Indian Journal of Clinical Cardiology

Cardiovascular disease represents a significant and growing public health challenge in India, with a notably higher burden of premature deaths compared to global averages. Concurrently, influenza infections contribute substantially to this burden by triggering cardiovascular complications, particularly among high-risk individuals. Despite evidence supporting the cardioprotective benefits of influenza vaccination, its integration into standard cardiology practice remains inconsistent. This consensus aims to deliver a comprehensive and detailed summary of the impact of influenza infections on cardiovascular disease, particularly in the Indian context, and to advocate for the adoption of influenza immunization as a defense against cardiac distress. The findings emphasize the importance of influenza vaccination in reducing the incidence of acute coronary syndrome, myocardial infarction, and other severe cardiovascular complications. It also discusses expert opinions concerning the role of vaccination against influenza in cardiovascular disease patients, highlighting the necessity of broader implementation in high-risk populations.

Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting millions globally and significantly increasing the risk of stroke, heart failure, and mortality. Traditional detection methods often fail to identify paroxysmal or asymptomatic atrial fibrillation, leaving many patients undiagnosed until serious complications arise. The proliferation of consumer-grade wearable technology, particularly smartwatches and smartphones with advanced sensing capabilities, has created unprecedented opportunities for large-scale, cost-effective atrial fibrillation screening. This review examines the current evidence regarding the accuracy, feasibility, and clinical impact of smartphone and smartwatch-based atrial fibrillation detection technologies. We analyze various technologies, including smartphone-based electrocardiogram attachments, photoplethysmography applications, and smartwatch algorithms, evaluating their diagnostic performance, implementation challenges, and potential for integration into clinical practice. The evidence suggests these technologies demonstrate promising diagnostic accuracy with sensitivity and specificity often exceeding 95% in controlled settings, though performance may vary in real-world conditions. Successful large-scale screening initiatives demonstrate the feasibility of technology-based approaches, while ongoing research continues to address limitations related to false positives, user adherence, and clinical workflow integration. As these technologies evolve, they stand to revolutionize atrial fibrillation screening paradigms, enabling earlier intervention and potentially reducing atrial fibrillation-related morbidity and mortality.

Pulmonary endarterectomy is the only potentially curable treatment of choice for chronic thromboembolic pulmonary hypertension, while balloon pulmonary angioplasty has been advocated for peripheral (distal) chronic thromboembolic pulmonary hypertension. In an environment where experts for surgical interventions are not readily available, oral medications should be considered early, especially when the distal pulmonary vessels are affected. We present a 43-year-old male diagnosed with elephantiasis of the left leg at 20 years of age. He presented at the emergency room with a 6-month history of progressive dyspnea, easy fatigability, cough with hemoptysis, and World Health Organization functional class IV. Electrocardiogram findings were consistent with pulmonary embolism. He had transthoracic echocardiography and also chest computed tomography pulmonary angiography, which confirmed peripheral chronic thromboembolic pulmonary hypertension. He was commenced on oral medications with significant improvement in prognostic variables such as 6-minute walk test, World Health Organization functional class, and oxygen saturation even a year after commencement.

Ebstein’s anomaly is an infrequent congenital malformation of the heart, in which the septal and posterior leaflets of the tricuspid valve are displaced to the apex, leading to partial “atrialization” of the right ventricle. Its clinical presentation varies widely, contingent on its severity and any co-occurring cardiac anomalies. Although most cases are identified in childhood, some individuals remain asymptomatic and may not be diagnosed until later in life. Conversely, rheumatic mitral valve disease represents one of the major causes of acquired cardiac disorders among children and young adults, particularly in developing regions such as India. Despite a significant decline in rheumatic heart disease incidence in India recently, it still poses a major public health challenge. Existing rheumatic heart disease studies report an average prevalence of 0.5 per 1,000 children aged 5-15 years. This report details the unusual co-occurrence of Ebstein’s anomaly and mitral valve stenosis rheumatic in origin in a 65-year-old man, a rare finding in an unoperated patient of this age.

Cardiovascular disease remains the leading global cause of death, with its burden exacerbated by rising rates of diabetes mellitus and obesity. Recent therapeutic advances have revealed the dual potential of novel antidiabetic agents—not only to improve glycemic control but also to significantly reduce cardiovascular and renal morbidity.

This report explores the emerging roles of sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in cardiovascular disease management. Evidence from major clinical trials highlights their efficacy in reducing heart failure hospitalizations, atherosclerotic events, and in slowing the progression of chronic kidney disease. The discussion emphasizes the mechanisms beyond glycemic control that underpin their cardio-renal benefits, and reflects on the paradigm shift towards integrated, multi-system disease management. These developments signify a promising future where metabolic therapies play a central role in cardiovascular care.

Right bundle branch block remains an intriguing cardiac conundrum, presenting challenges in diagnosis, prognostication, and management. Despite being a relatively common electrocardiographic finding, its clinical significance and underlying pathophysiology continue to perplex clinicians and researchers. This case series aims to delve into the enigmatic nature of right bundle branch block, exploring its epidemiology, etiology, diagnostic modalities, clinical implications, and therapeutic considerations. Through a comprehensive review of current literature and emerging insights, we endeavor to shed light on this intriguing cardiac phenomenon and pave the way for enhanced understanding and management strategies.

We report a unique echocardiographic sign, pathognomonic of a rare but serious complication of acute coronary syndrome.

Mitral annular disjunction is a structural abnormality characterized by atrial displacement of the mitral valve annulus or leaflet hinge point away from the ventricular myocardium. This anomaly is frequently associated with mitral valve prolapse, leaflet degeneration, and fibrosis of the papillary muscles and myocardium, and is increasingly recognized as a substrate for malignant ventricular arrhythmias. Mitral annular disjunction contributes to paradoxical systolic annular expansion and has been linked to arrhythmogenic mitral valve prolapse, with a higher risk of ventricular arrhythmias and sudden cardiac death. A disjunction length of ≥5 mm is considered clinically significant for predicting arrhythmic risk. Cardiac magnetic resonance imaging plays a pivotal role in identifying and quantifying mitral annular disjunction, assessing coexistent mitral valve prolapse, and detecting myocardial and papillary muscle fibrosis. These insights are vital for risk stratification and guiding patient management, particularly regarding electrophysiological interventions and surgical repair.

This journal scan highlights key research articles from cardiovascular journals published between June and October 2025. Happy reading.