Hitesh Gurjar

Interests

Teaching

Cardiology Internal MedicineSystemic Approach in patient management

Research

Thrombotic disease

Courses

No activities entered.

Scholarly Contributions

Books

• Gurjar, H. (2021). Covid-19 and Hypertension. New York: McGraw Hill Professional. doi:Alavi, F., & Gurjar, H. (2021). COVID-19 and Hypertension. COVID-19 and the Heart: A Case-Based Pocket Guide, 87.
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  Alavi, F., & Gurjar, H. (2021). COVID-19 and Hypertension. COVID-19 and the Heart: A Case-Based Pocket Guide, 87.

Journals/Publications

• Gurjar, H., & Singh, H. (2025). Concomitant Myocardial Infarction and Stroke Managed With a Unique Approach: A Case Report and Review of Literature.
• Haider, A., Gurjar, H., Ghazanfar, H., Singh, H., & Siddiqa, A. (2023). A Reversible Cause of Cutaneous Rash in a Patient With Alcohol Consumption. Cureus, 15(2), e35011.
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  The most common cutaneous manifestations of alcoholism include urticarial reaction, flushing, porphyria cutanea tarda, psoriasis, rosacea, seborrheic dermatitis, and pruritus. Here, we present a case of a young male with a history of alcohol abuse who presented with non-blanching, petechial, and perifollicular macular rash secondary to vitamin C deficiency in view of poor oral intake. The rash improved significantly with vitamin C supplementation. Although rare in developed countries, clinicians should keep vitamin C deficiency as a differential diagnosis for skin rash in alcohol consumers.
• Chilimuri, S., Mantri, N., Gurjar, H., Youthjug, K. A., Sun, H., Gongati, S., Zahid, M., Ronderos, D. M., De La Cruz, A., Varanasi, P., Shin, D., & Nayudu, S. K. (2022). Implementation and outcomes of monoclonal antibody infusion for COVID-19 in an inner-city safety net hospital: A South-Bronx experience. Journal of the National Medical Association, 113(6), 701-705.
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  Monoclonal antibody therapy (MAT) is recommended in mild to moderate Coronavirus disease 2019 (COVID-19) patients who are at risk of progressing to severe disease. Due to limited data on its outcomes and the logistic challenges in administering the drug, MAT has not been widely used in the United States (US) despite of emergency use authorization (EUA) approval by the Food and Drug Administration (FDA).
• Ghazanfar, H., Haider, A., Gurjar, H., Hernandez, N., Jyala, A., Bhatt, T., Zeana, C., & Chilimuri, S. (2022). Outcomes of Monoclonal Antibody Infusion Treatment During Delta (B.1.617.2) and Omicron (B.1.1.529) COVID 19 Variant Surges among Vaccinated and Unvaccinated Patients. Health services insights, 15, 11786329221127153.
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  Coronavirus infection of 2019 (COVID-19) is associated with significant morbidity and mortality. Vaccines supplement public health and social measures in preventing severe illness and mortality from COVID-19; however, vaccination rates remain inadequate in many regions. It is important to continuously explore the effective treatment due to the insufficient vaccination rate and increasing number of patients infected with virus. The emergence of new variants has led to multiple surges throughout the world requiring changes to treatment protocols.
• Ghazanfar, H., Kandhi, S., Shin, D., Muthumanickam, A., Gurjar, H., Qureshi, Z. A., Shaban, M., Farag, M., Haider, A., Budhathoki, P., Bhatt, T., Ghazanfar, A., Jyala, A., & Patel, H. (2022). Impact of COVID-19 on the Gastrointestinal Tract: A Clinical Review. Cureus, 14(3), e23333.
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  Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world, causing a pandemic that has resulted in more than 5 million deaths globally. The gastrointestinal (GI) tract is known to have high expression of angiotensin-converting enzyme 2 (ACE2) receptors in the human body, making it prone to direct damage from the cellular invasion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous GI symptoms have been reported among patients with COVID-19. This systemic review details the mechanism and effects of COVID-19 on the GI tract along with the hepatobiliary and pancreatic systems.
• Gurjar, H., Dhallu, M., Lvovsky, D., Sadullah, S., & Chilimuri, S. (2022). A Rare Case of Coronavirus Disease 2019 Vaccine-Associated Cerebral Venous Sinus Thrombosis Treated with Mechanical Thrombectomy. The American journal of case reports, 23, e935355.
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  BACKGROUND Vaccine-related thrombosis and thrombocytopenia syndrome (TTS) is a rare life-threatening syndrome reported after vaccination against COVID-19. CASE REPORT We describe a case of 56-year-old postmenopausal, obese woman with hypothyroidism and hyperlipidemia, who presented to the Emergency Department (ED) with fluctuating mental status and left-side weakness for 5 days. She received her first and second dose of mRNA-1273 vaccine (Moderna) at 12 and 8 weeks, respectively, prior to presentation. She was found to have multiple hemorrhages and infarcts on a computed tomography (CT) scan of the head. She was intubated in the ED for airway protection and mechanically ventilated. Magnetic resonance angiogram and venogram showed multiple infarcts in right frontal, parietal, and left parietal lobes, along with occlusion of left-side transverse sinus, sagittal sinuses, and left internal jugular vein, suggesting cerebral venous sinus thrombosis (CVST). Despite anticoagulation, her clinical condition continued to worsen, and she was referred for emergent endovascular thrombectomy. Her clinical condition improved after thrombectomy, and she was discharged on warfarin. At 4-month follow-up, she was able to walk with an assistive device and able to carry out activities of daily living with assistance. She is planned for further work-up for hypercoagulable state at follow-up. CONCLUSIONS This case highlights the occurrence of vaccine-related thrombosis 3 months after vaccine administration. Only 2 cases of TTS have been reported so far after mRNA-1273 vaccination (Moderna). To the best of our knowledge, this is the first reported case of CVST presenting 3 months after the first dose of COVID-19 mRNA-1273 vaccine (Moderna).
• Gurjar, H., Ghazanfar, H., Haider, A., Hernandez, N., Jyala, A., & Chilimuri, S. (2022). A High-Risk Patient With COVID-19 Vaccine Hesitancy Successfully Treated With Monoclonal Antibodies Through Two Major Surges. Cureus, 14(2), e22721.
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  Vaccine hesitancy remains a significant challenge in managing the current pandemic despite highly effective vaccines in the United States. Monoclonal antibodies (mAb) are an essential addition to coronavirus disease 2019 (COVID-19) treatment, along with oral antiviral agents (OAA), for non-hospitalized patients having risk factors for progression to severe COVID-19, especially in unvaccinated people. We present a case of a 74-year-old unvaccinated Hispanic woman with a history of diabetes mellitus, hypertension, coronary artery disease, obesity, and asthma who survived two episodes of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infections in January 2021 and December 2021 with exclusive use of mAb. Our case highlights the importance of using mAbs for treating high-risk patients with SARS-CoV-2 infection, especially in patients with vaccine hesitancy.
• Gurjar, H., Saad, M., Ali, N., Regmi, S., Upreti, P., Karna, S., Balaram, S. K., Kamalakkannan, G., & Vittorio, T. J. (2022). Post myocardial infarction left ventricular intramural dissecting hematoma: a case report describing a very rare complication. BMC cardiovascular disorders, 22(1), 83.
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  Dissecting intramural hematoma is a rare complication of acute myocardial infarction (AMI) and has been associated with increased mortality. There has been paucity of literature to establish protocols and guidelines for management in such cases.
• Gurjar, H., Singh, H., & Gurjar, B. (2022). Submassive Pulmonary Embolism Treated With Catheter-Directed Thrombolysis in Resource-Limited Setting: A Case Report and Review of Literature. Cureus, 14(1), e21760.
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  We describe a case of a young male who presented with acute onset progressively worsening shortness of breath for four days duration. He used to smoke cigarettes, and his profession required prolonged periods of standing. He underwent a two-dimensional echocardiogram showing right ventricular (RV) strain and computed tomography (CT) showing thrombus in the left major pulmonary artery. His pulmonary embolism severity index (PESI) score was high, predicting higher short-term mortality. Treatment options including risks and benefits were discussed with the patient, and he underwent catheter-directed thrombolysis (CDT) with rapid resolution of symptoms, oxygen saturation, and pulmonary artery pressures (PAP). He was discharged home safely after successful treatment of his condition.
• Haider, A., Gurjar, H., Ghazanfar, H., & Chilimuri, S. (2022). Necrotizing Fasciitis In A Patient with Metastatic Clear Cell Ovarian Carcinoma Treated with Bevacizumab. The American journal of case reports, 23, e935584.
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  BACKGROUND Necrotizing fasciitis is a life-threatening infection of the deep soft tissues that leads to progressive destruction of the fascia and subcutaneous fat. It typically spreads along the muscle fascia planes because of the relatively poor blood supply. Muscle tissue is usually spared because of its better blood supply. The usual risk factors for necrotizing fasciitis include trauma, malnutrition, obesity, uncontrolled diabetes mellitus, alcoholism, cirrhosis, neutropenia, and recent surgery. CASE REPORT We present a case of a middle-aged female who presented with necrotizing fasciitis of the right gluteal region. Her medical history was significant for well-controlled diabetes mellitus (hemoglobin A1c: 6.6), and clear cell carcinoma of ovaries (stage IV). She was on active chemotherapy with bevacizumab, paclitaxel, and carboplatin. She underwent incision and debridement of right gluteal abscess with drainage of 200 ml of foul-smelling pus and was started on intravenous antibiotics. Her blood cultures were negative, but the cultures taken from the right gluteal abscess showed moderate growth of Escherichia coli. The antibiotics were de-escalated and the patient was discharged with outpatient follow-up. CONCLUSIONS Bevacizumab, a humanized monoclonal IgG antibody, is a novel treatment for metastatic ovarian cancer. It is associated with necrotizing fasciitis due to anti-angiogenic, pro-thrombotic, and poor wound healing properties. It should be stopped in the patients presenting with necrotizing fasciitis.
• Khaja, M., Gurjar, H., Yapor, L., Abraham, M. C., Hernandez, N., & Haider, A. (2022). Reversible Systolic Heart Failure in a Patient on Ibrutinib Chemotherapy. Cureus, 14(3), e23266.
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  Ibrutinib is an irreversible Bruton tyrosine kinase inhibitor that is approved for the treatment of mantle cell lymphoma, chronic lymphocytic leukemia, small lymphocytic lymphoma, Waldenström macroglobulinemia, marginal zone lymphoma, and mantle cell lymphoma. However, it is associated with significant cardiotoxic effects, with hypertension and atrial fibrillation being the most common. We present the case of a 42-year-old female with a medical history significant for lymphoplasmacytic lymphoma who presented with non-arrhythmic, non-ischemic cardiomyopathy after four months of chemotherapy with ibrutinib. In addition, her left ventricular ejection fraction improved markedly within a few days of stopping ibrutinib. We propose that the use of ibrutinib may be associated with reversible non-ischemic cardiomyopathy even in the absence of cardiac arrhythmias. Therefore, clinicians should be cognizant of the signs and symptoms of cardiomyopathy in patients on ibrutinib chemotherapy.
• Saad, M., Gurjar, H., Rodriguez, M., Sharma, P., Roy, S., Timsina, L. R., Bhandari, M., & Vittorio, T. (2019). The Role of Cardioselective versus Non-Cardioselective Beta-Adrenergic Blockade in the Acute Phase of Takotsubo Cardiomyopathy. Journal of Cardiac Failure, 25(8), S28.
• Gurjar, H., Vijayvergia, R., Malhotra, P., Varma, S., & Wangkheimayum, S. (2015). Effect of danazol on cardiac, hematological, biochemical parameters and lipid profile in aplastic anemia patients. Indian Heart Journal, S90.
• Sharma, Y. P., Gurjar, H., Bagga, S., & Ahluwalia, J. (2015). Dual versus triple antiplatelet therapy in patients with acute coronary syndrome undergoing coronary artery stenting. indian heart journal, 67, s49--s71.