2.1 = | 1.751 Cit. to date |
842 Docs. to date |
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Paraskevi C Fragkou, Ioannis A Papadopoulos, Antonios Papadopoulos, Evangelos-Achilleas Kontoveros, Gregory Kaltsas, Foula Vassilara
2021-01-20
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Pancreatic neuroendocrine neoplasms (PanNENs) rarely secrete serotonin, which is the main cause of carcinoid syndrome. One of its unusual manifestations is carcinoid heart disease or Hedinger’s syndrome which is seldom accompanied by cardiac arrhythmias. We report the case of an 88-year-old woman who presented with recently experienced episodes of palpitations and a newly developed atrial flutter with a ventricular rate of 130 beats per minute. Echocardiography revealed thickened and tethered tricuspid and pulmonary valve leaflets causing severe valvular regurgitation and right ventricular dilatation. Episodes of intermittent diarrhoea over the previous 2 years were mentioned, making carcinoid syndrome our working diagnosis. The 5-hydroxyindoleacetic acid (5-HIAA) levels in a 24-hour urine collection specimen were elevated. Conventional imaging studies and a Ga-68 dodecane tetraacetic acid tyrosine-3-octreotate (DOTATATE) positron emission tomography/computer tomography (PET/CT) scan revealed the presence of a metastatic PanNEN arising from the pancreatic tail. The patient was managed with lanreotide and telotristat with remarkable improvement of her symptoms. To our knowledge, this is the first reported case of carcinoid syndrome presenting with atrial flutter as the initial symptom.
Ali Azari, Leila Bigdelu, Ossama Maadarani, Zouheir Bitar
2023-04-27
Views: 336
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Hydatid disease, also known as cystic echinococcosis, is a parasitic infection caused by the larval stage of Echinococcus granulosus. It usually invades organs such as the liver and the lungs but can affect any organ. Isolated cardiac involvement is a rare manifestation. We present a case of isolated left ventricle hydatid cyst with negative serological tests, which was treated with surgical removal and confirmed by histopathological examination.
Leila Bigdelu, Negar Ebrahimi, Ossama Maadarani
2023-08-25
Views: 369
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Acute pulmonary thromboembolism (PTE) is considered the third most frequent acute cardiovascular syndrome behind myocardial infarction and stroke, with annual incidence rates ranging from 39 to 115 per 100,000 people and ranking high among the causes of cardiovascular mortality. High-risk PTE is characterised by haemodynamic instability and encompasses clinical manifestations such as cardiac arrest, obstructive shock and persistent hypotension. The European Society of Cardiology (ESC) recommends a reperfusion strategy with systemic thrombolytic therapy for high-risk PTE under class I, level B if there are no contraindications. Overall, unsuccessful thrombolytic therapy and recurrent PTE have been reported in 8% of patients with high-risk PTE. The guidelines recommend surgical pulmonary embolectomy if thrombolysis is contraindicated or has failed. The position of repeated thrombolytic therapy as a treatment option in patients with recurrent high-risk PTE, especially in situations with a lack of surgical expertise or resources, was not mentioned in the guidelines. We report the case of a patient who suffered a recurrent high-risk PTE and was treated with repeated thrombolytic therapy that was effective and resulted in excellent outcomes.
Christos E Lampropoulos, Evagelia Sklavou, Charalampos Anastogiannis, Vasiliki Papanikolaou, Dimitris Tsilivarakis, Vasilis Vasiliou, Ioanna Papaioannou
2019-12-09
Views: 966
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Introduction: Carbon monoxide (CO) poisoning may cause severe cellular hypoxia.
Materials and methods: A 28-year-old male presented reduced levels of consciousness and dyspnoea after CO exposure. Clinical examination revealed tachypnoea, bilateral rales, dilated jugular veins and confusion. Troponin I, lactate and carboxyhaemoglobin levels were increased. Thoracic X-ray depicted pulmonary oedema and an echocardiogram, severe heart failure (HF; EF<25%). He was intubated due to clinical deterioration.
Results: He remained intubated for 5 days with excellent improvement of left ventricular function (EF>55%). He was discharged 1 week later with full recovery.
Discussion: Acute HF is a rare serious complication of CO poisoning, even in healthy young individuals.
Nuno Zarcos Palma, Mariana da Cruz, Gisela Evaristo Vasconcelos, Vitor Fagundes, Lindora Pires, Mari Mesquita
2019-06-10
Views: 957
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Heyde’s syndrome is a form of acquired von Willebrand syndrome that consists of bleeding from intestinal angiodysplasia in the presence of aortic stenosis (AS). An association with obstructive hypertrophic cardiomyopathy, rather than AS, by a similar mechanism has also been described. We report the case of a 78-year-old woman with chronic anaemia and hypertrophic obstructive cardiomyopathy in whom intestinal angiodysplasia with active bleeding was identified by an unconventional method. In this case, the authors describe a different approach to reach the correct diagnosis.
Paul Silaghi, Daniel T. Eitzman
2023-05-12
Views: 360
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Sickle cell disease is a prevalent hematologic condition, but some of the factors that lead to erythrocyte sickling are not fully known. A 58-year-old male patient with a history of sickle cell disease (SCD) and paroxysmal atrial fibrillation was transferred from an outside hospital for further management of refractory sickle cell crisis with acute chest syndrome. Before transfer, the patient received antibiotics and multiple packed red blood cell (pRBC) transfusions, with minimal effect on symptoms or anemia. After transfer, the patient developed rapid supraventricular tachycardia and atrial fibrillation (rates >160) with a drop in blood pressure. He was started on IV amiodarone. His heart rate was subsequently better controlled and converted to sinus rhythm the following day. Three days following initiation of amiodarone, the patient, with a hemoglobin count of 6.4 g/dl, required one additional unit of pRBC. On the fourth day, the patient’s hemoglobin count rose to 9.4 g/dl, and he reported a marked improvement in symptoms. The improvements in symptoms and hemoglobin count were sustained, and the patient was discharged two days later. This remarkable improvement in anemia and symptoms triggered a search for potential causes. Amiodarone is a complex drug shown to have effects on multiple cell types, including erythrocytes. A recent preclinical study demonstrated reduced sickling and improved anemia in a murine model of SCD. This case report raises the possibility that amiodarone may have contributed to the rapid improvement in anemia and should be further explored in clinical trials.
Natassja Moriarty, Nadeem Attar
2020-06-24
Views: 1275
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Objective: We present a case of a 22-year-old bodybuilder diagnosed with myocarditis secondary to clenbuterol use.
Results: The patient was primarily managed conservatively by the discontinuation of clenbuterol and the temporary use of dual anti-platelets, beta-blockers and nitrates.
Conclusion: Clenbuterol is a long-acting beta-2 agonist primarily used in veterinary medicine. In recent years, it has been illegally marketed as a weight loss supplement because of its anabolic properties and is popular among fitness enthusiasts. It is our aim to use this case to underscore the adverse effects of this drug with hopes that tighter regulations will be instituted to stem its illegal distribution.
Fahad Eid, Andrew Takla, Mohamed Magdi Eid, Mostafa Najim, Mostafa Reda Mostafa
2023-10-26
Views: 450
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This case report presents the management of a 53-year-old female with a complex psychiatric history who ingested multiple medications, resulting in severe cardiovascular compromise and subsequent respiratory failure. The patient’s ingestion included clonidine, fluoxetine, gabapentin, quetiapine and bupropion. Initial treatment involved supportive measures, including fluid resuscitation, bicarbonate infusion and correction of electrolyte imbalances. Despite these interventions, the patient remained haemodynamically unstable, requiring multiple vasopressors. Lipid emulsion therapy was initiated and led to a remarkable improvement in the patient’s cardiovascular status. However, she developed acute respiratory distress syndrome (ARDS) and required prolonged mechanical ventilation. Steroid therapy was initiated to manage the ARDS, and the patient was successfully extubated on day 6. The case highlights the potential effectiveness of lipid emulsion therapy in managing bupropion toxicity, but emphasises the need for further research to establish clear guidelines on dosing, timing and safety protocols. Adverse effects associated with lipid emulsion therapy must be carefully considered. Individualised decision-making and patient-centred care is crucial in optimising outcomes in cases of bupropion toxicity.
Fahad Eid, Mostafa Najim, Mostafa Elbanna, Mostafa Reda Mostafa, Mohamed Magdi
2023-12-12
Views: 244
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This report presents the clinical details and management of a 58-year-old Caucasian male with pericardial effusion and cardiac tamponade following outpatient inferior vena cava (IVC) filter removal. The patient was unresponsive and experienced cardiac arrest minutes after the procedure, requiring cardiopulmonary resuscitation. After return of spontaneous circulation he displayed somnolence, confusion and chest discomfort. Investigations revealed a large pericardial effusion, and an echocardiography confirmed cardiac tamponade. Prompt intervention involved pericardiocentesis, resulting in haemodynamic stabilisation and reduction in effusion size. The patient responded favourably with treatment. Differential diagnoses were considered and treatment options were discussed, highlighting the importance of timely recognition and appropriate intervention in managing pericardial effusion and cardiac tamponade. This report adds to the limited literature on pericardial effusion and cardiac tamponade following a scheduled outpatient IVC filter removal, emphasising the unique clinical presentation and successful management of this rare phenomenon.
Simon Kashfi, Shorabh Sharma
2022-04-12
Views: 429
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Inhalants are common drugs of abuse. Hydrocarbons, the active ingredient in most inhalants, exert depressant effects on the central nervous system, causing a ‘high’. In the heart, hydrocarbon toxicity can predispose patients to arrhythmias and heart failure through increased sympathetic susceptibility. We present the case of a 28-year-old female who developed dilated cardiomyopathy in the setting of chronic inhalant abuse.
2.1 = | 1.751 Cit. to date |
842 Docs. to date |
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