Introduction: Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean. Objective: To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas. Methods: The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF). Results: Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41–49%) were on this treatment. Conclusion: The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.

Background: An advanced age elevates risk for COVID-19-related cardiovascular complications and mortality. This study analyzes cardiovascular comorbidities and outcomes in hospitalized COVID-19 patients across age groups to assess its impact. Methods: The CARDIO COVID 19-20 registry is a prospective, multicenter cohort study of hospitalized SARS-CoV-2 patients across 44 institutions in 14 Latin American countries. Patients were categorized into four age groups, Group 1: under 40 years, Group 2: 40 to 64 years, Group 3: 65 to 79 years, and Group 4: 80 years or older. Results: A total of 3260 patients were included. A total of 36.8% were women, and key comorbidities included overweight/obesity (49.7% [G1: 48.9%, G2: 56.3%, G3: 45.6%, G4: 32.7%]), and hypertension (49% [G1: 11.3%, G2: 40.3%, G3: 67.9%, G4: 80.4%]). Primary cardiovascular complications during hospitalization were arrhythmias (9.1% [G1: 3.4%, G2: 6.1%, G3: 14.9%, G4: 12.9%]), and acute heart failure (8.5% [G1: 3.6%, G2: 6.1%, G3: 12.1%, and G4: 15.2%]). In our cohort, 53.5% of the patients were admitted to the intensive care unit (G1: 49.2%, G2: 57%, G3: 55.3%, G4: 38.3%). In-hospital mortality rose significantly in patients aged 65 and older; G3: 334 (34.7%) and G4: 156 (45.6%) (p value: <0.001). Conclusions: In Latin American COVID-19 patients, older age correlates with more comorbidities, cardiovascular complications, and higher in-hospital and 30-day mortality, indicating age as an independent mortality factor.

Background: Atrial fibrillation (AF) is a prevalent and sustained arrhythmia in adults, with an estimated global prevalence of 37.5 million cases in 2017. While it primarily affects elderly individuals with structural heart disease (prevalence >10% after age 80), it can also occur in younger individuals, albeit with a much lower prevalence (<1% in those aged <40 years). Increasing knowledge about the pathophysiology of AF shows that in every patient there may be an underlying cause, which, although it cannot be discovered in all patients, should be explored, especially in young patients without risk factors. Case Summary: We present a case of paroxysmal atrial fibrillation (PAF) in a 37-year-old female patient with no cardiovascular risk factors. The PAF was likely associated with an atypically located thymic cyst over the left atrium, which was incidentally discovered during an intracardiac echocardiogram (ICE) performed for pulmonary vein isolation. Subsequently, surgical cyst extraction was performed, resulting in improved episodes of atrial fibrillation. Discussion: This case underscores the importance of considering uncommon anatomical variations when evaluating and managing AF. It also highlights the need for further research and understanding of Non-valvular AF, particularly in cases associated with thymic abnormalities, to better inform clinical decision-making and enhance patient outcomes.

Background: Dilated cardiomyopathy is a leading cause of heart failure and heart transplantation. Among its etiologies, genetic variants account for up to 35% of cases. Variants in the FLNC gene have gained recognition due to their association with a higher risk of major ventricular arrhythmias and sudden cardiac death. Early identification and intervention are critical to improving patient outcomes. Case Presentation: We present the case of a 28‐year‐old male with no cardiovascular history who presented with ischemic stroke. Neurological improvement was noted following thrombolysis. Extensive testing ruled out infectious, thrombotic, and autoimmune causes. Subsequent evaluation revealed severe left ventricular systolic dysfunction (ejection fraction of 20%) and biventricular dilated cardiomyopathy. Genetic testing identified a likely pathogenic FLNC variant NM_001458.5(FLNC):c.1156G>T; p.Glu386∗, confirming the diagnosis of FLNC ‐associated dilated cardiomyopathy. Discussion: This case highlights the importance of investigating genetic causes in young patients presenting with unexplained dilated cardiomyopathy. Although truncating FLNC mutations are rare, they are associated with adverse outcomes, including major ventricular arrhythmias and sudden cardiac death. Atypical biventricular involvement suggests overlapping phenotypes, complicating the diagnostic process. Advanced imaging modalities, comprehensive management strategies, and early genetic testing are crucial to optimizing patient outcomes.