Background: An estimated 33% reduction in cardiovascular events can be achieved when incorporating whole grains, fruits, vegetables, poultry, nuts, and vegetable oils in the diet along with reduced consumption of refined carbohydrates, processed meats, and sugar sweetened beverages. We performed a systematic review to analyze the impact of nutritional intervention on stroke risk, as there is no current consensus concerning dietary recommendation for primary and secondary stroke prevention. Methods: A literature search of the PubMed database from January 2010 to June 2020 was performed using combinations of the following search terms: carotid disease, carotid artery disease, carotid stenosis, carotid intima-media thickness (CIMT), diet, nutrition, micronutrition, embolic stroke, and stroke. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist. Results: 28 studies met our inclusion criteria. Multiple studies showed an inverse relationship between consumption of vegetables and fruits and stroke risk. Vitamin B12 or a combination of B Vitamins was the most common supplement studied in stroke prevention. Only one RCT showed the use of B12 (500 micrograms/day) correlated with lower CIMT at follow up in healthy vegetarians. Discussion: The key findings from this systematic review indicate that adopting a diet rich in fruits and vegetables earlier in life may lower stroke risk compared with meats and fat intake. B vitamins also appear to confer some protection against stroke. However, not enough data exists to support the use of multivitamins, calcium, soy products and other supplements for primary or secondary stroke prevention.

Approximately 200 million people worldwide suffer from ischemic heart disease. Coronary artery bypass grafting (CABG) is known as a treatment option for multivessel and left main coronary artery disease, with better survival rates and lower major adverse cardiac events compared with medical therapy or percutaneous cardiovascular intervention alone in several cases. Lifestyle following CABG has been written about extensively; however, the creation of a general, evidence-based guide for both patients and physicians across different specialties appears necessary, given the overwhelming amount of literature available, the continued refinement of guidelines, and technological advancements over time. We reviewed the latest data on CABG in both the United States and worldwide, utilizing consensus statements from the American Heart Association/American College of Cardiology and European Society of Cardiology literature, as well as the PubMed database and UpToDate, to obtain the most up-to-date information on these topics. We then organized our findings into multiple categories detailing surgical techniques, postoperative care, medication types, long-term prognosis, the importance of cardiopulmonary rehabilitation, as well as future directions.

Adventitial cystic disease (ACD) is an uncommon condition that generally occurs at the popliteal artery but, rarely, can occur in the external iliac artery. To date, only eight cases of ACD occurring in the external iliac artery have been reported. We have reported the case of a 29-year-old man who had presented with new-onset claudication. Despite an extensive imaging workup, ACD was not confirmed until the gross intraoperative examination. We have reported our process of diagnosis and treatment in addition to that reported in previous studies to enhance the historical fund of knowledge for this rare pathology.

Background: Sudden cardiac arrest (SCA) is the leading cause of student-athlete mortality, often described interchangeably as sudden cardiac death (SCD). For persons aged ≤35 years, structural heart disease, such as hypertrophic cardiomyopathy, is historically the most common etiology. Regarding individuals aged >35 years, coronary artery disease is the main contributor to SCD during exercise. Indications: Though some athletes may endure prodromal symptoms prior to a SCA, approximately 25% to 50% do not. Up to 23,000 people aged <18 years die from SCA annually. SCA athlete deaths are reported to be the most common medical cause of death and the second most common overall behind motor vehicle accidents in this population. Therefore, it is important to acknowledge SCA prevalence and identify at-risk competitors. Technique Description: If a SCA is suspected, first assess surroundings for safety and athlete response to commands. Should there be no pulse, activate code. If necessary, an athlete’s shirt may be removed or cut to better access the bare chest for the automated external defibrillator (AED) pads. Apply pads and commence compressions. Refer to the AED for a shockable rhythm between compression cycles. Establish intravenous access as appropriate and if feasible. After 1 cycle of compressions, a shock is administered when a shockable rhythm is detected. Resume compressions if a pulse is not reestablished. If a pulse is reestablished, the athlete should then be immediately transported to the hospital. Results: A literature review yields illustration of the multifactorial criteria that comprise return-to-sports guidelines, including activity intensity, extent of cardiac disease, and psychological/physical benefit from sport. SCD incidence is higher in competitive versus recreational athletes. In general, consolidation of these investigations makes it apparent that utilizing a shared decision-making process and a progressive exercise program is warranted prior to play resumption in most cases. The greatest SCA/SCD survival determinant is collapse to defibrillation time. Discussion/Conclusion: The American Heart Association/American College of Cardiology and the European Society of Cardiology recommend preparticipation cardiac screening to identify cardiac conditions that predispose to SCA/SCD risk. SCD prevention in athletes hinges on the prompt availability of quality cardiopulmonary resuscitation and AEDs. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Background: Sudden cardiac death (SCD) and sudden cardiac arrest (SCA) remain leading causes of mortality in young athletes, highlighting the importance of cardiac screening prior to play. The guidelines on screening protocol are continually evolving but are often inconsistent across organizations. We explore the role of different screening modalities including electrocardiography (ECG) and various cardiac imaging testing; their effectiveness, cost considerations and clinical utility regarding sports cardiac screening, comparing European and American cardiac screening protocols. Additionally, we also discuss the divergence between the European and American guidelines and appraise the literature surrounding this topic. Methods: A comprehensive literature review was conducted using studies published between 2010–2025 on cardiac screening for young athletes. Parameters included an English filter with review of observational studies, systematic reviews, meta-analyses, and randomized controlled trials (RCTs). Manual searches of PubMed, Embase, and Google Scholar libraries were also performed to enhance the reach of our investigation. Articles were chosen based on relevance to the topic. Results: When compared to PPCS physical exam, ECG advantages include increased detection of cardiac conditions leading to SCD, improved sensitivity and specificity compared to history alone, Disadvantages are the need for trained specialists to complete testing properly, unreliability for detecting congenital coronary anomalies, cost-effectiveness concerns, and false positive risk. However, these disadvantages can be improved with improved ECG interpretation training for non-cardiologists and policies easing access to advanced cardiac care. Conclusions: ECG remains the cornerstone of cardiovascular screening due to its affordability and sensitivity in detecting electrical abnormalities, its limitations necessitate a multimodal approach. Integrating targeted ECG screening with echocardiography and advanced imaging in select cases may enhance diagnostic accuracy while balancing cost-effectiveness and accessibility. While the benefits of routine ECG are strongly supported by the literature, nationwide implementation of it remains challenging due to economic, geographical and logistical restraints. Therefore, more research needs to be conducted on the mortality benefits and cost-effectiveness of routine ECGs implementation in PPCS screening for young athletes.

Ehlers-Danlos is a connective tissue disorder characterized by hypermobile joints, hyperextensible skin, and increased bleeding tendency. We report a case involving endovascular repair of an intussusception of aortic dissection that occurred in an Ehlers-Danlos patient following surgical repair of an intercostal artery bleed. Given the rarity of Ehlers-Danlos, continued reporting of treatment outcomes is important for refining complication management in this population. Our experience lends support for endovascular rescue of failed aortic repair that may arise in Ehlers-Danlos patients and contributes to the otherwise small body of literature concerning endovascular intervention in this population overall.