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NATIONAL FE ATURE THE ANTICIPATED EFFECTS OF COVID-19 ON THE MEDICAL COST TREND IN 2021 05 The medica l cost trend could rise as much as 10% this year, according to PwC's Hea lth Research Institute. Deferred in-person visits, expanded telehea lth offerings and increased coverage for menta l hea lth are fueling the ups and downs. COVER FE ATURE UNPARALLELED CARE AT PENN STATE HEART AND VASCULAR INSTITUTE 06 Researchers are constantly pushing cardiovascular care forward with a combination of leading-edge clinica l tria ls and in-depth medica l education. SPECIAL CLINICAL SECTION: CARDIOLOGY BEST PRACTICES DEFINED FOR GENETIC TESTING IN CARDIAC AND VASCULAR DISEASES 13 Genetic testing for certain cardiovascular diseases provides insights for customized prevention and treatment approaches; however, the benefits may accrue to only a subset of patients. CLINICAL SECTION | CARDIOLOGY CARDIOVASCUL AR CARE CONTINUE TO MOVE FORWARD. IN THIS SECTION, OF THE HIGHLIGHTS OF THOSE ADVANCES. 11/24/20 1:56 PM work with and street and leave the page mechanical is complete special are only Dan's books turn them creating CARDIAC DAMAGE + Dilation of coronary blood vessels + Reduced ejection fraction + Aneurysm of coronary vessels HOPE FOR TREATMENT Most children responded well to a quick administration of glucocorticosteroids and intravenous immunoglobulin. QUESTIONS STILL TO BE ANSWERED MIS-C SIGNS TO WATCH FOR IN PATIENT CARE + Gastrointestinal symptoms + Persistent fever + Rash + Bloodshot eyes + Decreased function of heart and lungs *It's very important for children diagnosed with MIS-C to have regular check-ups, especially of the heart. This can lead to a more prompt recognition of MIS-C complications and immediate course of treatment. Children diagnosed with MIS-C should also have regular follow-ups with a cardiologist to monitor increased lifetime risk of clots, heart attack and stroke. CASE STUDIES REVIEWED A recent medical literature review published in EClinicalMedicine, a journal of The Lancet, reviewed 662 worldwide cases of MIS-C to provide more insight on the condition. Alvaro Moreira, MD, MSc, a neonatologist, assistant professor of pediatrics at the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio and contributor to the study, shares what is currently known about the cardiovascular implications of MIS-C: + Up to 71% of reviewed cases were admitted to intensive care. + Approximately 60% of cases reviewed presented with cardiac collapse or shock. + More than half of the 60% of cases presenting with cardiac collapse or shock required cardiac medication to deliver oxygen to tissues. + Out of 90% of children who had an EKG, 54% had abnormal results. + 11 of the 662 patients died. + Why are people of cer tain races and ethnicities more prone to develop the condition? + How is MIS-C comparable to MIS-A (Adult)? + How many children will have long-term consequences to their heart? + Can we predict which patients will have serious cardiovascular complications? 98% Percentage of MIS-C cases tested positive for SARS CoV-2 2% Percentage of MIS-C patients who were in close proximity with someone diagnosed with COVID-19 75% Percentage of cases occurring in Hispanic, Latino and Black populations children (MIS-C) is a condition that causes widespread inflammation to a child's vital organ systems, including the cardiovascular system. 059990064_0221_DV_MIS_C.indd 1 11/24/20 2:02 PM 06 contents ON THE COVER /////// ISSUE NO. 3, 2021 WHAT DOES ISCHEMIA MEAN FOR INTERVENTIONAL CARDIOLOGY? 14 W hile a multi-year study showed medication and lifestyle changes may be as effective as more invasive procedures for patients with stable ischemic heart disease, stents and bypass procedures for patients with angina resulted in lower rates of heart attacks and other cardiac events. DATA VAULT 15 A roundup of information about MIS-C, a condition that causes widespread inflammation to a child's vita l organ systems, including the cardiovascular system. 12 15