Purpose of Review: To provide an overview of the diagnosis and updated therapeutic approach to autoimmune pericarditis. Recent Findings: Subtypes of autoimmune pericarditis may benefit from IL-1 inhibition and future phenotyping based on clinical presentation, biomarkers, and imaging may aid in guiding future therapeutic approaches. Summary: Autoimmune pericarditis is a unique phenotype of pericarditis for which there is scarce data. The clinical spectrum of pericardial involvement associated with autoimmune disorders varies in acuity, recurrence, severity, and symptomatic presentation. There is a pathophysiologic distinction that separates autoimmune and autoinflammatory pericarditis from other pericarditis presentations. This review explores the state of the art in diagnosis and therapeutic management.

High-output heart failure can be a complication of having an arteriovenous fistula (or graft) for hemodialysis access. This review details the pathophysiology, diagnosis, and management of this serious but underdiagnosed condition.

Patients with autoimmune connective tissue diseases (CTDs) have a high burden of valvular heart disease and are often thought of as high surgical risk patients. Patients undergoing aortic valve replacement (AVR) were identified in the Nationwide Readmissions Database between January 2012 and December 2018. Patients with a history of systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, mixed C, Sjögren syndrome, polymyositis, and dermatomyositis were included in the CTD cohort. Patients undergoing coronary artery bypass grafting concomitantly with AVR were excluded. A total of 569 600 hospitalizations were included, of which16 531 (2.9%) had CTD. CTD patients were more likely to be females, with higher rates of heart failure, pulmonary hypertension, and more likely to be insured by Medicare. CTD patients had lower mortality than non-CTD patients [odds ratio (OR) 0.66; 95% confidence interval (CI): 0.59–0.74] and stroke [OR 0.87; 95% (CI): 0.79–0.97]. CTD patients undergoing SAVR had lower mortality [OR 0.69; 95% (CI): 0.60–0.80] and stroke [OR 0.86; 95% (CI): 0.75–0.98). CTD patients undergoing TAVR had lower mortality outcomes [OR 0.67; 95% (CI): 0.56–0.80]; however, they had comparable stroke outcomes [OR 0.97; 95% (CI): 0.83–1.13, P = 0.69]. Outcomes for patients with CTD requiring AVR are not inferior to their non-CTD counterparts. A comprehensive heart team selection of patients undergoing AVR approaches should place CTD history under consideration; however, pre-existing CTD should not be prohibitive of AVR interventions. Outcomes of patients with autoimmune connective tissue disorders undergoing aortic valve replacement and lessons learned from current study findings.

Background: ECGs are a primary assessment of cardiac structure and function. Alignment of their findings with cardiac imaging is not well defined. This study investigates the correlation of left atrial enlargement and left ventricular hypertrophy (LVH) found on ECG with transthoracic echocardiogram and cardiac magnetic resonance imaging (CMR) findings. Methods: This is a single‐center retrospective study of 1000 patients. It included patients with positive ECG criteria for left atrial enlargement or left ventricular hypertrophy (LVH) with transthoracic echocardiograms done within the same month. CMR data were included if within 6 months of the ECG. Receiver operator curves and area under the curves (AUC) were calculated based on whether ECG findings were confirmed on either imaging. Results: Left atrial enlargement ECG criteria best correlating with transthoracic echocardiograms were p‐wave duration of 120+ ms in lead II (AUC, 0.81 [95% CI, 0.79–0.83]; P value <0.0001) followed by negative p‐wave deflection of 1+ mm and 40 ms + in lead V1 (AUC, 0.59 [95% CI, 0.57–0.62]; P value <0.0001). CMR mirrored similar findings. For LVH ECG criteria compared with transthoracic echocardiograms, Romhilt–Estes criteria demonstrated the strongest correlation (AUC, 0.72 [95% CI, 0.69–0.74]; P value <0.0001), followed by Sokolow–Lyon (AUC, 0.67 [95% CI, 0.64–0.69]; P value<0.0001), Modified Cornell (AUC, 0.65 [95% CI, 0.63–0.68]; P <0001), and Cornell (AUC, 0.61 [95% CI 0.58–0.63]; P value<0.0001). CMR data corroborated this pattern. LAE and LVH criteria with the highest AUC were least represented by patients. Conclusions: ECG criteria for left atrial enlargement and LVH correlated poorly with both transthoracic echocardiograms and CMR. Updating current waveform criteria may improve diagnostic accuracy of ECGs.