ABSTRACT
Unruptured aneurysm of sinus of Valsalva (SOV) is extremely rare. They may be asymptomatic and diagnosed incidentally or can present with either fatal outcome following rupture or manifest acutely with compression of surrounding structures. Dissection of unruptured aneurysm of left SOV into interventricular septum (IVS) and presenting as intramyocardial mass is not reported in the literature. We are reporting a case of 21-year-old man who was referred to us following a seizure episode and was incidentally diagnosed with aneurysm of left SOV dissecting into IVS. Multimodality imaging confirmed the diagnosis. He successfully underwent surgical repair and was asymptomatic during follow-up.
Subject(s)
Aortic Aneurysm/diagnosis , Aortic Aneurysm/surgery , Aortic Dissection/diagnosis , Aortic Dissection/surgery , Sinus of Valsalva/surgery , Adult , Aorta/diagnostic imaging , Aorta/pathology , Aortography/methods , Cardiomyopathies , Cysts , Diagnosis, Differential , Follow-Up Studies , Humans , Magnetic Resonance Imaging/methods , Male , Tomography, X-Ray Computed/methods , Treatment Outcome , Ultrasonography , Ventricular Septum/diagnostic imaging , Ventricular Septum/pathology , Young AdultABSTRACT
The occurrence of acute myocardial infarction following a honeybee sting has been very rarely reported in the previous literature. Possible pathogenetic mechanisms include severe hypotension, rarely hypertension and coronary vasospasm with subsequent thrombosis of coronary vessels developed after the release of vasoactive, inflammatory and thrombogenic substances contained in the bee venom. This syndrome is also known as Kounis syndrome. We report a case of a 32-year-old man who presented with acute inferior wall myocardial infarction within 3 h of honeybee sting. He was treated with thrombolytic therapy. Coronary angiogram revealed normal coronary arteries.
Subject(s)
Bees , Insect Bites and Stings/complications , Myocardial Infarction/etiology , Adult , Animals , Humans , MaleABSTRACT
Thrombolytic therapy directed to the achievement of early reperfusion in cases with acute ST elevation myocardial infarction can have significant complications which can be due to bleeding or in the form of allergic reactions. Sometimes these complications can cause mortality or significant and incapacitating morbidity which may at times surpass the risk possessed by the disease itself. We are reporting an interesting case of 63-year-old male, who presented to us with acute anterior wall myocardial infarction and developed acute onset paralysis following intravenous administration of streptokinase and heparin. MRI spine revealed spinal epidural hematoma. Patient was advised urgent surgical evacuation of hematoma, but opted for conservative management. Patient had significant residual neurological deficits at follow-up. In conclusion, spinal epidural hematoma is a rare complication following thrombolysis for acute ST elevation myocardial infarction. Though rare, high index of suspicion is required by physicians, as prompt treatment may lead to complete recovery, which otherwise can lead to debilitating neurological sequel.
