ABSTRACT
A man in his 20s with no medical illness sustained a blunt chest injury with pneumothorax and lung contusion after involving in a motorbike accident. Five days postadmission, he subsequently had myocardial infarction with cardiac arrest, in which coronary angiogram and intravascular ultrasound showed diffused multivessel coronary artery dissection.
Subject(s)
Coronary Angiography , Myocardial Infarction , Thoracic Injuries , Wounds, Nonpenetrating , Humans , Male , Wounds, Nonpenetrating/complications , Thoracic Injuries/complications , Myocardial Infarction/etiology , Coronary Vessels/diagnostic imaging , Coronary Vessels/injuries , Accidents, Traffic , Adult , Aortic Dissection/etiology , Aortic Dissection/diagnostic imaging , Aortic Dissection/complications , Ultrasonography, InterventionalABSTRACT
A man in his 20s with underlying chemorefractory primary T-lymphoblastic lymphoma and hypereosinophilia developed acute chest pain in the ward after readmission for disease progression. ECG showed widespread ST depression and serum troponin was markedly elevated. Transthoracic echocardiography showed diffused thrombus deposition with preserved ejection fraction consistent with eosinophilic myocarditis. The patient ultimately succumbed to the disease, after complications with severe hospital-acquired pneumonia.
Subject(s)
Acute Coronary Syndrome , Eosinophilia , Lymphoma, Non-Hodgkin , Myocarditis , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma , Male , Humans , Acute Coronary Syndrome/diagnosis , Myocarditis/diagnosis , Eosinophilia/diagnosisABSTRACT
A 33-year-old woman with newly diagnosed disseminated tuberculosis presented with acute heart failure and incidental findings of intracardiac thrombus, demonstrating possible tuberculous myocarditis. (Level of Difficulty: Intermediate.).
ABSTRACT
OBJECTIVES: A history of severe hypoglycemia (SH) is associated with cardiovascular (CV) events among patients with type 2 diabetes mellitus (T2DM). In this study, we compared the severity of atherosclerotic coronary artery disease (ACAD) in T2DM patients with and without a history of SH. METHODOLOGY: We conducted a comparative case-control study involving 28 T2DM patients with a history of SH within the last 5 years with no documented ACAD, and matched them with 28 T2DM patients with no history of SH. All subjects underwent coronary artery calcium scoring (CACS) with or without coronary computed tomographic angiography (CCTA) to evaluate the severity of ACAD. RESULTS: A history of SH in T2DM was associated with a higher prevalence of significant ACAD (79% versus 46%, p=0.026). A high CACS (≥100) was seen in a greater number of patients with a history of SH compared to those without (75% versus 43%, p=0.029). Similarly, there was a higher prevalence of obstructive CAD in those with a history of SH compared to those without (72% versus 39%, p=0.036). Median C-reactive protein level was also higher among patients with a history of SH (0.41 mg/dL versus 0.16 mg/dL, p=0.029). CONCLUSION: In patients with T2DM, a history of SH is significantly associated with ACAD compared to those without SH. A history of SH warrants screening for ACAD.
