AUCTORES
Globalize your Research
Case Report
*Corresponding Author: Yasser Mohammed Hassanain Elsayed, Critical Care Unit, Kafr El-Bateekh Central Hospital, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt.
Citation: Yasser Mohammed Hassanain Elsayed. (2022) Bifascicular Block with Electrocardiographic Sisiisiii Pattern in Mild Covid-19 Pneumonia with Slight Pleural Effusion; Differentiation versus Outcome. Journal of Clinical and Laboratory Research. 5(3); DOI:10.31579/2768-0487/072
Copyright: © 2022 Yasser Mohammed Hassanain Elsayed. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 01 January 2022 | Accepted: 29 January 2022 | Published: 25 February 2022
Keywords: COVID-19 pneumonia; bifascicular block; SISIISIII pattern; left anterior fascicular block; pleural effusion
Rationale: Cardiovascular and chest involvement in a pandemic COVID-19 virus infection may be vital.Bifascicular heart block is affecting the conduction delay or block below the AVN in two of the three fascicles. There is a correlation between mortality with sudden cardiac death (SCD) and bifascicular block. SISIISIII pattern is meaning that the S-waves of amplitude is more than 1.5 mm in I, II, and III. It is a variable prognostic electrocardiographic finding.
Patient concerns: A 67-year-old, retired officer, smoker, married, Egyptian male patient was admitted to the intensive care unit with right bundle branch block, left anterior fascicular block, and mild COVID-19 pneumonia with slight pleural effusion.
Diagnosis: Bifascicular block with ECG SISIISIII pattern in mild COVID-19 pneumonia with slight pleural effusion.
Interventions: Electrocardiography, oxygenation, non-contrast chest CT, and echocardiography.
Outcomes: Good response and better outcomes despite the presence of several remarkable risk factors were the results.
Lessons: Associated hypoxia in the current COVID-19 pneumonia may play an essential role in the present new bifascicular heart block. SISIISIII pattern represents a variable prognostic ECG finding such as RVH, pulmonary embolism, and congenital heart disease. The presence of left ventricular septal hypertrophy is considered another risk. The presence of the elderly male sex, heavy smoker, COVID-19 pneumonia, pleural effusion, bifascicular heart block, SISIISIII pattern, and interventricular septal hypertrophy are prognostic factors for the severity of the disease.
Incomplete trifascicular block and Mobitz type II atrioventricular block were reported in the case of COVID-19. Bifascicular block is affecting the conduction delay or block below the AVN in two of the three fascicles [2]. Conduction to the ventricles will be thorough the single remaining fascicle [3]. The ECG will show typical features of the right bundle branch block (RBBB) plus either left (LAD) or right axis deviation (RAD). RBBB in association with a left anterior fascicular block (LAFB) is the most frequent of the two types. This is due to a single coronary artery blood supply (LAD) to the anterior fascicle. RBBB in association with a left posterior fascicular block (LPFB) is less common due to a dual blood supply (right and left circumflex arteries). The above association may be accompanied by more extensive underlying cardiac pathology [3]. It is usually associated with structural heart disease (SHD) in about 50-80 Percentage. But it may present with extensive fibrosis of the conducting system. So, progresses risk to be complete heart block (CHB if there are additional damage to the third remaining fascicle (1-4 Percentage per year). The patients may be asymptomatic. Syncope occurs in a 17 Percentage of annual risk of progression [2]. The presence of syncope or presyncope in the situation of a bifascicular block is a mark for hospitalization. Structural heart disease (SHD) such as ischemic heart disease (40-60 Percentage cases), aortic stenosis, anterior MI (5-7 Percentage of acute AMI), Lenègre-Lev disease, congenital heart disease, and hyperkalemia are common causes of bifascicular heart block [3]. A new-onset bifascicular block in the condition of chest pain is highly associated with proximal LAD occlusion [3]. There is a correlation between mortality with sudden cardiac death (SCD) and chronic bifascicular block [4]. The association of SCD with coronary disease and ventricular dysrhythmia suggested ventricular fibrillation (VF) as a suggested mechanism [4]. But, if idiopathic syncope after work-up, the pacing is recommended [2]. Cardiac affection in COVID-19 virus infection, as if primarily occurred by the virus or its clinical complications, or its medications cannot be ignored [1]. An incidence of pleural effusions is uncommon in COVID-19 [8]. SISIISIII pattern is meaning that the S-waves of amplitude is more than 1.5 mm in I, II, and III. It is one of the traditional findings which is associated with pulmonary embolism [5]. A SIRIIRIII pattern and SIRIIRIII pattern with a QRS-complex less than 0.12 seconds can be produced by right ventricular hypertrophy (RVH) or zonal right ventricular block [6]. about 90% of SISIISIII pattern cases are associated with congenital cardiac defects which were generally associated with manifestations of RVH and RV hypertension. The pattern is most frequent in children with complete transposition of the great vessels (TGA), associated interventricular communications, and in children having VSD with pulmonary hypertension [7]. Pleural effusion is considered an indicator for severe inflammatory state and carries poor clinical outcomes, and might be an integral risk factor in critical COVID-19 infection [9].
A 67-year-old, retired officer, smoker, married, Egyptian male patient was presented to the emergency department (ED) with dizziness, palpitations, and acute confusion state. He gave a recent history of fever, fatigue, dry cough, generalized body aches, anorexia, and loss of smell 3 days ago. There is a recent contact with a confirmed case of COVID-19 pneumonia. He gives a history of chronic hypertension on captopril (5mg; OD). He is smoking about 20 cigarettes for 28 years. The patient denied a history of other cardiovascular diseases, drugs, or other special habits. Informed consent was taken. Upon general physical examination; generally, the patient was anxious, distressed, with a regular pulse rate of VR; 74 bpm, blood pressure (BP) of 150/90 mmHg, respiratory rate of 23 bpm, the temperature of 37.7 °C, and pulse oximeter of oxygen (O2) saturation of 89%. Currently, the patient was admitted to the critical care unit with right bundle branch block (RBBB), left anterior fascicular block (LAFB), and mild COVID-19 pneumonia with slight pleural effusion. Initially, the patient was treated with O2 inhalation by O2 cylinder (100%, by nasal cannula, 5L/min). The patient was maintained treated with cefotaxime; (1000 mg IV every 8hours), azithromycin (500 mg PO single daily dose), oseltamivir (75 mg PO twice daily only for 5 days), and paracetamol (500 mg IV every 8 hours as needed). SC enoxaparin 80 mg twice daily), aspirin tablet (75 mg, once daily), clopidogrel tablet (75 mg, once daily), and hydrocortisone sodium succinate (100 mg IV every 12 hours) were added. The patient was daily monitored for temperature, pulse, blood pressure, and O2 saturation. Serial ECG tracings through the hospital admission stay were done. The initial ECG tracing was done on the ICU admission of VR; 74 showed NSR with RBBB, LAFB, and SISIISIII pattern (Figure 1A). The second ECG tracing was done within 8 minutes of the above tracing of VR; 76 showed the same abnormalities (Figure 1B). Laboratory workup was done during the third day of the presentation. The initial complete blood count (CBC); Hb was 14.4 g/dl, RBCs; 5.10*103/mm3, WBCs; 6.19*103/mm3 (Neutrophils; 61.9 %, Lymphocytes: 27.6%, Monocytes; 8.9%, Eosinophils; 1.3% and Basophils 0.3%), Platelets; 184*103/mm3. S. Ferritin was high; 478 ng/ml. D-dimer was high (0.756 ng/ml). CRP was high (41 g/dl). LDH was high (500 U/L). SGPT was normal (21.45 U/L), SGOT was normal (20.72 U/L). Serum albumen was low (2.5 gm/dl). Serum creatinine was normal (0.78 mg/dl) and blood urea was normal (17 mg/dl). RBS was normal (119 mg/dl). Plasma sodium was normal (139mmol/L). Serum potassium was normal (4.4 mmol/L). Ionized calcium was normal (1.3 mmol/L) and total calcium was normal (10.4 mg/dl). The troponin test was negative (0.03 U/L). CK-MB was normal (8 U/L). The initial CXR plain film was done during the second day of the presentation showing mild right pleural effusion and mild left parahilar ground-glass opacities (Figure 2A). The first chest CT without contrast was done during the second day of the presentation showing mild right pleural effusion and mild left perihilar ground-glass opacities (Figure 2B). Echocardiography was done during the third day of the presentation with EF; 73.61 % showed diastolic dysfunction with reversed EA ratio, IVS hypertrophy (18.89 mm), and mitral regurgitation (Figure 2C). Bifascicular block with ECG SISIISIII pattern in mild COVID-19 pneumonia with slight pleural effusion was the most probable diagnosis. The patient was discharged within 3 days of hospital admission nearly, after clinical and workup improvement. The patient was continued on aspirin tablets (75 mg, OD) and captopril tablets (5 mg; OD). Further cardiac and chest follow-up was advised.
• Overview:
• A 67-year-old, retired officer, smoker, married, Egyptian male patient was admitted to the intensive care unit with right bundle branch block, left anterior fascicular block, and mild COVID-19 pneumonia with slight pleural effusion.
• The primary objective for my case study was the presence of a patient who presented with a right bundle branch block, left anterior fascicular block, and mild COVID-19 pneumonia with slight pleural effusion in the ICU.
• The secondary objective for my case study was the question of; how did you manage the case at home?
• There was a history of contact with a confirmed COVID-19 case. The presence of confirmed COVID-19 case, left ground-glass consolidation, and laboratory COVID-19 suspicion on top of clinical COVID-19 presentation will strengthen the COVID-19 diagnosis.
• Interestingly, associated hypoxia in the current COVID-19 pneumonia may play an essential role in the present new bifascicular heart block.
• The dramatic response of the associated symptoms may be strengthening this suggestion.
• There is an existence of SISIISIII pattern with the S-waves of amplitude is more than 1.5 mm in I, II, and III. It represents a variable prognostic ECG finding such as RVH, pulmonary embolism, and congenital heart disease [5-7].
• The presence of left ventricular septal hypertrophy is considered another risk.
• Elderly male sex, heavy smoker, COVID-19 pneumonia, pleural effusion, recurrent ischemic cerebrovascular stroke, renal impairment, ischemic heart disease, hypocalcemia, diabetes, ischemic variant premature ventricular contractions, and QRS-complex fragmentation are risk factors.
• Acute myocardial infarction was the most probable electrocardiographic differential diagnosis for the current case study. Butthere is no ST-segment elevation that characterized AMI involving at least two consecutive leads.
• I can’t compare the current case with similar conditions. There are no similar or known cases with the same management for near comparison.
• The only limitation of the current study was the unavailability of coronary catheterization.
• Associated hypoxia in the current COVID-19 pneumonia may play an essential role in the present new bifascicular heart block.
• SISIISIII pattern represents a variable prognostic ECG finding such as RVH, pulmonary embolism, and congenital heart disease.
• The presence of left ventricular septal hypertrophy is considered another risk.
• The presence of the elderly male sex, heavy smoker, COVID-19 pneumonia, pleural effusion, bifascicular heart block, SISIISIII pattern, and interventricular septal hypertrophy are prognostic factors for the severity of the disease.
• The clinical and electrocardiographic response after using anti-COVID19 measures the signifying its role and suggest the diagnosis of COVID19 infection as a causation.
There are no conflicts of interest.
COVID-19: Coronavirus disease 2019
ECG: Electrocardiogram
ED: Emergency department
ICU: Intensive care unit
LAFB: Left anterior fascicular block
LPFB: Left posterior fascicular block
O2: Oxygen
RBBB: Right bundle branch block
SCD: Sudden cardiac death
SGOT: Serum glutamic-oxaloacetic transaminase
SGPT: Serum glutamic-pyruvic transaminase
SHD: Structural heart disease
VR: Ventricular rate
I wish to thank the team nurses of the critical care unit in Kafr El-Bateekh Central Hospital who make extra-ECG copies for helping me. I want to thank my wife to save time and improving the conditions for supporting me.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
