Pneumatocele Manifestation in Early Recovery Period of COVID-19: A Case Study.

In this case report, we review a case of pneumatocele in a 54-year-old Caucasian male patient diagnosed with infection of COVID-19 29 days prior, presenting with complaints of dyspnea and sharp pleuritic chest pain located in the left mid-axillary region exacerbated by deep inspiration with an episode of significant forceful cough a day prior. Preliminary labs were unrevealing for leukocytosis or neutrophilia, with normal troponins, and COVID-19 negative upon presentation. Radiographic imaging was significant for bilateral infiltrates in the left upper lobe, air fluid levels with initial concern for abscess but with subsequent inference of pneumatocele. Imaging was negative for pneumothorax. The patient was monitored, remained stable throughout admission, and discharged after work-up for fungal and bacterial infection were found to be negative with expectation of self-resolution of the pneumatocele. In this study, we overview the pulmonary impact of COVID-19 in the scope of pneumatocele occurrence in the early recovery phase of the viral illness.

Amphetamine-Dextroamphetamine-Induced Cardiomyopathy, an Emerging Cause of Heart Failure in Young Patient Populations: A Case Study Involving the Study Drug.

Amphetamine-Dextroamphetamine-induced cardiomyopathy has become an emerging cause of heart failure in teenage and young adult populations. With its increasingly widespread use for the treatment of attention-deficit/hyperactivity disorder (ADHD) as well as misuse as a "study drug" to increase concentration for educational performance, more patients are at risk of this cardiac manifestation, especially those without knowledge of these risks. It becomes vital to highlight the correlation of amphetamine-dextroamphetamine use and heart failure in order to increase awareness of this condition. This case study highlights the manifestation of tachycardia-induced cardiomyopathy in a 38-year-old female patient with long-standing amphetamine-dextroamphetamine use for refractory narcolepsy. Our patient was evaluated utilizing a thyroid panel, lipid profiles, EKG, Holter monitoring, stress echocardiography, and left heart catheterization, revealing an unremarkable thyroid panel, a left ventricular ejection fraction (LVEF) of 20-25% from 35% to 40% and normal coronary vessels. Amphetamine-dextroamphetamine was discontinued with the introduction of metoprolol, aspirin, and atorvastatin. The mainstay of treatment includes cessation of amphetamine-dextroamphetamine. It is important that physicians continue to recognize the implication of amphetamine-dextroamphetamine in the diagnosis of non-ischemic cardiomyopathy in young patients presenting with heart failure like symptomology and to attain a comprehensive history in order to establish this diagnosis.

Noninvasive Diagnostic Modalities in an Isolated Case of Cardiac Amyloidosis.

Amyloidoses are a family of inherited or acquired disorders characterized by the deposition of insoluble extracellular protein fibrils in various organs and tissues, thereby impairing their function. Amyloidoses are typically misfolded proteins, and on rare occasions, can deposit in the myocardium resulting in an infiltrative/restrictive cardiomyopathy. Restrictive cardiomyopathy is an underdiagnosed cause of congestive heart failure (CHF) with preserved ejection fraction, atrial and ventricular arrhythmias along with conduction defects. In elderly patients, as with this study, cardiac amyloidosis most often results from abnormalities in the liver protein transthyretin (TTR), a thyroxine and retinol-retinol binding complex transporter in blood. Mutated serum TTR results in familial systemic amyloidosis, whereas wild-type TTR results in senile cardiac amyloidosis predominantly seen in elderly males. Scintigraphy, a common non-invasive method used to facilitate early diagnosis of cardiac amyloidosis was the method used in this study. However, the gold standard for definitive diagnosis of cardiac amyloidosis is endomyocardial biopsy (EMB). Besides organ transplant, which is rarely done, therapy for cardiac amyloidosis is mainly aimed at symptomatic and supportive care. Plenty of evidence has shown that the left ventricular ejection fraction (LVEF) in patients with restrictive cardiomyopathy is usually preserved. However, in this study, we review the unique case of an 82-year-old male who was diagnosed with isolated cardiac amyloidosis with severe systolic dysfunction (decreasedLVEF), the methods used to establish the diagnosis, as well as the therapeutic interventions.

Racial and socioeconomic disparities in congenital heart surgery: A research article.

BACKGROUND: Though the modern era has proven to be reassuring with the advancement of perioperative care leading to improved survival, congenital heart disease (CHD) continues to underscore its significance in the lives of newborns and families worldwide. Particularly, CHD has disproportionately afflicted vulnerable minorities such as Black and Hispanic populations from the standpoint of ethnic disparities in mortality following heart surgery, increased resource utilization, and longer durations of stay. This study aims to identify and provide insight regarding the relationships between the aforementioned factors to develop targeted strategies of intervention to mitigate the outcomes for patients of these specific populations. METHODS: Free, current peer-reviewed literature from databases such as the American Heart Association, The European Heart Journal, Science Direct, and PubMed regarding CHD, racial disparities, and socioeconomic variances were accessed. The study was narrowed to a patient population including only infants without chromosomal anomalies or those that passed away before hospital discharge. RESULTS: Having private insurance and maternal education showed positive correlations with positive outcomes of patients post congenital heart surgery. Teaching hospitals were linked with increased mortality and complications. Male infants showed higher rates of complications. Hispanics had increased odds of complications. Black patients had increased risk for failures in being rescued. CONCLUSIONS: Race plays a major role in the disparities in CHD, it is imperative to evaluate the socioeconomic contributors, surgical efforts, and provisions in place regarding minority patients. The apparency of these disparities, and willingness to invoke changes in practice has the potential for improvements in outcomes for these patients.