Background and Aims: Nepal is a developing country with increasing rates of cardiovascular disease (CVD), and the recent 2015 earthquakes imposed critical social and epidemiological effects to the population. This study aims to assess the prevalence of CVD risk factors, social health behaviours and atrial fibrillation (AF) in a native population from a remote Nepalese village that was the epicentre of the May 2015 earthquake.Methods: Observational, cross-sectional study, addressing the population of dislodged inhabitants of Sindhupalchok. Data was collected during an opportunistic clinical screening in the midst of a humanitarian medical mission and consisted of demographic, anthropometric and medical data.Results: A total of 270 patients were assessed (41% in a temporary settlement with continuous organisational support and 59% in the remote village with less back-up). Among adults, 89% had low fruit consumption, 49% were overweight or had augmented waist circumference, 42% had smoking habits, 57% consumed alcohol regularly, 22% had high blood pressure measurements and 5% had abnormal glycaemic levels. An 11% prevalence of AF was found among the elderly.Conclusions: The studied population has a high prevalence of CVD risk factors, poor health behaviours and a significant prevalence of AF among the elderly representatives. International partnering and humanitarian work might be important tools to assess the population’s needs and implement corrective measures.

Background: Some of the patients admitted for acute myocardial infarction have non-obstructive coronary artery disease (MINOCA). Their prognosis is not always benign, making it necessary the development of tools for risk stratification of these patients. Objectives:To describe the characteristics of a sample of patients admitted for suspected MINOCA and to evaluate the prognostic value of GRACE score in this population.Methods: This was a retrospective, observational, single-center, cohort study involving 56 consecutive patients with MINOCA. During one-year follow-up, patients were assessed for mortality and major adverse cardiovascular events (MACE) -a composite of all-cause mortality and hospitalization due to acute myocardial infarction, heart failure, ischemic stroke, and acute limb ischemia. Statistical analysis was performed using a non-parametric approach, with the Mann-Whitney U test for quantitative variables and ROC curves for assessing the discriminatory power of the Grace score in predicting cardiovascular events. The level of significance was set at 5%. Results:Of the 56 MINOCA patients included in the study (median age 67 years), 55.4% were female. During the one-year follow-up, mortality rate was 5.5% and 9.1% of patients had MACE. A higher GRACE score was associated with mortality (p = 0.019; AUC 0.907; 95%CI 0.812-1.000; cut off 138) and MACE (p =0.034; AUC 0.790; 95%CI 0.632-0.948; cutoff 114). Conclusion:The definition of MINOCA includes various diagnoses and prognoses, and the GRACE score is useful for risk stratification of patients with this condition.

Purulent pericarditis is a rare entity, defined as the presence of neutrophilic pericardial effusion which is infected by a bacterial, fungus or parasite agent. The diagnosis can be challenging, especially if patients have taken previous antibiotic therapy; on the other hand the recognition of this pathology is often made late, with the onset of severe symptoms or signs of cardiac tamponade or even only at the autopsy. The authors describe the case of a 82-year-old woman with history of extensive laceration of the right lower limb from a dog bite in July 2016, admitted to the Cardiology Department one month later for Acute Pericarditis. During hospitalization she maintained recurrent fever peaks despite the treatment with non-steroidal anti-inflammatory drugs and colchicine. She collected blood cultures and repeated echocardiogram showed increased pericardial effusion with no signs of hemodynamic compromise. Blood cultures revealed the presence of Pasteurella multocida. Due to clinical suspicion of purulent pericarditis, pericardiocentesis was performed with drainage of liquid compatible with exudate and the patient was presented to the Cardiothoracic Surgery Department for pericardiotomy and adequate drainage of the liquid. Histological examination confirmed the diagnosis of Acute Pericarditis. It should be noted that Pasteurella is a very frequent agent (50-90%) in the gastrointestinal tract and nasopharynx of many domestic animals, namely dogs. The authors emphasize the need to aggressively treat this pathology, since untreated death is inevitable.

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The match result was not associated with a difference in incidence of CVEs in patients with a past history of CAD, with ischemic and arrhythmic substrate, who watched soccer matches on television.

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Funding Acknowledgements Type of funding sources: None. Background Behavioral and emotional factors may trigger cardiovascular events (CVE). Watching sports when there is an emotional connection between the supporters and the supportive team, is believed to be potentially associated with CVE. However, epidemiological studies have been inconsistent, with several studies showing an increase in CVE, while others reporting a protective effect. Purpose To assess the effect of watching sport events on the incidence of cardiovascular events. Methods Pubmed, and Embase were systematically searched to identify appropriate articles. Reference lists were then hand searched for additional relevant articles. To be included, articles had to assess the association between CVE and sport events supporters (adeptos). Pooled association measures, using random effects analysis, were calculated for mortality; arrhythmias; myocardial infarction (MI). Subgroup analysis was conducted based on gender. Publication bias and between-study heterogeneity were evaluated. Results There were nineteen studies included in the analysis. The pooled relative risks for mortality, arrhythmias and MI were 1.45(0.98-2.15; 95%CI; I2=70%; p=0.02); 1.31(0.98-1.77; 95%CI; I2=85%; p<0.01); 1.11(0.98-1.24; 95%CI; I2=91%; p<0.01) respectively (Figure 1A). The null association persisted in the subgroup analyses by gender for mortality (Figure 1B) as well as for MI and for the combined endpoint MI/stroke (non significant relative risks). Conclusions Overall this analysis suggests that watching sport events does not increase cardiovascular events regardless of gender.