Acute partial papillary muscle rupture as a rare complication following non-ST elevation myocardial infarction.

Papillary muscle rupture is a life-threatening complication of acute myocardial infarction that most commonly occurs 2-7 days after the infarct. We present a rare case of acute partial anterolateral papillary muscle rupture following non-ST elevation myocardial infarction. Our patient was an elderly male who had a detached anterolateral papillary muscle, which required emergent mitral valve replacement.

Managing Acute Intermediate Risk Pulmonary Thromboembolism in a Patient Who Developed Heparin-Induced Thrombocytopenia: Review of Current Guidelines and Literature.

Intermediate-risk pulmonary embolism describes hemodynamically stable patients with evidence of right ventricular strain, whereas high-risk pulmonary embolism comprises hemodynamic decompensation resulting in cardiogenic shock. The clinical manifestations of the two aforementioned conditions are challenging to treat in the setting of heparin-induced thrombocytopenia (HIT). Without immediate therapeutic anticoagulation, patients can subsequently deteriorate and require additional advanced therapies, with the end-goal of restoring pulmonary artery perfusion.

Type 2 Decompensated Diabetes Mellitus Weaned off Subcutaneous Insulin Therapy by Utilizing a Continuous Glucose Monitoring Device.

A case series was conducted on three patients diagnosed with decompensated type 2 diabetes mellitus (T2DM) who had hemoglobin A1c (HbA1c) levels ranging from 9.5% to above 14%. Patients were self-monitoring blood glucose (SMBG) levels four times a day.

Fluid management in septic patients with pulmonary hypertension, review of the literature.

The management of sepsis in patients with pulmonary hypertension (PH) is challenging due to significant conflicting goals of management and complex hemodynamics. As PH progresses, the ability of right heart to perfuse lungs at a normal central venous pressure (CVP) is impaired. Elevated pulmonary vascular pressure, due to pulmonary vasoconstriction and vascular remodeling, opposes blood flow through lungs thus limiting the ability of right ventricle (RV) to increase cardiac output (CO) and maintain adequate oxygen delivery to tissue.

Myxedema Coma: A Rare Case of Shock Post-Pericardial Window Procedure.

The clinical features of severe hypothyroidism vary in presentation, ranging from subclinical symptoms to multiorgan failure referred to as myxedema coma. The cornerstone treatments of myxedema coma include aggressive thyroid hormone replacement combined with excellent supportive care in the intensive care unit. We report a rare case of a 56-year-old female with history of hypothyroidism treated with levothyroxine, who developed myxedema coma post-pericardial window surgery for a large pericardial effusion.