Background: Influenza vaccination (IV) and Pneumococcus vaccination (PV) are recommended for patients with cardiometabolic diseases. This study aimed to evaluate the immunization rate of ambulatory cardiometabolic patients during the COVID-19 pandemic in the Americas. Methods: Electronic surveys were collected from 13 Spanish speaking countries between 15 June and 15 July 2020. Results: 4216 patients were analyzed. Mean age 60 (±15) years and 49% females. Global IV rate was 46.5% and PV 24.6%. Vaccinated patients were older (IV = 63 vs. 58 years; PV = 68 vs. 59, p < 0.01) but without gender difference. Vaccination rates were greater in higher-risk groups (65+, diabetics, heart failure), but not in coronary artery disease patients. In the Southern cone, the rate of IV and PV was approximately double that in the tropical regions of the Americas. In a multivariate model, geographic zone (IV = OR 2.02, PV = OR 2.42, p < 0.001), age (IV = OR 1.023, PV = OR 1.035, p < 0.001), and incomes (IV = OR 1.28, PV = OR 1.58, p < 0.001) were predictors for vaccination. Conclusions: During the COVID-19 pandemic, ambulatory patients with cardiometabolic diseases from the Americas with no evidence of COVID-19 infection had lower-than-expected rates of IV and PV. Geographic, social, and cultural differences were found, and they should be explored in depth.

In 2020, there was an estimated prevalence of more than 1.8 million adults with congenital heart disease (ACHDs) living in South America, and 677,000 in Central America and the Caribbean. The ACHD mortality is higher in developing countries, compared with developed countries, and it has been shown that concentrating this population in specialized ACHD units improves their survival and prognosis. Currently, Latin American (LATAM) and Caribbean countries have an insufficient number of specialists and specialized ACHD units. Analyzing this situation, the Inter-American Society of Cardiology's (IASC) ACHD chapter and Pediatric Cardiology Council have prepared the first recommendations for developing ACHD units in LATAM and Caribbean countries. This article is the first collaborative work between South American, Central American and Caribbean countries. It describes the main points for organizing and developing ACHD units adapted to our own reality. Each point has been discussed in terms of barriers and challenges, followed by specific recommendations for improving and developing ACHD care. They have been reviewed and endorsed by the International Society for Adult Congenital Heart Disease (ISACHD), and the goal of their implementation is for each ACHD unit in the region to have the standards of quality and efficiency to improve the prognosis and survival of ACHDs in the region.

Congenital heart disease (CHD) in America has a global prevalence of 8-13 cases per 1,000 live births, with close to 45% being of medium and high complexity. Mortality continues to be high in Latin America and the Caribbean, with wide disparities in care, compared to North American countries. Fifty years ago, only 15% of children with CHD survived to age 18. Today, survival is greater than 90% in most countries worldwide. Currently, there are 2.2 million adults with congenital heart disease in the United States, with more than 1.8 million in South America. According to the Adult Congenital Heart Association, fewer than 10% of adults with congenital heart disease are estimated to be under specialized care, and more than 200 regional centers would be needed in the United States to meet the needs of this rapidly growing population. However, there are only 35 accredited programs in a total of 23 states. The scenario for Latin America and the Caribbean is bleaker and more distant, needing at least 249 programs, but lacking a formal census of centers and having few cardiologists who are experts in adult congenital heart disease. At the same time, there are insufficient paediatric cardiovascular centers. Thus, these countries have a double problem (children and adults with congenital heart disease, at the same time). In 2018, the Inter-American Society of Cardiology´s Inter-American Congenital Heart Disease Council was founded, which is working on various inter-American projects seeking to improve health care for adults with congenital heart disease.

Scholarly articles on cardiology Journal of Cardiology & Cardiovascular Therapy is an Open Access, international peer reviewed journal launched from Juniper Publishers. Cardiology is a branch of medicine deals with the disorders of heart that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular diseases. Congenital heart disease is the most frequent malformation, many cases are complex cyanotic congenital heart defects characterized by low arterial oxygen saturation. Unrepaired intracardiac or extracardiac congenital heart defects which causes a persistent right to left shunt, they are responsible for hypoxemic syndrome, this is a multisystemic disorder affecting various organs and symstems: hematopoietic, central nervous, gastrointestinal, urinary, cardiovascular, Immune, musculoskeletal and endocrine. The objective this review is to explain the pathophysiological mechanisms adapted to the chronic hypoxia, the consequences derived from the affectation in the different systems. The diagnostic approach and management in centers specialized in adults with congenital heart disease. This review was made with articles search sources in databases PubMed, ScienceDirect, OVID, HINARI, SciELO, MD Consult. At the end of the article review recommendations on lifestyle, exercise, travel, non-cardiac surgery, contraception and pregnancy, are given.