Journal of Cardiovascular Medicine and Surgery

Air pollution is one of the leading potent environmental problem in the modern world for all living creatures. It produces multiple health hazards like cardiovascular dieseses, respiratory diseases and skin diseases. However, air pollution is emerging as a leading risk factor for coronary artery disease. It promotes oxidative stress, systemic inflammation, autonomic dysfunction, metabolic dysregulation, hypercoagulability, and epigenetic changes. Individuals with genetic susceptibility face compounded risks, underscoring the need for personalized and public health interventions. Through a combination of behavioural, public awareness, medical and policy-driven strategies, the burden of air pollution-induced coronary artery disease can be significantly reduced.

Racial and ethnic disparities in cardiovascular diseases (CVDs) remain a significant public health challenge, influenced largely by social determinants of health (SDoH). While genetic predispositions play a minor role, inequities in healthcare access, quality, and outcomes are more prominent. This review highlights the impact of race and ethnicity on cardiovascular risk factors, disease prevalence, and management outcomes. Hypertension, diabetes, obesity, coronary artery disease, and valvular heart diseases exhibit pronounced disparities, with minority populations facing higher disease burdens and suboptimal care. In India, the epidemiological shift toward non-communicable diseases has further exacerbated regional disparities. Culturally tailored interventions, equitable healthcare access, and increased representation in clinical research are essential to mitigate these disparities. Addressing SDoH through policy reforms and community-based initiatives can significantly improve cardiovascular health outcomes across racial and ethnic groups. KEY MESSAGES: • Race and ethnicity are socio-political constructs that significantly influence healthcare disparities, including access, quality, and disease outcomes. • Minority populations, especially Black individuals, have higher hypertension prevalence, poorer blood pressure control, and greater target organ damage due to socioeconomic and environmental factors. • Racial and ethnic minorities, particularly South Asians and African Americans, face a higher burden of obesity and type 2 diabetes, with earlier disease onset and worse metabolic profiles contributing to cardiovascular disease risk. • Despite a high burden of cardiovascular risk factors, racial and ethnic minorities experience disparities in CAD diagnosis, treatment, and outcomes, with lower rates of guideline-directed therapy, reperfusion strategies, and invasive procedures. • Racial and ethnic disparities exist in the diagnosis and treatment of valvular heart diseases, with lower access to surgical and transcatheter interventions.

A 42-year-old female with a history of tuberculosis treated with anti-tubercular therapy (ATT) presented with progressive abdominal distension for 7 years and shortness of breath for 2 years. Clinical evaluation, including echocardiography, revealed signs of constrictive pericarditis (Septal bounce). The patient underwent successful pericardiectomy, with marked improvement in cardiac function and resolution of ascites postoperatively. Histopathology confirmed fibrosed pericardial tissue, and microbiological studies were negative for active tuberculosis. This case highlights the importance of considering constrictive pericarditis along with ascites and deranged liver function as a long-term complication in patients with a history of tuberculosis.

Massive haemoptysis remains a serious clinical emergency, often requiring urgent intervention to control bleeding. Rasmussen aneurysm, a rare vascular complication associated with chronic infections such as tuberculosis, is one of the causes of massive haemoptysis. Bronchial and pulmonary artery embolization have emerged as effective therapeutic strategies for controlling such haemorrhages. A 55-year-old male with a history of treated pulmonary tuberculosis presented with sudden onset of massive haemoptysis. Imaging studies revealed a Rasmussen aneurysm arising from a pulmonary artery branch. Bronchial artery embolization was first performed to control bleeding from the bronchial arteries, followed by pulmonary artery embolization to address the pseudoaneurysm. The patient showed immediate cessation of haemoptysis following embolization, with stabilization of his hemodynamic status. Post-procedure imaging confirmed the successful occlusion of the bleeding vessels. This case report discusses the role of embolization in massive haemoptysis with Rasmussen aneurysm.

Vascular access site complications, including infections, have become increasingly prevalent with the rise of interventional procedures. This case report presents a 48-year-old male with a history of coronary artery disease who developed a rare intra-arterial abscess following angioplasty and stenting of the right superficial femoral artery through the left femoral access. Initially, the patient underwent percutaneous coronary intervention (PCI) via the right femoral artery, followed by peripheral angioplasty and stenting for right femoral artery stenosis. Postprocedure, he developed a superficial abscess at the right groin, which persisted despite initial drainage and medical therapy. Surgical exploration during debridement revealed extensive arterial destruction, with complete femoral artery destruction, thrombosis both proximal and distal to the stent, and a localized infected stent. The patient was initiated on culture-directed antibiotic therapy. This case highlights the rare but severe complication of intra-arterial abscess formation following endovascular procedures, with significant potential for stent thrombosis, vessel rupture, and arterial destruction. It underscores the critical need for routine antibiotic prophylaxis, vigilant post-procedural surveillance, and prompt intervention in cases of stent infection. Furthermore, it emphasizes the importance of deferring revascularization procedures until the infection has resolved to mitigate the risk of further complications.

Dr. John Heysham Gibbon was a pioneering American surgeon & researcher renowned for his groundbreaking work in developing the Heart Lung machine, which revolutionized cardiac surgery by making open-heart procedures possible. His work transformed the field of open-heart surgery by enabling procedures that required stopping the heart while maintaining circulation through mechanical means. His invention of Heart–Lung machine stands as a monumental contribution to both medical science and clinical practice.