First Report of Acute Myocarditis Post-Pfizer-BioNTech COVID-19 Vaccination in the Kingdom of Bahrain.

We present a case of a 24-year-old male patient who presented to our institution five days after receiving his first dose of Pfizer-BioNTech vaccine to rule out acute coronary syndrome due to chest pain along with troponin increase and ECG changes. Acute coronavirus disease 2019 (COVID-19) infection was excluded based on a negative real-time reverse transcription-polymerase chain reaction (RT-PCR) test of specimens acquired using nasopharyngeal swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and all other viral serologies were found to be negative. Coronary angiogram showed normal coronaries, and the presence of late gadolinium enhancement, which is indicative of myocarditis, was identified using cardiac magnetic resonance imaging (MRI). Our case report raises concern that the COVID-19 vaccine may cause myocarditis as a rare side effect.

Transcatheter Aortic Valve Implantation: Bahrain Experience.

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that is considered a good alternative to surgical aortic valve replacement (sAVR) in selected patients. Our aim is to determine the baseline, procedural characteristics and one-year clinical outcomes of our TAVI registry. METHODS: This study is a retrospective observational analysis of a prospectively designed cohort comprising 81 consecutive patients treated at Mohammed bin Khalifa Cardiac Centre (MKCC) who were enrolled in Bahrain TAVI registry from February 2014 to February 2019. The clinical endpoints were defined according to the updated Valve Academic Research Consortium-2 (VARC-2) consensus document. RESULTS: Out of the 81 patients included in our study, there were 37 (45.7%) males. The mean age was 76.4 ± 8.9 years with a mean Logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE II) of 4.1 ± 2.5 and a mean Society of Thoracic Surgery (STS) Risk Score of 4.2 ± 3.5. Evolute-R valve was used for 36 (44.4%) patients, Edward Sapien for 26 patients (32.1%), and Core valve for 19 patients (23.5%). At one year follow up, all-cause death was reported in three (3.7%) patients; none of them was cardiovascular mortality. As per VARC-II criteria, no cases fulfilled the criteria of valve dysfunction but TAVI-related complications (i.e., TAV-in-TAV deployment) were reported in four (4.9%) cases. One (1.2%) case of major bleeding was encountered but no patient experienced life-threatening bleeding. Major vascular complications were documented in two patients (2.5%) only. Significant Acute Kidney Injury (AKI) occurred in two (2.5%) patients, both classified as stage-2 but no one deteriorated to stage-3 or hemodialysis. Seven (8.6%) patients required permanent pacemakers, and all were implanted during the index admission for TAVI. One patient (1.2%) had stroke and all survivors completed one-year follow up. CONCLUSION: The TAVI program in Bahrain is encouraging and corresponds to the finest international centers outcomes in terms of procedural success and complications rate.

Spontaneous left atrial multiseptated intramural dissecting hematoma.

Our case was initially admitted with chest discomfort and congestive heart failure with a presumptive diagnosis of non-ST segment elevation myocardial infarction and was later found to have a large left atrial (LA) mass. In addition to a complete echocardiography study, multimodality imaging was utilized to better characterize the LA mass. Despite this, the diagnosis could not be confirmed. It was decided to proceed to cardiac surgery, and surprisingly, this revealed a large LA mass with pockets of fresh blood within the LA. Pathological specimen examination confirmed a diagnosis of thrombus, effectively outruling other atrial neoplasms. Although contrast echocardiography and cardiac magnetic resonance imaging suggested this diagnosis, in the absence of any predisposing factors, the final diagnosis was made at surgery and histopathological examination.

Computerized Tomography Use in Williams-Beuren Syndrome Aortopathy.

Williams-Beuren syndrome is a multisystem genetic disorder caused by hemizygous deletion on chromosome 7q11.23, encompassing about 28 genes including the elastin gene, ELN. Cardiovascular abnormalities are frequent and are related to elastin insufficiency. These abnormalities include supravalvular aortic stenosis (SVAS) in 70% of case, pulmonic valve stenosis, and renal artery stenosis. Definitive therapy for supravalvar aortic stenosis consists of surgical correction of the arteriopathies. Outcomes after surgical correction of SVAS depend on the extent of the arteriopathy and the presence of other associated lesions. We present a case of a 4-year-old boy, with Williams - Beuren syndrome with an SVAS. The patient was assessed with computerized tomography angiography to determine the extent of the aortopathy before surgical intervention.