Background

We describe a unique case of fulminant myocarditis in a patient with presumed SARS-CoV-2 reinfection. Patient had initial infection 4 months backand had COVID-19 antibody at the time of presentation. Endomyocardial biopsy showed lymphocytic myocarditis, that is usually seen in viral myocarditis. The molecular diagnostic testing of the endomyocardial biopsy for cardiotropic viruses was positive for Parvovirus and negative for SARS-CoV-2. Authors highly suspect co-infection of SARS-CoV-2 and Parvovirus, that possibly triggered the immune cascade resulting in fulminant myocarditis. Patient was hemodynamically unstable with ventricular tachycardia and was supported on VA ECMO and Impella CP. There was impressive recovery of left ventricular function within 48 hours, leading to decannulation of VA ECMO in 72 h. This unique case was written by the survivor herself.

No abstract

Despite therapy with multiple optimally dosed medications, hypertension remains poorly controlled in a sizeable number of people worldwide. This has spurred interest in exploring other pharmacologic and nonpharmacologic options for treatment. The carotid baroreceptors are important in regulating blood pressure in chronic hypertension by centrally mediated sympathoinhibitory effects and other effects. This has led to renewed interest in treating hypertension by electrically stimulating the carotid baroreceptors. Although this concept was fi rst studied several decades ago, modern technology and better understanding of physiology have fi nally allowed the development of a feasible treatment option. Ongoing trials are fi nding signifi cant and sustained reductions in blood pressure, a good safety profi le, and tolerable side-effects. These promising results indicate that this modality has the potential to become a useful tool in future treatment of hypertension.

Obstructive sleep apnea-hypoapnea syndrome (OSA) is a disorder that results in repetitive occlusion of the airway and hypoxemia during sleep. Epidemiologic studies have associated this disorder with increased cardiovascular morbidity and mortality. Systemic hypertension is prevalent among patients with OSA and has been recognized as a common identifiable cause of hypertension. Nasal continuous positive airway pressure (nCPAP) ventilation is an effective therapy for OSA and it may additionally reduce blood pressure. The use of nCPAP ventilation to treat hypertension in patients with OSA has been studied extensively. However, whether it is effective in treating hypertension in this population remains unclear. This review evaluates the recent literature that investigates the effects of nCPAP ventilation on hypertension in patients with OSA.