The recent emergence of the coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China is now a global health emergency. The transmission of SARS-CoV-2 is mainly via human-to-human contact. This virus is expected to be of zoonotic origin and has a high genome identity to that of bat derived SARS-like coronavirus. Various stringent measures have been implemented to lower person-to-person transmission of COVID-19. Particular observations and attempts have been made to reduce transmission in vulnerable populations, including older adults, children, and healthcare providers. This novel CoV enters the cells through the angiotensin-converting enzyme 2 (ACE2) receptor. There is a higher risk of COVID-19 infection among those with preexisting cardiovascular diseases (CVD), and it has been connected with various direct and indirect complications, including myocarditis, acute myocardial injury, venous thromboembolism, and arrhythmias. This article summarizes the various cardiovascular complications and mechanisms responsible for the same with COVID-19 infection. For the benefit of the scientific community and public, the effect of COVID-19 on major vital organs such as the kidneys, liver, and intestines has been briefly discussed. In this review, we also discuss drugs in different stages of clinical trials and their associated complications, as well as the details of vaccines in various stages of development.

Superior vena cava (SVC) aneurysms are rare mediastinal vascular lesions. We report a case of a 42-year-old female, who presented to the outpatient department with features suggestive of lower respiratory tract infection. Chest X-ray showed abnormal contour and widening of right border of mediastinum. Computed tomography (CT) thorax revealed fusiform aneurysmal ectasia of SVC measuring 4.5 × 5.5 × 8.9 cm without internal thrombosis or dissecting flap. Management options include observation with follow-up and in some cases anticoagulation and surgical excision may be considered. The general consensus is that fusiform variety can be managed conservatively in view of the low risk of complications. The saccular aneurysms may need to be managed with anticoagulation therapy or surgically in view of the possible risk for thrombus formation and pulmonary embolism. Since in our case it was an asymptomatic primary fusiform SVC aneurysm, patient was advised for conservative management and follow-up.

Background: Cardiovascular diseases (CVD) are the main cause of mortality and disability in India. Early and sustained exposure to behavioral risk factors leads to development of CVD. The present study was conducted to compare different cardiovascular calculators for CVD risk assessment models in young Indian patients presenting with myocardial infarction.Methods: This study included 85 patients with myocardial infarction (MI). Their predicted 10-year risk of CVD was calculated using three clinically most relevant risk assessment models viz. Framingham Risk score (RiskFRS), American College of Cardiology/American Heart Association (RiskACC/AHA) and the 3rd Joint British Societies risk calculator (RiskJBS).Results: RiskFRS recognized the highest number of patients (15.4%) at high CVD risk while RiskACC/AHA and RiskJBS calculators provided inferior risk assessment but statistically significant relationship. RiskFRS and RiskACC/AHA (Pearson's r 0.870, p<0.001).Conclusions: RiskFRS seems to be as most useful CVD risk assessment model in young Indian patients. RiskFRS is likely to identify the number of patients at ‘high-risk’ as compared to RiskJBS and RiskACC/AHA.

J-curve can be defined as an increase in event rates when the blood pressure (BP) goes below a particular level. Now that we have safe and powerful drugs available for treatment of hypertension, it has become possible to bring down the BP to very low levels. However, the concept of "lower is better" is now being questioned. Trials looking at J-curve have given conflicting results. Probably, there is no J-curve for systolic BP. J-curve for stroke and renal end points is also debatable. It is in patients with significant obstructive coronary artery disease that there are data for a J curve for diastolic BP. In such patients, we should gradually titrate the dose of drugs, carefully watching for increasing angina. Isolated systolic hypertension (ISH) is another situation wherein care has to be taken when aggressively reducing systolic BP. Even here, there are questions to be answered. The low diastolic BP could be a marker of increased aortic stiffness. Or, the low diastolic BP may be due to other associated comorbid conditions. The fear of J-curve should not lead to undertreatment and thus deny patients the benefit of BP reduction.

Over the past decade, the burden of thromboembolic diseases has increased in India; however, there is a huge gap between the diagnosis and treatment of these ailments. This is further complicated by the presence of various options for anticoagulation therapy and the absence of a clinical consensus on the use of these anticoagulants. To address this issue and establish consensus statements on the use of anticoagulation therapy in Indian settings, an expert consensus was developed in alignment with the latest available evidence. A group of 38 clinical experts discussed, in detail, various case-based scenarios on stroke prevention in atrial fibrillation (AF), anticoagulation for patients with valvular heart disease, stroke, or deep-vein thrombosis. Anticoagulation management options for special populations, including patients with renal dysfunction, elderly patients, and pregnant women, were also discussed in detail. The key opinions the experts (cardiologists, cardiovascular and thoracic surgeons, consulting physicians, and neurologists) are intended to address gaps in Indian clinical practice concerning anticoagulation therapy. Based on scientific evidence, clinical experience, and guidelines on the use of anticoagulation therapy, various consensus statements were proposed. This document was drafted, reviewed, validated, and modified by the expert panel until a final agreement was reached. This pioneering consensus document will lay the foundation for future anticoagulation education modules based on evidence-based treatment approaches for Indian clinicians.