Magnesium is an important co-factor that helps regulates the movement of ions through voltage-mediated channels within myocardial tissues by the membrane sodium-potassium pump, and its deficiency can reduce the pump's activity, leading to partial depolarization and changes in the activity of many potential-dependent membrane channels leading to arrhythmias. In this case report, we are looking to establish the direct relationship between hypomagnesemia caused by proton pump inhibitors (PPIs), which could lead to cardiac arrhythmias. Here, we present a 45-year-old Hispanic female, with a known past medical history of supraventricular tachycardia (SVT), hiatal hernia on proton pump inhibitor (PPI), and chronic smoking, who presented to the emergency department complaining of dizziness and palpitations that started two hours prior arrival to the hospital.
View Article and Find Full Text PDFAtrial fibrillation (AFib) is a common type of cardiac arrhythmia, characterized by disorganized atrial electrical activity with features of irregularly irregular heart rhythm and often with rapid ventricular response increasing the risk of stroke and heart failure due to tachyarrhythmia. The pathophysiology mechanism of AFib is either triggered by atrial distension, abnormality in conducting system, catecholamine excess, or increased atrial irritation or automaticity. Risk factors include uncontrolled diabetes, obesity, obstructive sleep apnea, hypothyroidism, and certain stimulants.
View Article and Find Full Text PDFAspirin-exacerbated respiratory disease (AERD) consists of a triad of asthma, chronic rhinosinusitis with nasal polyposis, and a hypersensitivity reaction to aspirin consisting of nasal congestion and broncho-constriction. This disease presents a conundrum in cardiac patients undergoing percutaneous catheterization intervention (PCI) who might require stent deployment due to the need for aspirin as part of the dual antiplatelet therapy required if a stent is placed. Here, we present the case of a patient who underwent a coronary angiogram showing two-vessel disease but had to undergo aspirin desensitization first before planned PCI as he had a history of severe aspirin allergy in the past.
View Article and Find Full Text PDFAn aortic dissection is a life-threatening event that requires urgent evaluation. A dissection is defined as a tear in the innermost layer of the aortic wall forming a true and false lumen. This is normally diagnosed with a CT with contrast when clinical suspicion is present.
View Article and Find Full Text PDFVaricella zoster is one of the common causes of aseptic meningitis, typically seen in immunosuppressed individuals and rarely in the immunocompetent. The varicella zoster virus (VZV) infection is normally associated with a dermatomal rash in the abdomen with spread to the back. The small prevalence of VZV in immunocompetent individuals may be due to lack of recognition; thus, it is always important to keep it in mind when meningitis is in the differential.
View Article and Find Full Text PDFSeveral prospective epidemiological studies have shown that there is a clear inverse relationship between serum high-density lipoprotein-cholesterol (HDL-C) concentrations and risk for coronary heart disease (CHD), even at low-density lipoprotein-cholesterol (LDL-C) levels below 70 mg/dL. However, more recent evidence from genetic studies and clinical research has come to challenge the long-standing notion that higher HDL-C levels are always beneficial, while lower HDL-C levels are always detrimental. Thus, it becomes apparent that HDL functionality plays a much more important role in atheroprotection than circulating HDL-C levels.
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