RESUMEN
Alcohol septal ablation (ASA) has been widely used in relieving the left ventricular outflow tract (LVOT) obstruction caused by hypertrophic obstructive cardiomyopathy (HOCM). There is limited data about the utility of ASA in cases of cardiac amyloidosis with LVOT obstruction. Our patient is 71-year-old male with a history of multiple myeloma complicated by cardiac amyloidosis and end-stage renal disease on hemodialysis who presented from the dialysis center due to hypotension. The patient was admitted to our hospital for further workup. He underwent echocardiography that showed severely elevated LVOT gradient pressures and the decision was made to proceed with ASA, which led to significant improvement in the LVOT gradient pressures and the patient being able to tolerate his dialysis sessions.
RESUMEN
This case report explores the rare occurrence of a needle embolism in the heart among individuals with intravenous drug use (IVDU). The intricate symptomatology, ranging from overt chest pain to asymptomatic cases, poses diagnostic challenges and may lead to underrecognition. Healthcare professionals must navigate varied presentations, emphasizing the need for a nuanced diagnostic approach. The interplay of needle embolisms with infective endocarditis and sepsis adds complexity, requiring a comprehensive understanding. Ongoing education and training are crucial for healthcare professionals to address the evolving challenges of needle embolism management within the broader context of infective endocarditis and sepsis. Our patient is a 31-year-old female with a history of IVDU who presented with heart palpitations and shortness of breath. A CT scan revealed lung lesions and a needle in the right ventricle. The patient was admitted for methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia, where she underwent video-assisted thoracoscopic surgery (VATS) involving empyemectomy and wedge resection of the right-middle and lower lobes. However, it was deemed very risky to remove the needle from the right ventricle. Despite extensive discussion and patient education, she left the rehabilitation center without follow-up, highlighting the challenges of managing IV drug-related complications. In conclusion, heightened awareness and a proactive approach are crucial in managing rare complications such as needle embolisms in IVDU patients. This case underscores the significance of staying informed to improve patient care and outcomes amid evolving healthcare practices.
RESUMEN
Intra-aortic balloon pumps (IABPs) are used to assist with left ventricular (LV) unloading in patients with cardiogenic shock (CS). There are different mechanical devices that can be used in CS, of which the IABP represents the simplest, the easiest to insert and remove, and the most cost-effective. Compared to traditional femoral IABPs, axillary IABPs allow patients to remain ambulatory. This is especially beneficial in patients awaiting heart transplants. Our case presents a patient with CS, where axillary IABP was used to unload the LV. However, our patient developed ventricular arrhythmia secondary to IABP migration to the LV.
RESUMEN
Thrombocytopenia, a condition characterized by low platelet counts, can arise from various causes, including autoimmune diseases. Immune thrombocytopenia (ITP), a diagnosis made by excluding other possible causes, is categorized as primary or secondary, with primary ITP being idiopathic and secondary ITP associated with infections or autoimmune conditions. This study highlights a unique instance of severe thrombocytopenia triggered by Helicobacter pylori infection.
RESUMEN
Sarcoidosis is defined as an immune-mediated multi-organ granulomatous disease with unknown etiology, which is characterized by the presence of multiple non-caseating granulomas in the absence of a definite infective or toxic cause. Neurosarcoidosis (NS) occurs when sarcoid granulomas invade the central or peripheral nervous systems. Sarcoidosis usually presents with non-specific manifestations, including dry cough, fatigue, night sweats, weight loss, skin changes, and eye manifestations. Many patients who develop NS present with neurological manifestations within two years of being diagnosed with sarcoidosis. Herein, we present a case of newly diagnosed sarcoidosis in a 49-year-old male patient initially presenting with neurological manifestations of unknown origin, later identified as NS on peripheral lymph node biopsy with non-caseating granuloma.
RESUMEN
Multiple sclerosis (MS) is a chronic demyelinating disorder resulting in demyelination, neuroaxonal degeneration, and sclerosis. This often-debilitating disease affects young females mainly. Literature describing the pathology and phenotypic features is vast. Although there are extensive descriptions of new-onset MS presentations, few document the initial presentation as a transient ischemic attack or ischemic stroke. The case we present highlights the rarity of such presentation. In the literature, we found scarce reports about MS as presenting as a stroke mimicker with some studies quoting from 2.2% to 4.4% of the cases having MS. Our case serves as a reminder that MS can mimic acute ischemic strokes and the importance of maintaining MS apart of the differential in a young female with no significant history present with acute neurological deficits to reduce the complications of MS and the healthcare-associated costs.