Navigating the Unexpected: Right Aortic Arch Unveiled During Left Heart Catheterization.

A right aortic arch (RAA) is an extremely rare congenital anomaly with seven identified variants. While most variants are asymptomatic, those with a vascular ring can be associated with severe symptoms. We present an incidental RAA finding during left heart catheterization (LHC) in a 68-year-old female with multiple morbidities presented with worsening angina. Her echocardiogram was significant for inferolateral wall akinesia, prompting LHC. The procedure was challenging with an unexpected course of the guide wire distally behind the cardiac shadow. Pressure tracing confirmed arterial access and contrast injection revealed RAA. A subsequent aortic computed tomography angiography (CTA) confirmed RAA with mirror-image branching. Abnormal origin and angle of aortic arch branches pose challenges in choosing the proper access. We used the right radial artery approach, but the left radial approach may be superior in providing a more proximal access and avoiding the abnormal origin of the right subclavian artery (RSA). Choosing the appropriate angiographic view is also of utmost importance, and the right anterior oblique view provided better visualization in our case. Aortic arch anomalies are confirmed by a CTA or magnetic resonance angiography (MRA) of the aorta. This case underscores the importance of identifying the aortic arch anomalies and the imposed challenges during the LHC.

COVID-19 Education for Health Professionals Caring for Spanish-Speaking Patients.

Introduction: The COVID-19 pandemic has disproportionately affected Hispanics in the United States, who make up 18% of US inhabitants but 29% of COVID-19 cases as of June 2021. Recent studies have attributed higher COVID-19 infection, hospitalization, and death rates among Hispanics to social determinants of health. Given that the majority of US Hispanics are bilingual or Spanish-dominant, it is imperative for health care providers to be prepared to discuss COVID-19 prevention and treatment in Spanish. Methods: We developed an interactive workshop aimed at increasing health professionals' confidence in discussing COVID-19 prevention, risk factors, and treatments with Spanish-speaking patients. Learners were expected to have an intermediate level or higher proficiency in medical Spanish. The workshop consisted of a PowerPoint presentation and English/Spanish scripts to facilitate interactive learning. The workshop was evaluated using a postworkshop questionnaire to assess learners' perceived confidence in communicating with Spanish-speaking patients. Results: The workshop was implemented with 70 participants, who had diverse ethnoracial identities and professional roles, at five different medical schools. Fifty-three participants completed the postworkshop questionnaire. More than 50% reported near complete to complete confidence in meeting the three learning objectives. Discussion: With Hispanics being the largest non-White ethnoracial group in the US and being disproportionally affected by COVID-19, it is essential for health professionals to access training tools that allow them to practice medical Spanish. This module can uniquely aid in the preparation of health professionals caring for Spanish-speaking patients who present with COVID-19 symptoms.