Sexual Health and Well-Being in Adults With Congenital Heart Disease: A International Society of Adult Congenital Heart Disease Statement

Unrecognized Cause of Native Valve Infective Endocarditis Due to Staphylococcus aureus: Laser Hair Removal

Laser hair removal for esthetic purposes has commonly been performed worldwide. This procedure is considered to be safe and effective, and severe complications such as systemic bacterial infections have seldom been reported. We present a case of native valve infective endocarditis (IE) potentially associated with laser hair removal. A 32-year-old female with a history of childhood atopic dermatitis presented with fever and arthralgia. She had been receiving monthly total body laser hair removal treatments for nine months. Physical examination revealed numerous painful purpuras on her fingers and soles. Laboratory examinations revealed a positive troponin level, and a 12-lead electrocardiogram revealed ST-segment elevation in inferolateral leads. Transthoracic echocardiography revealed mild wall motion abnormalities from the mid-posterior wall to the apex and thickening of the anterior mitral valve leaflet. Blood cultures grew methicillin-susceptible Staphylococcus aureus (MSSA). Based on these findings, we made a diagnosis of native valve Staphylococcal IE and acute myocardial infarction due to septic embolism. Due to the progression of mitral valve destruction, she underwent mitral valve replacement surgery and received an eight-week course of antibiotics, leading to a successful recovery. This case highlights a potential association between laser hair removal and Staphylococcal IE. Laser hair removal may compromise the skin barrier, potentially allowing the entry of bacteria such as S. aureus. Increased awareness of this potential complication is necessary, especially in populations at high risk for IE. Further research is needed to investigate the link between laser hair removal and bacteremia, particularly in high-risk populations, to guide prevention strategies.

Health Equity and Policy Considerations for Pediatric and Adult Congenital Heart Disease Care among Minoritized Populations in the United States

Achieving health equity in populations with congenital heart disease (CHD) requires recognizing existing disparities throughout the lifespan that negatively and disproportionately impact specific groups of individuals. These disparities occur at individual, institutional, or system levels and often result in increased morbidity and mortality for marginalized or racially minoritized populations (population subgroups (e.g., ethnic, racial, social, religious) with differential power compared to those deemed to hold the majority power in the population). Creating actionable strategies and solutions to address these health disparities in patients with CHD requires critically examining multilevel factors and health policies that continue to drive health inequities, including varying social determinants of health (SDOH), systemic inequities, and structural racism. In this comprehensive review article, we focus on health equity solutions and health policy considerations for minoritized and marginalized populations with CHD throughout their lifespan in the United States. We review unique challenges that these populations may face and strategies for mitigating disparities in lifelong CHD care. We assess ways to deliver culturally competent CHD care and to help lower-health-literacy populations navigate CHD care. Finally, we review system-level health policies that impact reimbursement and research funding, as well as institutional policies that impact leadership diversity and representation in the workforce.