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Massive pulmonary embolism with acute cor pulmonale
A 51-year-old immobilised man, while recovering at stroke rehabilitation, complained of sudden onset chest pain prior to an unconscious collapse. Observations on arrival were heart rate 120 bpm, blood pressure 80/60 mm Hg and oxygen saturations of 90% on 10 L of oxygen. ECG demonstrated new right bundle branch block (RBBB) with classical S1Q3T3 repolarisation abnormality of acute right heart strain (figure 1A). Urgent CT pulmonary angiogram revealed saddle pulmonary embolism with extensive thrombus burden (figure 1B). Transthoracic echocardiogram (TTE) showed acute right ventricular (RV) overload with c...
Source: Postgraduate Medical Journal - July 25, 2016 Category: Journals (General) Authors: Nelson, A. J., Wong, G. R., Roberts-Thomson, R., Parvar, S. L. Tags: Journalology, Drugs: cardiovascular system, Echocardiography, Pain (neurology), Stroke, Hypertension, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Vascular surgery, E Source Type: research

The Assassin: Chagas Cardiomyopathy
A 35-year-old Salvadoran woman had been hospitalized for heart failure multiple times over a 5-year period, yet the etiology of her disease remained elusive. She also had a history of stroke. Again, she presented to the emergency department with shortness of breath, chest pain, and fatigue. Although these symptoms were chronic, they had been increasing for 3 weeks prior to admission. The patient denied fevers, chills, cough, or gastrointestinal complaints. She had no history of smoking, alcohol consumption, or illicit drug use. Her medications included carvedilol, furosemide, and warfarin.
Source: The American Journal of Medicine - July 19, 2013 Category: Journals (General) Authors: Uppinder K. Mattu, Gagan D. Singh, Jeffrey A. Southard, Ezra A. Amsterdam Tags: Diagnostic dilemma Source Type: research

Elderly female with CHF complains of abdominal pain, nausea and vomiting, dizziness, and confusion for 5 days. What is the cause?
Author: V. Dimov, M.D.Reviewer: S. Randhawa, M.D.A 96-year-old African American female (AAF) was admitted from a nursing home with complaints of abdominal pain, nausea and vomiting (N/V), dizziness, confusion and double vision for 5 days. She was discharged from the hospital just 4 days ago. Digoxin was started during that previous hospitalization for control of tachycardia in atrial fibrillation. One day prior to discharge, digoxin level was 1.8 mg/mL and digoxin dose was decreased to 125 mcg PO Q 48 hr.Past medical history (PMH)Hypertension, atrial fibrillation, coronary artery disease, stroke, congestive heart failure.M...
Source: Clinical Cases and Images - August 2, 2009 Category: General Medicine Tags: Cardiology Intensive Care Toxicology Source Type: news

A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report
ConclusionsAcute renal infarction from thromboembolism is a rare but serious complication of arterial fibrillation. More efficient and different options for intervention methods will benefit the treatment of this disease. Here, we report a combination therapeutic method that has not been used in acute renal infarction associated with arterial fibrillation, and which restored renal perfusion and prevented long-term kidney injury.
Source: Journal of Medical Case Reports - October 19, 2022 Category: General Medicine Source Type: research