CASE REVIEW: The Great Chest Pain Mimic.

It was just quarter to 8 a.m. on a busy Tuesday morning in Lagos.

Fifty-two-year-old Mr. Abaniwonda had barely started his day as a commercial bus driver plying the Idiaraba-Ojuelegba route when a sudden excruciating pain shot across his chest. It was unlike the muscle aches he occasionally experienced after long hours behind his steering wheel. He later described it as if “something had suddenly torn inside his chest.”

Within minutes, some of the other bus drivers rushed him to the Lagos University Teaching Hospital (LUTH) accident and emergency department.

The cardiologists-on-call found the history all too familiar: A middle-aged man; severe chest pain; sweating; anxious; clutching his chest. Naturally, their first diagnosis was a myocardial infarction (MI); after all, MI is one of the most common and dangerous causes of sudden chest pain, and every minute counts. However, he kept repeating that the pain felt like something was tearing apart. He also complained that the pain radiated to his back, in between his scapula.

On examination, Mr. Abaniwonda’s blood pressure measured 185/95 mmHg in his right arm but 155/90 mmHg in his left. He had a noticeably weak left radial pulse compared to the right, and a diastolic murmur was heard on auscultation along the left sternal border. These findings prompted the doctors to consider other diagnoses.

An urgent Electrocardiogram (ECG) and CT angiogram of the thoracic aorta were ordered. ECG demonstrated sinus tachycardia with nonspecific ST-T wave changes but no convincing evidence of ST-segment elevation myocardial infarction (STEMI).

The diagnosis was immediately apparent on CT angiogram. Mr. Abaniwonda had acute aortic dissection. This condition occurs when there is a tear involving the intima layer of the ascending aorta allowing blood to dissect between the layers of the vessel wall, creating a false lumen that extends into the ascending aorta, aortic arch and sometimes the brachiocephalic vessels.

The cardiothoracic surgery unit was subsequently called upon to intervene.

Clinical Pearls

Acute aortic dissection remains one of the most lethal cardiovascular emergencies and is frequently referred to as “the great masquerader” because its presentation often resembles that of an acute myocardial infarction. Both conditions commonly present with severe chest pain, diaphoresis, and autonomic distress, making the initial distinction challenging.

However, careful attention to the clinical history often reveals important diagnostic pointers. Unlike the heavy, pressure-like chest discomfort classically associated with myocardial infarction, the pain of an acute aortic dissection is typically abrupt, reaches maximum intensity at onset, and is frequently described as sharp, tearing, or ripping. Radiation to the back (especially the interscapular region), pulse deficits, differences in blood pressure between the arms, and the presence of a new early diastolic murmur, are all features that should immediately raise suspicion for aortic dissection.

Recognizing these features directly influences management and can be lifesaving. Therapies routinely administered for acute myocardial infarction, including thrombolytic agents and anticoagulants when indicated, may precipitate life-threatening hemorrhage or extension of the dissection if the underlying diagnosis is an acute aortic dissection.

Fortunately for Mr. Abaniwonda, the diagnosis was made through careful clinical reasoning supported by targeted investigations. The ECG helped exclude an obvious STEMI, but it was the patient's history, physical examination, and prompt CT angiography that revealed the true cause of his chest pain and allowed lifesaving treatment to proceed without delay.

RESEARCH SPOTLIGHT

Microplastics and Heart Disease: Should Cardiologists Be Concerned?

Plastic has become an indispensable part of modern life. From food packaging and bottled water to clothing and household items, it surrounds us every day. As these products degrade over time, they release tiny fragments known as microplastics (measuring less than 5 mm) and even smaller nanoplastics, particles so small that they can be inhaled or ingested and eventually enter the bloodstream.

For years, the health implications of these particles remained largely speculative. However, emerging cardiovascular research is beginning to suggest that their effects may extend far beyond the environment.

A recent study presented at the European Society of Cardiology (ESC) Congress 2026 and published in the European Heart Journal compared blood samples obtained during coronary angiography from three groups of patients: those presenting with an acute ST-elevation myocardial infarction (STEMI), patients with chronic ischemic heart disease, and individuals with angiographically normal coronary arteries. Micro- and nanoplastics were detected in 84% of patients with acute myocardial infarction, compared with 40% of patients with chronic ischemic heart disease and 32% of those with normal coronary arteries.

So, does this mean that microplastics cause heart attacks? Not necessarily.

The study was observational and included only 61 participants, meaning it can demonstrate an association but cannot establish a cause-and-effect relationship. Other cardiovascular risk factors may partly explain the findings. Notably, participants with higher exposure to cigarette smoking and fine particulate air pollution were also more likely to have detectable micro and nanoplastics in their blood, making it difficult to separate the independent contribution of plastic particles from other environmental exposures.

Nevertheless, the biological hypothesis is plausible. Laboratory and animal studies suggest that micro and nanoplastics may promote oxidative stress, endothelial dysfunction, chronic inflammation, and plaque instability. These are all mechanisms known to contribute to atherosclerosis and acute coronary syndromes. The investigators also observed higher levels of inflammatory markers among participants with greater microplastic burdens, further supporting the need for continued research.

It is important to note that these findings do not stand alone. In 2024, a landmark study published in the New England Journal of Medicine reported that patients with micro and nanoplastics embedded within carotid atherosclerotic plaques had a significantly higher risk of myocardial infarction, stroke, or death during follow-up than those whose plaques did not contain these particles. Together, these studies suggest that environmental plastic exposure may represent a previously underrecognized risk factor in cardiovascular disease, although much remains to be understood before any causal conclusions can be drawn.

Why this matters

Cardiovascular disease prevention has largely focused on familiar risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, and physical inactivity. Research into microplastics raises a new possibility that environmental pollutants may also contribute to cardiovascular risk.

For now, there is no evidence that reducing microplastic exposure alone prevents heart attacks. However, the study highlights the growing importance of environmental health in cardiovascular medicine and reinforces the need for larger, prospective studies to determine whether these particles are harmless bystanders or active participants in the development of atherosclerotic disease.

UPCOMING EVENTS

The Global Cardiovascular Symposium

The 13th Annual Global Cardiovascular Symposium- GCVS 2026 is currently underway. It holds as a series of virtual multi-session webinars that takes place across the weekends in August 2026. The symposium will bring together leading cardiovascular experts from across the globe to discuss the latest advances in cardiovascular medicine, with a focus on improving heart care in Africa through education, innovation, and collaboration. The virtual program covers the full spectrum of modern cardiovascular care and also features expert-led presentations, real-world case reviews and interactive discussions. It promises to be highly engaging. Visit the website for more information.

Nigerian Cardiac Society Conference

The 55th Annual General Meeting and Scientific Conference of the Nigerian Cardiac Society (EKO 2026) is scheduled for late September 2026 in Lagos, Nigeria bringing together cardiologists to share the latest advances in cardiovascular medicine. The conference will feature scientific presentations, expert discussions, networking opportunities, and sessions focused on improving cardiovascular care, promoting research, and fostering collaboration within Nigeria and beyond. Although the period for the early bird registration has elapsed, late registration continues till September 20th and the 21st of September for onsite registration. Visit the Nigerian Cardiac Society website for more information.

Webinar and Induction Ceremony of New CIGN Members

The Cardiology Interest Group Nigeria (CIGN) is excited to welcome members and aspiring cardiologists to an insightful Webinar & Induction Ceremony designed to demystify the journey toward a U.S. cardiology career.

This edition features Dr. Toluwalase Awoyemi, a Cardiovascular Disease Fellow at Massachusetts General Hospital/Harvard Medical School, who will share practical guidance on navigating the path to a U.S. cardiology residency. Attendees can expect valuable insights into building a competitive portfolio, avoiding common application pitfalls, and positioning themselves for success in an increasingly competitive training environment.

Beyond the educational session, the event will also celebrate the induction of new members into the Cardiology Interest Group Nigeria, reaffirming the organization’s commitment to mentoring and empowering the next generation of cardiovascular professionals. The webinar holds on August 29th at 4 p.m. prompt.

Cardio Trivia Corner

Last Month’s Trivia Answers

Did you test your cardiology knowledge in our last issue? Here are the answers to last month’s trivia before you take on this month’s challenge!

1. Which electrolyte imbalance classically produces tall, peaked T waves on an ECG? Answer: B. Hyperkalemia

Hyperkalemia characteristically causes tall, narrow, peaked T waves on the ECG due to accelerated ventricular repolarization.

2. Which ECG finding is most commonly associated with left ventricular dysfunction (LVD)? Answer: A. Left bundle branch block (LBBB)

LBBB is frequently associated with left ventricular systolic dysfunction because it reflects delayed electrical activation of the left ventricle. Although not all patients with LVD have LBBB, its presence should prompt further evaluation of ventricular function, often with echocardiography.

3. What was the primary role of the AI-ECG algorithm in the featured COVID-19 study? Answer: C. To rapidly screen for left ventricular dysfunction and help identify patients who should undergo echocardiography.

Rather than replacing echocardiography, AI-ECG serves as a rapid screening tool that helps identify patients at risk of left ventricular dysfunction. This allows clinicians to prioritize echocardiography for those most likely to benefit which improves efficiency and conserves healthcare resources.

4. Why might AI-ECG be particularly valuable during infectious disease outbreaks such as COVID-19? Answer: C. It provides rapid screening while reducing unnecessary staff exposure and conserving imaging resources.

A routine 10-second ECG enhanced with artificial intelligence can quickly identify patients who may require further cardiac evaluation. During infectious outbreaks, this approach helps reduce unnecessary exposure of healthcare workers.

August’s Trivia

Ready for a quick challenge? Test your cardiology knowledge with this month’s trivia questions and see how much you know!

1. Which of the following clinical features should most strongly raise suspicion for an acute aortic dissection rather than an acute myocardial infarction?

A. Chest pain relieved by rest
B. Chest pain radiating to the left arm only
C. Sudden tearing chest pain radiating to the back with unequal blood pressures between the arms
D. Gradually worsening chest discomfort over several hours

2. Why is it important to distinguish an acute aortic dissection from a myocardial infarction early?

A. Aortic dissection usually resolves without treatment.
B. Thrombolytic therapy and anticoagulation used for myocardial infarction may worsen an aortic dissection.
C. ECG changes are always absent in aortic dissection.
D. Cardiac troponins are never elevated in aortic dissection.

3. According to the recent European Society of Cardiology (ESC) study featured in this issue, what is the current evidence regarding microplastics and myocardial infarction?

A. Microplastics have been proven to directly cause myocardial infarction.
B. Microplastics were found only in patients with myocardial infarction.
C. Patients with myocardial infarction were found to have higher levels of circulating micro and nanoplastics, but the study demonstrated an association rather than causation.
D. Eliminating microplastic exposure has been proven to prevent heart attacks.

Answers will be revealed in the next issue of our newsletter. Stay tuned!

Thank you for reading CIGN’s Substack. Click on the subscribe button for more contents. Check out our other social media platforms here.

Uchenna Ukaegbu and Obukofe Okeoghene,

For the newsletter team,

CIGN.

Welcome to Q3! We made it to mid-year. I hope we’re smashing our 2026 goals?

Okay, I have a confession. I enjoyed the ECG session in the last monthly meeting a little too much and got obsessed that the algorithm brought articles to my feed. A 2020 paper on detecting left ventricular dysfunction in COVID-19 patients with AI-ECG caught my attention. Here’s the tea:

Coronavirus disease 2019 (COVID-19) frequently causes myocardial injury and fulminant myocarditis, leading to a rapid deterioration of cardiac function and a high risk of mortality. While transthoracic echocardiography is the standard tool to assess left ventricular (LV) function, it is resource-intensive, requires advanced expertise, and increases infection exposure risks for healthcare staff.

Investigators sought to evaluate whether a convolutional neural network (AI-ECG) previously trained on a large general population could successfully serve as a rapid, point-of-care screening tool to identify LV dysfunction specifically in COVID-19 infected patients.

Despite the small cohort size (n=27) and the highly acute nature of the patients with over half (55.6%) suffering from Acute Respiratory Distress Syndrome (ARDS), the AI algorithm achieved an incredible 0.95 Area Under the Curve for detecting an EF <40%.

Crucially, the AI network used in this study was originally trained on a dataset of 97,829 patients that contained absolutely no viral-infected subjects. The fact that its accuracy held up perfectly proves that the algorithm translates seamlessly to highly complex, acute infectious settings without needing custom retraining.

The algorithm identified low EF both in patients with pre-existing heart failure and in those experiencing brand-new, acute viral myocardial injury. This proves the AI detects ventricular remodeling and stress irrespective of the causative disease process.

Implementing AI-ECG algorithms at the point of care provides an instant, zero-friction clinical triage layer. By using a simple, 10-second ECG to confidently filter out patients who are unlikely to have ventricular involvement, healthcare systems can reserve resource-heavy echocardiograms for high-risk individuals speeding up the delivery of guideline-directed medical therapy (GDMT) while maximizing staff safety.

Electrocardiograms (ECGs) and artificial intelligence ECG results in a 77-year-old woman who developed left ventricular dysfunction due to coronavirus disease 2019 myocarditis.

Artificial intelligence is reshaping cardiovascular care in remarkable ways. From improving early detection and diagnostic accuracy to enabling personalized treatment and continuous patient monitoring, AI is helping clinicians deliver more efficient, proactive, and patient-centered care.

The future of cardiology is not about choosing between humans and machines, it is about harnessing the strengths of both. As AI continues to evolve, the most successful healthcare systems will be those that combine technological innovation with the compassion, experience, and clinical expertise that remain at the heart of exceptional cardiovascular care.

REFERENCES

Attia, Zachi I et al. “Artificial Intelligence ECG to Detect Left Ventricular Dysfunction in COVID-19: A Case Series.” Mayo Clinic proceedings vol. 95,11 (2020): 2464-2466. doi:10.1016/j.mayocp.2020.09.020

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UPCOMING EVENTS

Our probationary period lecture series for new CIGN recruits officially kicked off on Saturday 4th of July, 2026 and will span across all Saturdays in the months of July and August. It is going to be an intensive two-month training programme. The series is designed to introduce new members to the interest group’s culture, activities, and opportunities for growth—laying a strong foundation for active membership.

We warmly welcome all our new members and wish them a rewarding and enriching learning experience.

Join us for another engaging edition of our Monthly General Meeting slated to hold on Saturday, 25th July, 2026.

This month’s general meeting will feature:

Heart to Heart Interactive Session: CIGN will host our Faculty Advisor, Professor Ogah Okechukwu. The session will be an opportunity to reflect on our achievements, discuss ways to improve, share fresh ideas and foster stronger connections within the community. Our President, Chukwuebuka Asogwa will be giving an overview of the CIGN’s activities and achievements in the first half of the year.

ECG Lecture Series: Building on the concepts covered in the previous session, we will conclude the second part of the ECG tutorial by Dr. Mobolaji Alakija,

Trivia: Are you up for a challenge? Bring your A game!

Don’t miss this opportunity to learn and engage with the community.

JUNE RECAP

At the general meeting held on the 27^th June 2026, Professor John Oluyemi Mabayoje Journal Club presented a critical appraisal on Cardiac Sarcoidosis. We also had the first part of our ECG lecture series delivered by Dr. Mobolaji Alakija.

The journal group critically appraised a 2022 Systematic Review on Cardiac Sarcoidosis by Ahmed Maryam, Opeyemi Tobalesi, Singh Avtar, Kwafo Prince Michael Gyan, et al., which analyzed data from six studies involving over 18 million participants identifying 128,921 patients with cardiac sarcoidosis. Among affected patients, hypertension (63.8%) and diabetes mellitus (31.1%) were the most common comorbidities. Approximately 1 in 4 patients developed heart failure (23.4%), while ventricular tachycardia (2.4%) and mortality (2.9%) were also significant adverse outcomes.

One of the major challenges with cardiac sarcoidosis is its under-recognition. Many patients present with nonspecific symptoms and up to 25% of cases occur without evidence of sarcoidosis elsewhere in the body. Advanced imaging with cardiac MRI (CMR) and FDG-PET has become central to diagnosis, often eliminating the need for invasive myocardial biopsy.

Current treatment focuses on corticosteroids, often combined with other immunosuppressive agents, alongside guideline-directed therapy for heart failure and arrhythmias. Implantable cardioverter-defibrillators (ICDs) and pacemakers play an important role in selected patients, while ongoing clinical trials are evaluating novel immunomodulatory therapies.

Our invited guest, Dr. John Oladapo, a resident at University College Ibadan shared his clinical insights. He emphasized that clinicians should maintain a high index of suspicion in patients with unexplained heart failure, arrhythmias or conduction disease. Available investigations for Cardiac Sarcoidosis in Nigeria includes : Chest X-ray (hilar lymphadenopathy), Serum levels of Angiotensin Converting Enzyme (ACE) and a Mantoux test that is completely zero.

We applaud Professor John Oluyemi Mabayoje Journal Club for the wonderful session and Dr. John Oladapo for his brilliant contributions.

Cardio Fun Corner

Last Month’s Trivia Answers

Did you test your cardiology knowledge in our last issue? Here are the answers to last month’s trivia before you take on this month’s challenge!

1. Which ECG finding is most commonly seen in stress cardiomyopathy?
Answer: B. ST-segment elevation.

Takotsubo cardiomyopathy often mimics an acute myocardial infarction, with ST-segment elevation being a common initial ECG finding despite the absence of obstructive coronary artery disease.

2. The classic ventricular pattern in Takotsubo cardiomyopathy is:
Answer: C. Apical ballooning

The hallmark imaging feature of Takotsubo cardiomyopathy is transient apical ballooning of the left ventricle, giving it the characteristic “octopus trap” appearance.

Ready for a quick challenge? Test your cardiology knowledge with this month’s trivia questions and see how much you know!

1. Which electrolyte imbalance classically produces tall, peaked T waves on an ECG?

A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia

2. Which ECG finding is most commonly associated with left ventricular dysfunction (LVD)?

A. Left bundle branch block (LBBB)
B. ST-segment elevation in leads II, III, and aVF
C. Short PR interval
D. Right axis deviation

3. What was the primary role of the AI-ECG algorithm in the featured COVID-19 study?

A. To replace transthoracic echocardiography for measuring ejection fraction.
B. To diagnose COVID-19 infection from an ECG.
C. To rapidly screen for left ventricular dysfunction and help identify patients who should undergo echocardiography.
D. To predict the need for mechanical ventilation.

4. Why might AI-ECG be particularly valuable during infectious disease outbreaks such as COVID-19?

A. It completely replaces echocardiography.
B. It requires no electricity.
C. It provides rapid screening while reducing unnecessary staff exposure and conserving imaging resources.
D. It directly measures ejection fraction.

As always, answers will be revealed in the next issue of our newsletter. Stay tuned!

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Thank you for reading CIGN’s Substack. Click on the subscribe button for more contents. Check out our other social media platforms here.

Temitope Olatunji, Chidera Nweke and Uchenna Ukaegbu

For the Newsletter Team,

CIGN.

“My heart is broken.” Most of us have said this at some point. When you got turned down by someone you like or when you don’t get a Valentine’s Day gift from your supposed ‘talking stage’ or when you do poorly on an exam you poured your blood and sweat into preparing for. Arsenal fans have definitely made this statement more than most (pun intended). All of these are trivial, and they would never compare to the feeling of grief when losing a loved one.

CASE STORY

A 58-year-old woman was rushed to the emergency department with crushing chest pain and shortness of breath. ECG revealed she had ST-segment elevation. Troponin levels were also elevated. Everything pointed towards a myocardial infarction, a ‘heart attack’ which occurs due to a blocked coronary artery. She was moved quickly to the Cath lab for an intervention to help save her life. To everyone’s surprise, her coronary arteries were normal, there was no obstructed coronary artery in sight.

“What then could have caused all this?” was the question on the minds of the clinicians managing her case. They decided to go back to the very start, her history. It was then they discovered something that wouldn’t have appeared on any blood test, scan or angiogram. This woman had lost both her parents within the past month. Interesting right? This intense feeling of grief had literally stunned her heart.

The diagnosis was made, she had ‘Takotsubo Cardiomyopathy’ or ‘Broken Heart Syndrome’ or ‘Stress cardiomyopathy’. It was first identified in 1991, in Japan. The name ‘takotsubo’ translates to a Japanese word for octopus trap because the cardiac morphology that characterises this condition resembles a traditional Japanese octopus trap.

Perhaps the biggest lesson from this case is that when people say their heart is broken, they may be speaking more truthfully than we realise. While most forms of heartbreak heal with time, severe emotional stress can, in rare cases, leave a measurable impact on the heart itself.

Sometimes, a broken heart is more than just a metaphor.

Upcoming Events

June is a Period of Raising Awareness of Arrhythmias!

June brings global attention to heart rhythm disorders. Although major awareness activities are held in the early part of the month (between 1^st and 7^th), efforts to promote education, early recognition, and prevention continue throughout June. Awareness is aimed at highlighting conditions such as atrial fibrillation, bradyarrhythmias, and tachyarrhythmias. These disorders often present quietly at first with symptoms like palpitations, dizziness, fatigue, or brief episodes of syncope, however they remain an important and sometimes overlooked cause of preventable cardiac complications and sudden death.

As doctors and future doctors, and most especially cardiologists in the making, we are in a position to improve early recognition beyond the hospital setting. Simple actions such as teaching people how to check their pulse, encouraging timely ECG evaluation when symptoms arise, and raising awareness of irregular heart rhythms can make a real difference. This June, let us extend our role in medicine into our communities and share this knowledge with at least one or two people around us, because even small moments of awareness can help save a life.

CIGN Monthly General Meeting: 27^th June 2026

The next CIGN Monthly General Meeting is scheduled for 27th June 2026. Prof. John Mabayoje Journal Club will be leading an insightful academic presentation at the meeting this month. Attending these meetings offer networking among members and valuable academic development. See you there!

From the Last meeting in May

At the previous meeting on 30th May 2026, the Rene Laennec Journal Group presented a critical appraisal on disparities in Clinical Features and Outcomes of Peripartum Cardiomyopathy in High vs Low Prevalent Regions in Nigeria.

The journal group critically appraised a 2021 study by Karaye K.M. et al., which analysed 226 peripartum cardiomyopathy (PPCM) patients from the PEACE Registry across 14 Nigerian centres to compare clinical profiles and 17-month outcomes between Kano (a high-prevalence region) and other geopolitical zones. Key findings revealed that while patients in Kano presented later and with larger heart chambers, they were generally less symptomatic and demonstrated better reverse cardiac remodelling than patients from other regions.

The presentation also reviewed the study’s overall mortality rate of 20% (17.6% in Kano versus 23.2% in other regions), noting heart failure as the primary cause of death. While evaluating the research, the presenters highlighted its strengths as the largest prospective PPCM registry in Nigeria, but noted limitations typical of post-hoc observational designs, such as unequal regional group sizes and a potential risk of residual confounding. Ultimately, the study underscores significant regional disparities and offers valuable clinical and epidemiological insights for low-resource African settings.

Following the presentation, Dr Olanike Orimolade, a renowned cardiologist in Nigeria, shared her expert insights on the critical appraisal. She emphasised the clinical importance of the findings from the study, gave her clinical experience with PPCM cases she has managed, the need for screening especially in underserved regions in the country, and the broader implications for maternal health in Nigeria.

The session was both highly engaging and thought-provoking. We commend the Rene Laennec Journal group for an insightful appraisal and to Dr Orimolade for her invaluable contributions. We look forward to another enriching session at our next meeting this June.

Cardio Fun and Facts

Myth: “Broken Heart Syndrome” is a poetic metaphor.

Fact: Takotsubo cardiomyopathy is a real medical condition that can temporarily weaken the heart muscle after severe emotional or physical stress.

Myth: Takotsubo cardiomyopathy is the same as a heart attack.
Fact: It often mimics a heart attack with chest pain and ECG changes, but unlike a classic myocardial infarction, there is usually no blocked coronary artery.

Quiz

Let’s do a check on your understanding of stress cardiomyopathy:

1. Which ECG finding is most commonly seen in stress cardiomyopathy?

A. Deep Q waves in inferior leads
B. ST-segment elevation
C. Atrial fibrillation
D. Normal ECG

2. The classic ventricular pattern in Takotsubo cardiomyopathy is:

A. Global hypokinesia
B. Basal ballooning
C. Apical ballooning
D. Septal hypertrophy

Answers will be revealed in the next issue of our newsletter. Stay tuned!

Thank you for reading if you made it this far ❤️. Please make sure you subscribe, so you won’t miss any of our upcoming posts. Check out our other social media platforms here.

Obukofe Okeoghene, Uchenna Ukaegbu and Temitope Olatunji,

For the newsletter team,

CIGN.

Welcome to the month of May!

Hypertrophic cardiomyopathy is one of the leading causes of sudden cardiac death in young athletes. It is often hidden in plain sight, masked by high levels of physical activity. What looks like ‘athlete fatigue’ can often be the first sign of a life threatening structural anomaly.

Our case story for the month exposes us to how hypertrophic cardiomyopathy typically presents, highlighting the importance of timely and appropriate intervention in reducing mortality.

CASE STORY

A 21 year old male professional footballer collapsed during training after complaining of dizziness and palpitations. He had been in his usual state of health prior to presentation. Witnesses reported a brief loss of consciousness lasting less than one minute with spontaneous recovery.

On further questioning, he admitted to experiencing intermittent exertional chest discomfort, palpitations, and near-syncope over the past 6 months. These episodes were often brief and self-resolving and he had not sought medical attention, attributing them to fatigue from training.

There was no history of hypertension, diabetes mellitus or substance use. However, his older brother had died suddenly at the age of 25 while playing sports.

On examination, he was alert but anxious; pulse rate was 96 bpm; blood pressure was 110/70mmHg; auscultation of precordium revealed a harsh systolic murmur best heard at left sternal border which increases with Valsalva maneuver.

On investigation, ECG showed left ventricular hypertrophy; echocardiogram showed asymmetric septal hypertrophy with preserved ejection fraction and evidence of left ventricular outflow tract obstruction.

A diagnosis of hypertrophic cardiomyopathy was made.

Management

• He was started on beta blockers to slow his heart rate and reduce outflow obstruction.

• He was counselled on lifestyle modification and avoidance of strenuous exertion.

• Family screening was initiated.

Currently, he remains stable, adhering to his management plan.

Key Takeaways

• Sudden collapse in a young athlete is a strong pointer to hypertrophic cardiomyopathy.

  Family history of sudden cardiac death is a critical clue

• The murmur of hypertrophic cardiomyopathy increases with Valsalva’s maneuver, unlike most other murmurs.

• Early discovery can be lifesaving.

UPCOMING EVENTS:

May 17 is World Hypertension Day!

Hypertension is one of the most common and most overlooked cardiovascular risk factors in our environment. Often asymptomatic, it quietly leads to complications such as heart failure, chronic kidney disease, and stroke, hence its dub as a “silent killer.”

In Nigeria, where many individuals are either undiagnosed or poorly controlled, World Hypertension Day serves as a reminder of the role we all have to play in changing the narrative. This year’s World Hypertension Day carries the theme “Controlling Hypertension Together!” a reminder that tackling high blood pressure requires collective action. Simple actions like routine blood pressure checks, patient education, and lifestyle counselling can make a significant difference.

As members of the Cardiology Interest Group Nigeria, this is an opportunity to expand our impact beyond the clinic. We are going to be running a 7-day structured online campaign between 10th-17th May in alignment with this year’s theme. It promises to be fun and informative with posts geared towards increasing awareness, correcting misconceptions, promoting early detection, and blood pressure monitoring/control. Join in on all the fun across all our social media platforms with the hashtag: #KnowYourNumbersNG.

CIGN Monthly General Meeting – 30^th May, 2026

The next CIGN Monthly General Meeting is scheduled for 30^th May 2026. A major highlight of our meetings is the academic presentation led by one of our journal clubs, which features educative literature reviews on important cardiology concepts, emerging topics, or current guideline updates in cardiovascular medicine. For enthusiasts who are not yet members, joining CIGN offers access to these kinds of enriching meetings and academic development.

From the last meeting held in April

At the previous meeting on 25^th April 2026, the Ayodele O. Falase Journal Club presented a literature review on The Role of Statins in Reducing the Risk of Ischaemic Stroke.

The presentation explored stroke as a major cause of mortality and long-term disability worldwide, with modifiable risk factors such as hypertension, diabetes mellitus, smoking, and dyslipidaemia. The role of elevated LDL cholesterol in atherosclerosis was emphasised as a key mechanism underlying ischaemic stroke.

The presentation also reviewed how statins reduce cardiovascular risk through LDL cholesterol reduction, plaque stabilisation, anti-inflammatory effects, and improved endothelial function. Evidence from landmark studies demonstrating reductions in recurrent stroke and other vascular events was also discussed.

The session was both informative and thought-provoking. We commend the Ayodele O. Falase Journal Club for an excellent presentation and look forward to another enriching session at the upcoming May meeting.

The 5th Port Harcourt Cardiovascular Conference 2026 is Just around the Corner.

We are excited to announce the upcoming Port Harcourt Cardiovascular conference themed ‘Evolution in Cardiovascular Medicine.’ It promises to be a gathering of medical professionals, researchers, and healthcare innovators dedicated to the latest advancements in heart health and clinical practice.

Date: 29th and 30th May, 2026

Time: 8:00 am daily

Venue: Diamond/Gold Hall Autograph, 30/33 Sani Abacha Road, GRA Phase3, Port Harcourt

EXCITING OPPORTUNITY:

Applications are now open for new members to join the Cardiology Interest Group Nigeria (CIGN). As you know, we are a growing community of students and young professionals united by a shared interest in cardiovascular medicine, academic excellence, leadership, and impact.

For anyone passionate about medicine and cardiology, this is an opportunity to be part of a network that supports learning, collaboration, and professional growth. Do you have interests in clinical practice, research, advocacy, or simply exploring cardiology further? CIGN provides a platform to develop and connect.

Members benefit from opportunities in research, academic activities, leadership development, mentorship, projects, events, and collaborations with like-minded peers and professionals across the country. It is also an excellent way to build experience, strengthen your CV, and prepare for future career pathways.

You do not need to have all the answers or extensive cardiology knowledge before joining, you only need to bring your curiosity, commitment, teamwork, and willingness to learn.

Registration is free and open to medical students and medical officers only.

Application Deadline: 30^th May, 2026

Apply here: CIGNrecruitmentform

Please note that slots are limited, so interested applicants are encouraged to apply early and become part of a community committed to advancing cardiovascular health in Nigeria and beyond!

CARDIO FUN & FACTS:

Care to have a little fun? Welcome to our fun and facts corner where we’ll be dispelling some myths and dropping a few nuggets.

Myth: Only obese people get heart disease.

Fact: Obesity is a strong risk factor for most heart diseases but individuals who are not obese can still have heart diseases in the presence of other risk factors.

Myth: If I feel fine, my blood pressure is okay.

Fact: Many people with alarmingly high readings have no symptoms. Hence, the moniker, ‘silent killer.’

Did you know?

• Hypertrophic cardiomyopathy is the leading cause of sudden death in young athletes with death usually being the first presenting symptom.

• Laughter can improve blood flow by up to 20%, while stress can constrict vessels.

• The heart can continue to beat even when moved from the body (briefly) if it still has enough oxygen because it has its own electrical conduction system.

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Chidera Nweke, Uchenna Ukaegbu & Favour Obukofe,

For The Newsletter Team,

CIGN

Welcome to our March issue!

What happens when the clinical picture of a medical condition is somewhat less straightforward?

In malaria-endemic regions like Nigeria, fever frequently dominates the diagnostic landscape. Yet not all fevers point to infection.

In this month’s case story, we explore how a seemingly familiar presentation concealed a life-threatening cardiovascular emergency and how timely recognition made all the difference.

CASE STORY

When Fever Distracts from the Real Diagnosis

A 55-year-old previously active man was brought to the emergency department because of worsening difficulty breathing.

Two weeks earlier, he had sustained blunt trauma to his left leg while restraining a cow for slaughter. He did not seek hospital care. Over the next several days, his left calf became swollen and painful. Because of discomfort, he significantly reduced his mobility and spent most of his time indoors.

A nurse was invited to assist at home. The leg was bandaged, and on subsequent visits, gentle massage was performed to relieve pain.

About 10 days after the trauma, he began experiencing mild shortness of breath. His wife noticed he was breathing faster than usual, even at rest, but he dismissed it.

The following day, he developed a low-grade fever.

Given Nigeria’s malaria-endemic setting, malaria was immediately suspected. A blood test reportedly showed malaria parasites, and he was commenced on intravenous fluids and quinine therapy at home.

However, over the next 24 hours, his breathing worsened significantly. He became visibly distressed and unable to speak in full sentences. A home blood pressure reading was 153/95 mmHg, though his prior hypertensive status was unknown.

He was then taken to the hospital.

On examination at presentation: Respiratory rate: 30/min; Pulse: 118 bpm; Blood pressure: 148/92 mmHg; Oxygen saturation: 85% in room air. Chest examination was largely clear. However, his left calf was still relatively swollen and mildly tender compared to the right.

Detailed history led to a problems list of: Recent leg trauma; Prolonged reduced mobility; unilateral leg swelling; Acute dyspnea; Hypoxia and tachycardia

These raised strong suspicion for deep vein thrombosis with pulmonary embolism.

Upon investigations: ECG showed Sinus tachycardia; cardiac biomarkers were elevated; D-dimer was Elevated; Doppler ultrasound showed Left lower limb deep vein thrombosis; CT pulmonary angiography revealed pulmonary embolism in segmental branches.

Final Diagnosis: Submassive pulmonary embolism secondary to provoked DVT.

Management and Outcome

The patient was started immediately on:

• Oxygen therapy

• Therapeutic anticoagulation

• Close cardiopulmonary monitoring

Because he remained hemodynamically stable, thrombolysis was not required.

His respiratory status improved over several days. He was discharged on oral anticoagulation with appropriate follow-up and counseling.

He survived largely because the underlying cause was eventually recognized and treated promptly.

Management Tip: When PE is strongly suspected, start anticoagulation immediately, provided there is no active bleeding or significant bleeding risk. Don’t wait for D-dimer, Doppler, or CT confirmation. Early treatment saves lives.

The Importance of Fever:

Fever significantly altered the clinical history of this case. In malaria-endemic environments like Nigeria, fever often leads to immediate antimalarial treatment sometimes before a broader differential diagnosis is considered, as seen with the home nurse in this case story.

However, Pulmonary embolism can also present with low-grade fever due to inflammatory response to pulmonary infarction and fever does not exclude thromboembolic disease.

Key Learning Points:

• Unilateral leg swelling after trauma and immobility should prompt suspicion of DVT.

• Massage of a potentially thrombosed limb may increase embolic risk.

• Acute unexplained dyspnea with hypoxia requires urgent evaluation for pulmonary embolism.

• Fever in malaria-endemic regions should not automatically narrow the differential diagnosis.

• Early anticoagulation saves lives in pulmonary embolism.

  ---

Meet Our New Executive Committee

Over the past month, CIGN entered a new chapter of leadership. Following a structured series of interviews, a new set of leaders were appointed. It is our honour to introduce them to you.

Asogwa Chukwuebuka

President of the Executive Council

Princess Prause Calix Udo-Udofia

Vice President of the Executive council

Okeke Chibuzor Ifeanyichukwu

Programs Director

Okpalanozie Chiemeka

Financial Secretary

Abioye Peter

Student Liaison Officer

Marvelous O. Adelaja

Grants Director

Folusho Olu-Adegbola

Head of Media

In addition, we introduced themed Journal Clubs named in honour of renowned cardiologists. These clubs were created to represent and further our commitment to cultivating analytical thinking, research literacy, and leadership in cardiology. Here are the clubs and the newly appointed leaders.

Uche-Orji Christabel

Team lead “Renè Laennec” journal club

Ola-Daniel Samuel Olaoluwa

Team lead “Helen B Taussig” journal club

Oluronke Peculiar Ojasope

Team lead “Professor John Oluyemi Mabayoje” journal club

Matthew Aremu

Team lead “Ayodele O. False” journal club

With this dynamic team at the helm, we are excited for a year full of skill-building sessions, interactive activities, and community impact.

Cardio Fun Corner

It’s time to unwind a little. Let’s dive into this month’s Cardio Fun Corner for some trivia and tongue twisters!

Pulmonary Embolism Trivia:

Did you know?
1. Rudolf Virchow was among the first to recognise that blood clots forming in the veins can break loose and travel to the lungs, laying the foundation for understanding pulmonary embolism.

2. The development and widespread use of CT pulmonary angiography (CT‑PA) in the 1990s greatly improved the speed and accuracy of diagnosing PE.

3. Pulmonary embolism doesn’t always present with chest pain? Yes, some patients have only shortness of breath or mild fever, which can delay diagnosis.

Tongue Twisters:

Haha! Try saying these three times fast:

1. Deep veins develop dangerous drifting debris daily.
2. Massaging medial malleolar mishaps may mobilise menacing material.

Thanks for reading CIG’s Substack!

Follow us on our social media platforms via https://linktr.ee/cardioignigeria

Uchenna Ukaegbu & Favour Obukofe,

For The Newsletter team,

CIGN

Welcome to 2026!

As we welcome the new year, it’s only fitting that we begin by reflecting on the strides we made together. The past year was marked by learning, collaboration, and steady progress toward our mission of advancing cardiology education and engagement in Nigeria. Let’s revisit the moments and milestones that shaped our year.

Growing the CIGN Community

We started 2025 with 52 members. In March, we welcomed 95 new members and successfully onboarded 83 of them. Growth did not stop as we admitted 26 more members during an off-cycle admission. At our peak, this community has grown to 153 members. We are grateful for everyone who has joined the journey.

World Hypertension Day Community Outreach

To commemorate World Hypertension Day, CIGN organized an Awareness Walk and Talk in May 2025, held in Ibadan and Lagos.

Through this outreach, we engaged directly with community members to raise awareness about hypertension, promote healthy lifestyles, and emphasize the importance of early detection. Free blood pressure screenings were conducted, with CIGN doctors on ground to offer counselling, prescribe antihypertensive therapy where appropriate, and refer individuals with elevated readings for further evaluation. This initiative showed our commitment to community engagement and preventive cardiovascular care.

Clinical Externship Programme

We also kicked off our Clinical Externship Programme at Cardiocare Multispecialty Hospital, Abuja, marking an important step in hands-on cardiovascular training. Three members rotated through various units of the advanced cardiac facility over a two-week period, gaining firsthand exposure to cardiac interventions and multidisciplinary care.

During the externship, participants completed case write-ups based on their clinical experiences, which were later presented at the Annual Symposium in December. Building on the success of this pilot programme, we look forward to expanding and replicating similar externship opportunities for members across other centres nationwide in 2026.

Showcasing Member Research on a National Stage

In August, at the Nigerian Cardiac Society (NCS) and Pan-African Society of Cardiology (PASCAR) 54th Annual conference, we had 2 representatives of the interstate group, Dr Henry Ezeh and Dr Ifunanyachukwu Nebo, who presented their research among leading cardiovascular experts. We are proud of the strides our members are making, and this is just the beginning.

Hybrid Meeting

In 2025, the Cardiology Interest Group of Nigeria hosted its first-ever hybrid meeting.

Held in September at LASUTH, the meeting coincided with the International Day for Interventional Cardiology and World Heart Day. Renowned Nigerian Interventional Cardiologists were present to give insight on the subspecialty in Nigeria. For many members, this was the first opportunity to meet physically, connect beyond virtual spaces, and build stronger professional relationships. The atmosphere was engaging and fun which made it a truly memorable gathering for the group.

Research Bootcamp

In October, we successfully hosted the first ever Research Bootcamp of the interest group. It was a 4-week intensive program designed to introduce members to the foundations of medical research.

The bootcamp brought together 48 participants whom with the help of the Bootcamp took their first structured steps into academic medicine.

This marked an important milestone for the group, and it set the tone for a growing culture of research and collaboration.

Anniversary Symposium

The Cardiology Interest Group of Nigeria successfully hosted its Anniversary Symposium 2025, themed “Advancing Cardiovascular Care in Nigeria: Innovations and Interventions.”

Held from 12–13 December 2025 in Ibadan, the two-day event also marked the second anniversary of the Group, making it a significant milestone in our journey. Leading cardiologists, researchers, and healthcare professionals from across the country came together for insightful keynote lectures, panel discussions, and interactive sessions. The symposium served not only as an academic platform, but also as a celebration of two years of growth, collaboration, and commitment to advancing cardiology in Nigeria. The full Anniversary Symposium e-brochure, including programme highlights, speakers, and picture gallery is available here.

We hope that 2025 gave us plenty to be proud of. We are carrying that energy straight into the new year. Bigger ideas, memorable events, stronger connections, and an even better 2026 ahead.

Thanks for reading CIG’s Substack!

Follow us on our social media platforms via https://linktr.ee/cardioignigeria

Uchenna Ukaegbu & Favour Obukofe,

For The Newsletter team,

CIGN

Here’s what’s new:

1. A single “Chain of Survival” : For years CPR teaching was split, one algorithm for adults and a slightly different one for kids and another for infants. Great in theory but terrible in panic. Now the AHA adopts a single continuous chain of survival that applies to anyone, no matter the age.

This model puts emphasis on early activation of emergency response system even before the commencement of resuscitation.

2. A revised Foreign Body Airway Obstruction(FBAO) algorithm: For conscious adults and children,alternating cycles of 5 back blows and 5 abdominal thrusts are to be given, starting with the back blows. To be done until the object is expelled or the person becomes unresponsive. This is in contrast to the former guidelines which recommend only back blows be delivered. This new sequence carries a higher success rate that the latter.

For infants , 5 back blows and chest compressions are to be delivered in alternating cycles. This is in keeping with the 2020 recommendation. However, the two finger technique has been eliminated and it it now recommended that the heel-of-one hand technique or the two-thumb encircling technique be done.

Abdominal thrust for infants are still discouraged, as they may cause significant organ damage.

3. Introduction of a new guidance on opioid-related emergencies, including increased public access to naloxone

4. More emphasis on bystander/community training and expansion of CPR education, including teaching children aged 12+ how to perform CPR.

What does this mean for you:

Whether you’re a student, clinician or potential rescuer; up-to-date training matters. The new recommendations are more evidence based as well as intuitive. Remember that when seconds count, doing the right thing fast makes a life difference.

Upcoming Events:

Cardiology Interest Group Nigeria Presents: ANNUAL SYMPOSIUM 2025 !!!

Did you know that cardiovascular diseases are responsible for nearly 40% of all non-communicable disease (NCD) deaths in sub-Saharan Africa? While the challenge is significant, effective solutions are within our grasp.

The Cardiology Interest Group Nigeria is delighted to announce its ANNUAL SYMPOSIUM 2025, themed:

“Advancing Cardiovascular Care in Nigeria: Innovations and Interventions.”

The symposium will take place on 12th–13th December 2025 in Ibadan, Nigeria.

Over the course of two days, leading cardiologists, researchers, and healthcare professionals will converge to discuss the latest advancements and strategies in cardiovascular care. Attendees will benefit from thought-provoking presentations, interactive workshops, and valuable networking opportunities with experts driving the future of cardiology in Nigeria.

To save your spot click here

Cardio Fun Corner: Tetralogy of Fallot Edition

Imagine a little heart working extra hard: in Tetralogy of Fallot, four structural quirks make it tricky for blood to get fully oxygenated.

Quick quiz: Which of these is not part of the classic four defects?

A) Ventricular septal defect (VSD)

B) Pulmonary stenosis

C) Overriding aorta

D) Left ventricular hypertrophy

(Hint: three belong, one sneaked in!) 😉

Here’s something cool: Babies with TOF sometimes squat during “Tet spells”. This instinctive move raises blood pressure, helping more oxygen-rich blood circulate. Doctors can also use beta-blockers, which slow the heart and relax the right ventricular outflow tract, making these spells much easier to handle.

Your heart really is a tiny superhero, isn’t it?

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Check out our other social media platforms here

Obukofe Okeoghene and Oladunni Damilola,

For the Newsletter team,

CIGN.

Welcome to November!

As the year draws to a close and the world takes time to reflect on gratitude this November, we too pause to appreciate the tireless effort of healthcare professionals and researchers who continue to advance Cardiology medicine.

AI Stethoscope Revolutionizes Cardiac Diagnosis

For over 200 years, the traditional stethoscope has been a symbol of medicine used by clinicians as a powerful diagnostic tool. Now, doctors at Imperial College London have given it a 21st-century upgrade powered by artificial intelligence.

The new AI stethoscope, developed by researchers at Imperial Health College London in collaboration with Eko Health, can detect heart failure, valve disease, and abnormal rhythms in just 15 seconds.

In trials involving over 12,000 patients in the United Kingdom, those examined with the device were twice as likely to be diagnosed with heart failure and three times more likely to have atrial fibrillation detected.

By combining sound recording with a built-in ECG, the device sends data to a secure cloud where AI algorithms analyze subtle heartbeat patterns, spotting what the human ear cannot.

Doctors then receive instant results on a smartphone, helping identify patients at risk before symptoms become severe.

“This could transform heart care,” says Dr Patrik Bächtiger of Imperial College. “For the first time in two centuries, we’ve reimagined the stethoscope.”

While the tool isn’t meant for healthy individuals, its early use in symptomatic patients could save lives and reduce emergency admissions.

A simple 15-second test and the future of cardiology might already be in your doctor’s pocket.

Curious about how the AI-powered stethoscope works? Watch a short demonstration of the Eko Duo Digital Stethoscope, the same technology tested by Imperial College London researchers in their groundbreaking trial.

Upcoming Event

We are thrilled to announce that our next General Meeting, taking place later this November, will feature a distinguished guest speaker who is an Emeritus Professor of Paediatric Cardiology! This promises to be an enlightening session where we gain more insight from a foremost professional whose contributions to the field have helped shaped innovations and improve cardiovascular care in Nigerian children.

Stay tuned to our social media platforms for more details on the date and venue. Don’t miss this opportunity to learn and engage with one of the leaders of paediatric cardiology in Nigeria right here in our community.

Over the Past Weeks:

We had a highly engaging, first of its kind research bootcamp 1.0 in the cardiology Interest Group. Through this programme, we were able to bring together members of our community who are eager to build and strengthen their research skills. The bootcamp covers four modules via four different zoom sessions including:

• Research Dissemination: Attendees learned the pathways to sharing their work with the world from manuscript writing and journal publishing to writing impactful abstracts and abstract presentation.

• Research Design and Methodology: This session broke down the blueprint of scientific inquiry including types of study designs, how to formulate a strong research question, and how to choose the right methodology for robust, ethical studies.

• Database Search and Referencing: Attendees learned how to discover literature through scholarly databases and gained hands-on experience using Zotero for efficient referencing and citation management.

• Data Analysis and Literature Review: The fourth and final module concludes the bootcamp and will hold next weekend. It focuses on how to interpret, organise, and present research data effectively alongside developing a strong literature review.

A big thank you to all the facilitators and participants who have made this learning experience a success!

If you missed our research bootcamp 1.0, stay tuned to our newsletter and social media platforms for announcement about the next edition!

Cardio Fun Corner

This month, as we talk about the AI-stethoscope and how it is reshaping cardiac diagnosis, let’s take a heartbeat-long trip through history to also celebrate the brilliant minds that started it all.

Did you know that long before algorithms and AI became a thing, a curious French doctor named René Laennec rolled up a piece of paper into a tube and listened to his patient’s chest? He refined his idea into a wooden tube and voila! The stethoscope was born in 1816. His invention has gone through various modifications since then and now two centuries later, that wooden tube is being upgraded to an AI-powered pocket machine that can detect subtle cardiac abnormalities than ever before.

But Dr Laennec is not the only one that has made this new tech possible; In the early 1900s, Dr. Willem Einthoven gave us the Electrocardiogram (ECG), one of the most important inventions of cardiology that we cannot live without today and which is also very useful in the AI-stethoscope!

Now test your Heart Smarts before you go! Let’s see how much you know about the foremost professionals and research that have helped advanced cardiovascular medicine!

Who invented the first stethoscope?

Who gave us the electrocardiogram?

What modern device allows continuous heart rhythm monitoring from your wrist?

What do AI algorithms listen for when analysing heart sounds in order to detect murmurs, arrhythmias, and structural problems? Rhythm, Pitch, or Pressure?

Who is considered the father of cardiology?

Answers: Dr. René Laennec, Dr Willem Einthoven, Smart Watches, Rhythm and Pitch, Dr. William Harvey.

Got them all? Your heart can swell with pride! Missed a few? Take heart and better luck next time.

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Uchenna Ukaegbu & Chidera Nweke,

For The Newsletter team,

CIGN

As Nigeria marks 65 years, we hope the nation continues to show resilience and moves toward achieving milestones that benefit the populace in the years ahead. In that same spirit, this issue brings you a new milestone in the field of cardiology.

A New Anti-hypertensive on the Horizon

Every so often in cardiology, a drug comes along that sparks real excitement. Right now, that spark has a name: Baxdrostat. This new dug has caught the attention of the cardiology community since results from the BaxHTN Phase III trial were published by researchers in late August 2025.

Baxdrostat belongs to a new class of medicines called aldosterone synthase inhibitors. Aldosterone dysregulation plays an important role in resistant and uncontrolled hypertension. “Uncontrolled” in this context means patients on ≥ 2 antihypertensive agents with persistently elevated BP while “resistant” implies ≥3 agents (including a diuretic) still insufficient to bring BP down. Aldosterone is made in the adrenal glands, and it manages fluid and salt in the blood by facilitating the excretion of potassium by the kidneys while retaining sodium and water. Excess aldosterone therefore means increased retention of sodium and water by the kidneys with increased excretion of potassium. The result is a higher blood pressure and other cardiovascular complications. For years the main strategy has been to block the aldosterone receptor with drugs like spironolactone or eplerenone, so called aldosterone receptor antagonists. While that approach works, it has the common adverse effect of hyperkalemia and spironolactone in particular often brings unwanted hormonal side effects.

Baxdrostat takes a different route by reducing the very production of aldosterone at the enzymatic source instead of just blocking the receptor. By aiming at aldosterone synthase, it lowers hormone levels of aldosterone across the system. The BaxHTN trial led by Professor Bryan Williams from University College London enrolled nearly 800 patients whose blood pressure remained stubbornly high despite multiple medications. After twelve weeks those who received Baxdrostat at one or two milligrams daily saw systolic pressures drop nearly ten millimeters of mercury more than those who received placebo. Around forty percent reached controlled blood pressure, more than double the control group.

The drug appears well tolerated so far. A small fraction of patients developed hyperkalemia but far fewer than what clinicians often see with aldosterone receptor antagonists. Other adverse events have been mild and without new safety signals. These findings suggest that Baxdrostat could become a valuable option for patients with resistant hypertension, especially for those who have struggled with spironolactone or eplerenone.

We are still early in the story. Longer term safety data are still necessary and outcomes beyond blood pressure control such as heart attack, stroke, and kidney protection will also need further research. Yet the trajectory looks promising. For a condition that continues to frustrate doctors and patients alike, Baxdrostat may soon give us a better alternative to tame aldosterone dysregulation and bring relief from resistant hypertension where it has long been missing.

Exciting Opportunity this October

The very first of its kind in Cardiology Interest Group Nigeria, Research Bootcamp 1.0, will be starting this October. This 4-week virtual program provides the opportunity for members of the interest group to learn more about research while also giving room for growth as scientists.

Upcoming Events

October is sudden cardiac arrest awareness month!

Sudden cardiac arrest is the abrupt loss of heart function caused by an electrical malfunction that stops the heart’s pumping action, leading to collapse and death within minutes if not treated. SCA affects 1,000 people of all ages each and every day and nearly 90% of SCAs are fatal. This month reminds us to keep championing early detection of conditions that can lead to SCA, community awareness of SCA and of cardiopulmonary resuscitation, and wider access to automated external defibrillators (AEDs). A single life saved through advocacy and preparedness justifies the effort.

October 16 is World Restart a Heart Day

On October 16, Nigeria joins the world in marking World Restart a Heart Day, a campaign that shines light on sudden cardiac arrest and the lifesaving role of CPR. As doctors and future doctors, and most especially cardiologists in the making, we are privileged to spread this knowledge beyond the walls of the hospital. Even if it is just one or two people around you, family, friends, or neighbors who have never seen CPR performed, taking a few minutes to demonstrate chest compressions can teach skills that may one day save a life. This October, let us not only practice medicine but also drive its impact in our communities.

Over the past weeks:

Two members of our Cardiology Interest group proudly presented their papers at the 54th Annual Conference of the Nigerian Cardiac Society (NCS) and the 17th Biennial Conference of the Pan-African Society of Cardiology (PASCAR), contributing to the vibrant exchange of ideas shaping the future of cardiovascular medicine in Africa. Dr Henry Ezeh presented his systematic review and meta-analysis of AI-Enhanced Electrocardiogram Accuracy in Predicting Peripartum Cardiomyopathy. Dr Ifunanyachukwu Nebo presented her findings from the Ibadan Heart Failure project on the Clinical Implications of Left Bundle Branch Block in Patients with Chronic Heart Failure. Check out highlights here

We also hosted our very first hybrid meeting for the interest group 🎉. This meeting held at LASUTH and commemorated the International Day for Interventional Cardiology and World Heart Day. Catch the highlights on our various social media platforms.

Cardio Fun Corner

Before you go, here’s a quick pulse check: Which organ produces aldosterone, a hormone important in resistant hypertension? A) Kidneys B) Adrenal glands C) Pituitary D) Liver.

Also, did you know that if you stretched out all the blood vessels in the human body, they would cover between 9,000 and 19,000 kilometers? To picture it, imagine driving from Lagos to Maiduguri and back six times! That’s a lot of plumbing works in our body for us to stay healthy. Amazing, right? Yeah!

Thanks for reading CIG’s Substack!

Follow us on our social media platforms via https://linktr.ee/cardioignigeria

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Uchenna Ukaegbu & Favour Obukofe,

For The Newsletter team,

CIGN

Happy International Day for Interventional Cardiology. Ever wonder why it is celebrated on September 16th?

The first successful coronary angioplasty, performed by Dr. Andreas Roland Grüntzig on September 16, 1977, marked a significant breakthrough in Cardiology. Before this, patients with severe coronary artery disease had to undergo open-heart surgery for coronary artery bypass requiring several weeks to months until full recovery. However, Grüntzig's groundbreaking less-invasive procedure was done in awake patients under local anesthesia who could walk out of the hospital later that day.

The index case involved a successful expansion of a small, 3mm section of the Left Anterior Descending (LAD) artery that had a significant 80% blockage with a carefully kitchen-built catheter.

A 10-year follow-up revealed that the LAD stenosis remained almost completely resolved. With less than 10% residual narrowing, its patency was confirmed across multiple radiographic views, showing no significant change from its condition 10 years prior.

Interventional cardiology is a subspecialty in cardiology that deals specifically with the catheter-based treatment of heart diseases. The field includes the diagnosis and treatment of coronary artery disease, vascular disease and acquired structural heart disease with a minimally-invasive approach.

Common procedures done in the Cardiac Catheterization lab include Percutaneous Coronary Intervention (PCI)/ Angiography and Stenting, Coronary Angiography, Transcatheter Aortic Valve Replacement (TAVR) and MitraClip / Transcatheter Mitral Valve Repair, to mention a few.

Grüntzig's work sparked an era of innovation that led to significant improvements in the balloon device and still serves as an inspiration today.

Perhaps, you could lean in and become an Interventional Cardiologist saving hearts.

To celebrate the International Day for Interventional Cardiology and World Heart Day, we'll be hosting renowned Interventional Cardiologists in our first ever hybrid CIGN meeting in Lagos at the MRC Auditorium, LASUTH, 10:00 AM on September 27th, 2025

Theme: “Innovations, Impacts and Future of Interventional Cardiology in Nigeria”

Register here to confirm attendance: bit.ly/42ceK4K

Prepare to attend and kindly support our team.

More Events in September

The 54th Nigerian Cardiac Society (NCS) and 17th Biennial Conference of the Pan-African Society of Cardiology (PASCAR) is currently underway. Two members of the Interest group will be presenting at the Conference.

September 15th-19th, 2025- 54th Nigerian Cardiac Society (NCS) and 17th Biennial Conference of the Pan-African Society of Cardiology (PASCAR)

Register for the conference via https://nigeriancardiacsociety.com/abuja2025/

Venue: Shehu Musa Yar'adua Centre, Abuja

September 29th, 2025: World Heart Day

Theme: “Don’t miss a beat”

Follow us on our social media platforms via http://linktr.ee/cardioignigeria

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Temitope Olatunji

For The Newsletter Team,

CIGN

Welcome to the Ember season.

The year is drawing closer to an end and we're probably looking at our personal goals and wondering how well we're doing. Now, the same applies for our targets as an Interest Group. Don't worry, I'm not here to judge you on your performance whether personal or professional, I’ll leave it to Judge Judy. I'm just here to spill the tea on what's happening this month.

September 15th-19th, 2025- 54th Nigerian Cardiac Society (NCS) and 17th Biennial Conference of the Pan-African Society of Cardiology (PASCAR)

Register for the conference via https://nigeriancardiacsociety.com/abuja2025/

Venue: Shehu Musa Yar'adua Centre, Abuja

September 16th, 2025- International Day for Interventional Cardiology

September 27th, 2025: CIGN MEETING

We're thrilled to announce our first ever hybrid meeting which would take place this September to celebrate World Heart Day and World Interventional Cardiology Day! We'll be hosting leading interventional cardiologists in Lagos for this special event at the MRC Auditorium, LASUTH, at 10:00 AM.

September 29th, 2025: World Heart Day

Theme: “Don’t miss a beat”

Have you marked these notable days and upcoming event(s) on your calendar? If no, why not?

Remember that we look forward to seeing you at our very first hybrid meeting. We hope to connect physically & virtually and to commemorate these significant dates through dialogue and participation to promote greater awareness of cardiovascular health.

More details would be passed across in the coming days.

Have a productive month!

Follow us on our social media platforms for more juicy news via http://linktr.ee/cardioignigeria

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Temitope Olatunji

For The Newsletter Team,

CIGN

Hypertension causes degenerative changes in blood vessels. Since blood vessels are present in all organs of the body, it implies that hypertension is detrimental to all organs of the body, leading to complications such as stroke, myocardial infarction (heart attack), renal failure, aneurysm, retinal damage, and heart failure.

In case you’re wondering what this buzz word means, hypertension simply put is chronic high blood pressure defined by a systolic reading equal to or greater than 140mmHg and/or a diastolic reading equal to or greater than 90mmHg.

9 in 10 cases of hypertension are primary (idiopathic). However, even in the idiopathic cases, certain risk factors have been found out to predispose an individual to hypertension. These risk factors include family history, older age, obesity, physical inactivity, alcohol consumption, and high-salt diet.

For more information on hypertension, check out these related contents:

SUGGESTED VIDEOS:

Hypertension In Details by Mayo Clinic

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How to Measure Blood Pressure

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2 UPCOMING EVENTS IN MAY

World Hypertension Day Awareness Walk & Talk

In commemoration of World Hypertension Day, CIGN presents her Awareness Walk and Talk scheduled this Saturday, 17th May 2025, both in Ibadan and Lagos respectively. Let’s spread the word about hypertension and encourage lifestyle changes for better heart health.

Awareness Walk

Date: Saturday, May 17th 2025
Time: 8:00am prompt
Convergence: Alexander Brown Hall, UCH, Ibadan

This event is open to the public. To be a part of the awareness walk, click the link below:
https://chat.whatsapp.com/E1V8RRCdTsgIIBNk6H0Y6a

Awareness Talk

Date: Saturday, May 17th 2025
Time: 9:00am prompt
Convergence: Ojuelegba Underbridge, Lagos

This event is strictly for CIGN members.

Walk with us, talk with us, and let’s spread awareness on hypertension together!

4^th Port Harcourt Cardiovascular Conference 2025

Register and plan to attend the 4th Edition of the Port Harcourt Cardiovascular Symposium themed “Revolutionizing the Diagnosis & Treatment of Cardiovascular Diseases”.

Venue: 30/33 Sani Abacha Road, GRA Phase III, Port Harcourt, Rivers State.

Date: 30th-31st of May, 2025

Time: 8:00am prompt

You are invited to be a part of transforming cardiovascular care!

Temitope Olatunji (MBChB)

For The Newsletter Team,

CIGN

It would feature discussions with seasoned Cardiologists from home and abroad, with opportunities for BLS and ACLS trainings.

Theme: TOTAL CARE FOR THE HEART

Venue: The Autograph Events Business and Lifestyle, No 30/33 Sani Abacha Road, GRA phase III, Port Harcourt, Rivers State.

Date: 20th of April, 2024

Time: 8:00am Prompt

You are invited to come if you would be able to make it there.

Signed,

Iyawe Efosa (MD),

Director of Programs,

CIG.

At CIG, we emphasize participation and so we hope that you were a part of our February Program which featured Dr Seyi Bolorunduro. There, he highlighted characteristics of future Cardiologists, emphasizing excellence and productivity.

In order to promote healthier communities, we are partnering with Smilebuilders Initiative for a program on NCDs at the University College Hospital, Ibadan. It’s holding today, 2nd of March, 2024. Registration is at https://forms.gle/TirMiMTTXe1WxmU17

Members who are close by can attend if interested.

We hope that by now you are following all of our Social Media pages. If not, please do so and interact. The Thursday Trivia questions have been designed to be very educative for us.

The 2024 ANPA Conference starts on June 19th. Deadline for submission of Abstracts remains April 19th. Do well to participate.

We wish you an amazing year ahead. Let’s continue to participate as a team where hearts meet the heart.

Efosa Iyawe MD,

For the CIG Board.

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