Infective endocarditis complicated with nonobstructive ST elevation myocardial infarction related to septic embolism with intracranial hemorrhage: A case report

In this report, we report a 38-year-old female suffering from intermittent fever and was later diagnosed as IE. Initially antibiotic was given and mitral valve surgery was also arranged due to large vegetation with severe mitral regurgitation. Nevertheless, sudden conscious loss with desaturation happened and brain computed tomography (CT) showed intracranial and subdural hemorrhage related to possible septic embolism. In addition, electrocardiography (ECG) revealed ST elevation over precordial leads, and elevation of cardiac enzymes was also noted. Diagnoses: Emergent coronary angiography was arranged but result showed normal coronary arteries without any evidence of stenosis. The diagnoses of IE complicated with nonobstructive STEMI were made. Interventions: After coronary angiography, the patient underwent craniotomy and subdural hematoma removal. Surprisingly, follow-up ECG also revealed ST segment resolution. Outcomes: The patient received full course antibiotic treatment and follow-up brain CT also showed improvement of intracranial hemorrhage (ICH) and subdural hemorrhage. Because follow-up echocardiography still revealed severe mitral regurgitation with mitral valve prolapse due to leaflet destruction with partially decreased vegetation size, mitral valve replacement with bioprosthetic valve was performed and the patient was finally discharged smoothly. Lessons: In our knowledge, this case should be the 1st case of IE complicated with nonobstructive STEMI,...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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This study aimed to assess the relative safety and short-term efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (c-TACE) for treating peculiar anatomical sites of gastric cancer liver metastasis. MATERIAL AND METHODS Of the 68 patients with gastric cancer liver metastases confirmed by imaging and pathology, 35 were treated with DEB-TACE and 33 with c-TACE. The DEB-TACE group comprised 26 males and 9 females aged 28-75 years (56.8±6.3), and the c-TACE group included 19 males and 14 females aged 33-77 (60.2±9.4) years. Liver functions of th...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
This study proposed a classification system and a possible mechanism for stress fractures of the first rib using three-dimensional computed tomography (3D-CT). The data of 10 stress fractures of the first rib in adolescent athletes obtained using 3D-CT between 2007 and 2018 were reviewed. Fractures of the first rib were classified according to the location and type of the fracture line. Stress fractures of the first rib were classified into three types: type 1, center-transverse fracture; type 2, center to posterior-oblique fracture; and type 3, posterior-transverse fracture. There were three type 1 fractures, five type 2 ...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Upper Limb Source Type: research
Recent literature suggests that adults do not necessarily develop osteoarthritis if they have an osteochondral lesion of the talus (OLT). The purpose of this study was to determine if children with OLT are at risk to develop any radiographic evidence of early joint degeneration despite treatment efforts. Fifty-six ankles were identified over 6 years with stable OLT that underwent operative treatment. Preoperatively, each lesion was classified according to Berndt-Hardy for radiographs, Hepple for MRI, and Ferkel and Sgaglione for computed tomography. Radiographs were also evaluated for physeal status, OLT characteristics (l...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Leg & Foot Source Type: research
Tarsal coalitions have been reported in the setting of equinovarus foot deformities, but only as rare isolated findings. Failure to recognize this diagnosis may inhibit successful equinovarus correction. Here, we review a series of tarsal coalitions seen in congenital and neuropathic equinovarus deformity at two institutions, to report the breakdown of types of coalitions encountered, and to suggest methodology to facilitate earlier diagnosis. The records of all patients treated by two of the authors for bilateral equinovarus deformities and found to have either a unilateral or bilateral tarsal coalition between 2006 and 2...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Leg & Foot Source Type: research
Publication date: Available online 31 May 2020Source: SteroidsAuthor(s): Fernando A.C. Seara, Emerson L. Olivares, Jose H. M. Nascimento
Source: Steroids - Category: Drugs & Pharmacology Source Type: research
CONCLUSION: We report the successful management of anesthesia without lethal arrhythmia in a patient with ARVC and an ICD. An adequate amount of analgesia should be administered during general anesthesia to maintain adequate anesthetic depth and to avoid stress and pain. PMID: 32473832 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
June 1, 2020 -- AstraZeneca’s Brilinta (ticagrelor) has been approved in the US to reduce the risk of a first heart attack or stroke in high-risk patients with coronary artery disease (CAD), the most common type of heart disease. The approval...
Source: Drugs.com - New Drug Approvals - Category: Drugs & Pharmacology Source Type: news
Abstract The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary ang...
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Abstract The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary ang...
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Abstract The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary ang...
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
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