Self-perceived heart disease risk assessment in patients with hypertension

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): The University of Adelaide supported fieldwork Introduction Heart disease is the leading cause of morbidity and mortality worldwide. The risk of heart disease is significantly high among patients with hypertension. However, patients’ poor understanding of their risk even further intensifies the risk of heart disease. Therefore it is crucial to improve patients’ understanding of their lifetime risk and applying a healthy lifestyle, to reduce the risk of heart disease. Purpose The aim of this study was to explore self-perceived heart disease risk and knowledge of heart disease risk factors in patients with hypertension. Methods A cross-sectional study was conducted in patients with a confirmed diagnosis of hypertension who attended follow up care clinics at two referral hospitals in eastern Ethiopia. Data were collected through face-to-face interviews using two validated instruments (ABCD risk questionnaire for assessment of self-perceived risk and heart disease fact questionnaire for assessment of knowledge of cardiovascular risk factors). Data analysis was conducted using SPSS version 25, and descriptive and correlation analysis were conducted. Results A total of 203 patients were included in the study, 60% of them were females, and the mean age was 50 ± 9 years. The majority 143 (70.4%) perceived their future heart disease risk as low, however 60 (29.6%) perceived their future chance of developing heart disease as moderate. The mean heart disease risk factors knowledge score was 72.3 + 13.7, and more than half (57%) had optimal knowledge of heart disease risk factors (scored ≥70%), whereas, the remaining 43% had sub-optimal knowledge. Moreover, there is a statistically significant positive association between self-perceived heart disease risk and knowledge of heart disease risk factors (r = 0.28, p= 0.00). Conclusion Despite being at high risk, many patients with hypertension underestimate the chance of developing heart disease in their lifetime. Implementation of interventions to promote healthy lifestyle behaviour is crucial to prevent heart disease risk as well as to improve patient’s understanding of these risks.

Spontaneous pulmonary artery thrombus in a neonate

Background Pulmonary artery thrombosis is rare in neonates and mimics as persistent pulmonary hypertension or congenital heart disease. Risk factors include septicemia, dehydration, polycythemia, maternal diabetes, asphyxia, and inherited thrombophilias. They present with cyanosis and respiratory distress. Careful echocardiogram assessment helps in identifying the thrombus in the pulmonary artery and its branches. Computed tomography pulmonary angiography confirms the diagnosis. Case presentation We present a case of term neonate who presented with respiratory distress and cyanosis and a detailed echocardiogram revealed thrombus in the origin of left pulmonary artery. The neonate was managed initially with unfractionated heparin and later with low molecular weight heparin with which there was significant resolution of the thrombus Conclusion Spontaneous pulmonary artery thrombosis though rare should be suspected in any cyanotic neonate with respiratory distress. Management in these cases depends on the haemodynamic instability and lung ischemia.

Optimizing indices of AF susceptibility and burden to evaluate AF severity, risk and outcomes

Atrial fibrillation (AF) has heterogeneous patterns of presentation concerning symptoms, duration of episodes, AF burden, and the tendency to progress towards the terminal step of permanent AF. AF is associated with a risk of stroke/thromboembolism traditionally considered dependent on patient-level risk factors rather than AF type, AF burden or other characterizations. However, the time spent in AF appears related to an incremental risk of stroke, as suggested by the higher risk of stroke in patients with clinical AF versus subclinical episodes and in patients with non-paroxysmal AF versus paroxysmal AF. In patients with device-detected atrial tachyarrhythmias, AF burden is a dynamic process with potential transitions from a lower to a higher maximum daily arrhythmia burden, thus justifying monitoring its temporal evolution. In clinical terms, the appearance of the first episode of AF, the characterization of the arrhythmia in a specific AF type, the progression of AF, and the response to rhythm control therapies, as well as the clinical outcomes, are all conditioned by underlying heart disease, risk factors, and comorbidities. Improved understanding is needed on how to monitor and modulate the effect of factors that condition AF susceptibility and modulate AF-associated outcomes. The increasing use of wearables and apps in practice and clinical research may be useful to predict and quantify AF burden and assess AF susceptibility at the individual patient level. This may help us reveal why AF stops and starts again, or why AF episodes, or burden, cluster. Additionally, whether the distribution of burden is associated with variations in the propensity to thrombosis or other clinical adverse events. Combining the improved methods for data analysis, clinical and translational science could be the basis for the early identification of the subset of patients at risk of progressing to a longer duration/higher burden of AF and the associated adverse outcomes.

Knowledge and Prevalence of Heart Disease Risk Factors Among Staff of a Tertiary Institution in Nigeria

Background Cardiovascular disease is the most common cause of mortality worldwide. Hence, awareness of cardiovascular risk factors is an essential step towards effective reduction of the disease burden. This study determined the knowledge and prevalence of cardiovascular risk factors among Staff of Ekiti State University. Ado-Ekiti, Nigeria. Methods A cross-sectional study which comprised of 223 members of staff. Results There were 103 males (46.2%). Low knowledge of heart disease risk factors was found in 68.6% of the respondents. The prevalence of hypertension, diabetes mellitus, overweight, obesity, physical inactivity was 35.4%, 12.1%, 31.8%, 23.3%, and 83% respectively. Family history of hypertension was a predictor of a high level of knowledge. Conclusion A low level of knowledge and increasing prevalence of cardiovascular risk factors existed among staff of Ekiti State University, Nigeria. Hence, there should be a step-up of awareness campaigns and promotion of healthy lifestyle among this category of people.

Atrial Fibrillation After Coronary Artery Bypass Surgery: Risk Factors, Prevention and Treatment

This review focuses on the issue of atrial fibrillation (AF) following coronary bypass surgery in patients with ischemic heart disease. Risk factors of this complication are discussed in detail. The authors addressed the effect of diabetes mellitus on development of postoperative AF. Data on current methods for prevention and treatment of AF are provided.