Small Bowel Obstruction Masquerading as Acute ST Elevation Myocardial Infarction.

ST segment elevation on EKG remains among the most important presentations of acute myocardial infarction. Due to the urgency of intervention for this finding, other clinical scenarios causing ST elevations on EKG may sometimes go unaddressed and can lead to fatal complications. We present a case of an 86-year-old male presenting with small bowel obstruction leading to EKG findings of ST segment elevation in the absence of critical coronary obstruction. The EKG finding resolved after the improvement of small bowel obstruction reflecting the reversible cause of the changes.

Left Ventricular Aneurysm Presenting as a Late Complication of Childhood Chemotherapy.

Cardiotoxicity is a well known adverse effect of chemotherapy. Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction. A left ventricular aneurysm due to chemotherapy is a rare and a dangerous complication which is particularly challenging in diagnosis requiring a high index of suspicion and periodic imaging. We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

Aortico-Left Atrial Fistula: A Rare Complication of Bioprosthetic Aortic Valve Endocarditis Secondary to Enterococcus faecalis.

Paravalvular aortic root abscess with intracardiac fistula formation is an exceedingly rare complication of infective endocarditis. This condition is even more rarely encountered in patients with bioprosthetic valve endocarditis. We report an unusual case of a 68-year-old Bosnian female with a bioprosthetic aortic valve, who developed an extensive aortic root abscess, complicated by an aortico-left atrial intracardiac fistula. This case illustrates that a high index of suspicion, prompt diagnosis by echocardiography, proper antibiotic therapy, and early surgical intervention are crucial to improving treatment outcomes for this rare condition.

Complete heart block with diastolic heart failure and pulmonary edema secondary to enlarging previously diagnosed thrombosed aneurysm of sinus of valsalva in a patient with history of autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is associated with vascular aneurysms that can affect any part of the vascular tree, like ascending aorta or coronary arteries. Sinus of Valsalva is known as an anatomical dilation at the root of aorta above the aortic valve and very few cases show aneurysm at that site in patients with ADPKD. Sinus of Valsalva aneurysm (SVA) can present with rupture and acute heart failure and infective endocarditis or could be asymptomatic accidentally discovered during cardiac catheterization. We report a case of a 76-year-old male with a unique constellation of cardiovascular anomalies associated with ADPKD. Patient was previously diagnosed with aneurysms affecting ascending aorta, sinus of Valsalva, and coronary arteries. Several years later, he came with complete heart block which was discovered later to be secondary to enlargement of his previously diagnosed thrombosed SVA. His case was complicated with acute heart failure and pulmonary edema. Conclusion. Patients with ADPKD can present with extrarenal manifestations. In our case, aneurysm at sinus of Valsalva was progressively enlarging and presented with complete heart block.

Recurrent sinus pauses: an atypical presentation of temporal lobe epilepsy.

Autonomic dysfunction related to seizures may give rise to a broad spectrum of cardiovascular abnormalities. Among these, ictal bradycardia and conduction delays may be encountered. Failure to recognize these abnormalities may contribute to sudden, unexplained death in epilepsy patients. We report a case of a Haitian female with temporal lobe epilepsy associated with recurrent sinus pauses.

Adult T-Cell Leukemia-Lymphoma during Pregnancy.

Adult T-cell leukemia-lymphoma (ATL) is an uncommon highly aggressive T-cell lymphoma associated with human T-cell lymphotropic virus type 1 (HTLV-1) infection. It is rarely encountered during pregnancy and is particularly challenging to treat due to its aggressive nature and because of the lack of robust data on optimal chemotherapy. We report a case of a Jamaican immigrant diagnosed with ATL during pregnancy.