RESUMEN
Despite being a rare phenomenon, pericardial hydatid cysts present unique diagnostic challenges and require a multimodality imaging as well as a multidisciplinary approach for a curative management. The authors here present a case of a middle aged man who was referred to them for management of new onset atrial flutter with mitral regurgitation.
Asunto(s)
Aleteo Atrial , Equinococosis , Insuficiencia de la Válvula Mitral , Humanos , Masculino , Aleteo Atrial/complicaciones , Aleteo Atrial/diagnóstico , Equinococosis/complicaciones , Equinococosis/diagnóstico , Insuficiencia de la Válvula Mitral/diagnóstico , Insuficiencia de la Válvula Mitral/etiología , Insuficiencia de la Válvula Mitral/complicaciones , Persona de Mediana Edad , Diagnóstico Diferencial , Pericardio/diagnóstico por imagen , Ecocardiografía/métodos , Quiste Mediastínico/complicaciones , Quiste Mediastínico/diagnóstico , Quiste Mediastínico/diagnóstico por imagenRESUMEN
A South Asian male in his early 60s presented with acute-onset dyspnoea on postoperative day 4 after undergoing middle hepatic vein sacrificing partial liver resection for epithelioid angiomyolipoma. The patient's SpO2 on presentation was 65% in standing position which improved to 90% in left lateral decubitus. He was suspected of having platypnea-orthodeoxia syndrome (POS) which was confirmed on echocardiogram with microbubble contrast showing a large intracardiac right-to-left shunt. The patient was taken up for transcatheter closure of patent foramen ovale (PFO). A 30 mm Amplatzer PFO Occluder was deployed across the PFO which reduced the intracardiac shunt resulting in an improved arterial saturation as well as immediate relief of patient's symptoms. This case illustrates the importance of suspecting and recognising POS clinically as well as the efficacy of transcatheter closure of PFO in such cases leading to resolution of hypoxaemia in a short span of time.
Asunto(s)
Foramen Oval Permeable , Dispositivo Oclusor Septal , Humanos , Masculino , Persona de Mediana Edad , Disnea/diagnóstico , Foramen Oval Permeable/complicaciones , Foramen Oval Permeable/diagnóstico por imagen , Foramen Oval Permeable/cirugía , Hipoxia/etiología , Hipoxia/terapia , Hipoxia/diagnóstico , Hígado , Síndrome de Platipnea OrtodesoxiaRESUMEN
Often termed as 'vanishing mystery' epidemiologically, endomyocardial fibrosis (EMF) continues to be the the most common cause of restrictive cardiomyopathy in Africa and some parts of the Indian subcontinent, where it is considered a significant public health problem. On the other hand, in developed countries, it is considered a rare phenomenon. This entity is considered incurable due to lack of targeted therapies, even after 75 years since its discovery. The authors describe here a case of an Indian male, in his early 30s who presented with complaints of dyspnoea on minimal daily activities, swelling of both legs and abdominal fullness for 3 months. The clinical features were suggestive of isolated right heart failure. He was diagnosed with EMF on echocardiography and the findings were confirmed on cardiac MRI. The patient has progressed to develop biventricular dysfunction and is being managed symptomatically with diuretics due to unavailability of targeted treatment options at present.
Asunto(s)
Fibrosis Endomiocárdica , Insuficiencia Cardíaca , Masculino , Humanos , Fibrosis Endomiocárdica/complicaciones , Fibrosis Endomiocárdica/diagnóstico por imagen , Ecocardiografía , Insuficiencia Cardíaca/etiología , Radiografía , Imagen por Resonancia MagnéticaRESUMEN
Intramuscular injection has been used to administer medications for more than a hundred years. However, despite our profession's long experience with intramuscular administration, preventable complications such as injection nerve palsies are still prevalent in developing countries. Injections account for one-fifth of all traumatic nerve injuries. These injuries largely occur due to indiscriminate use of intramuscular injections for treating common illnesses, frequently by unlicensed or undertrained practitioners administering unnecessary treatment to impoverished patients. The sciatic nerve is the most commonly injured, and frequently the resulting muscle weakness and associated disability are irreversible. This case report includes a video of a patient with foot drop 6â weeks after gluteal intramuscular injection. Such injuries can be prevented by proper awareness and training, the implementation of safer injection techniques, and quality assurance methods.