brings no additional benefits to the patients.

Between 2013 and 2016 there were approximately 6.2 million adults in the United States living with heart failure; nearly half had an ejection fraction that was preserved. Despite the high prevalence of heart failure with preserved ejection fraction (HFpEF), our understanding of this disease is limited and it still carries significant morbidity and mortality worldwide. At present, physicians are burdened by the inconclusive benefits of currently available treatment options. Recently the scientific community has seen an influx of new pathophysiology studies and outcome trials that have reshaped our understanding of HFpEF as a complex, multi-systemic disease. Pharmacological trials involving beta-blockers, angiotensin II receptor antagonists, aldosterone antagonists, and angiotensin-neprilysin inhibitors have demonstrated encouraging results, but have yet to reach the significance of advancements made in the treatment of heart failure with reduced ejection fraction. This review aims to summarize landmark clinical trials that have influenced current treatment guidelines, and reports on emerging evidence supporting/ refuting new treatment modalities including pharmacotherapy, lifestyle modification and device therapy.

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BackgroundOut-of-hospital cardiac arrest (OHCA) is a major health challenge; the impact of the COVID-19 pandemic on OHCA in the South Bronx is unknown. The aim of this study was to determine differences between return of spontaneous circulation(ROSC), witnessed arrest, bystander CPR and survival to discharge, prior to and during the COVID-19 pandemic to improve ROSC and survival.MethodsSingle-center retrospective study of non-traumatic OHCA adult patients admitted to Lincoln Medical Center between 8/2019 to 6/2021, 3/2020 being the first established date of the COVID-19 pandemic in New York City. International Classification of Diseases (ICD) coding was used to identify cardiac arrests and collect information. Statistical analysis was performed using IBM-SPSS.ResultsROSC time pre COVID-19 was 26 minutes, during the COVID-19 pandemic it was 25 minutes 54 seconds. A significant difference in witnessed arrests in the pre COVID-19 period compared to the COVID-19 period (86% vs 55% p = 0.03). Bystander CPR occurred 36% of the time in the pre COVID-19 period contrasting to 19% during. Prior to the COVID-19 pandemic the overall survival to discharge in OHCA ROSC cases was 28.5% comparing to 29% during the pandemic. ROSC was 18 minutes among survivors during the pandemic, compared to 21 minutes in survivors prior to COVID (p = 0.2).ConclusionThere was a non-significant difference in ROSC, bystander CPR and survival to discharge in non-traumatic OHCA prior to and during the COVID-19 pandemic in the South Bronx. There was a significant difference in witnessed vs unwitnessed OHCA prior to and during the COVID-19 pandemic.

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Pericardial disease is a common manifestation of malignancy. Gynecologic malignancies such as ovarian cancer rarely present with cardiac involvement. Cardiac tamponade may be the initial presentation of malignancy in as many as half of pericardial disease cases. We report the case of a 60-year-old female with known ovarian adenocarcinoma, who achieved initial success with tumor debulking and adjuvant chemotherapy but was lost to follow-up. She presented again three years later with new-onset dyspnea and described a syncopal episode. A chest radiograph showed an enlarged cardiac silhouette and bilateral pleural effusions. Transthoracic echocardiography revealed a large pericardial effusion with diastolic collapse of the right atrium and ventricle, consistent with tamponade physiology. Subxiphoid pericardiocentesis and pigtail drain were placed under fluoroscopy with resolution of symptoms and no recurrence. Neoplastic etiology was confirmed by immunocytochemistry on cell block positive for PAX-8. As an adjunct or alternative to cytologic evaluation, diffusion-weighted magnetic resonance imaging and calculation of the apparent diffusion coefficient can be used to differentiate between malignant and benign effusions. Malignant pericardial effusion in ovarian cancer is a treatable oncologic emergency where timely diagnosis and management may facilitate palliation and prolong life.