Statin medications act by inhibiting the enzyme hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (HMGCR), thus decreasing hepatic cholesterol synthesis. They are considered the mainstay treatment of hypercholesterolemia due to their tremendous efficacy and mortality benefit. Although generally well tolerated, statins may adversely affect skeletal muscle resulting in side effects ranging from mild myalgia to life-threatening necrotizing myositis.
View Article and Find Full Text PDFThe presence of an aortoenteric fistula following aortobifemoral graft repair of an abdominal aortic aneurysm is associated with a high probability of infection leading to clinically significant bacteremia. We report a case of an aortoenteric fistula that developed two years after initial aortic grafting resulting in colonization with the anaerobe, Eggerthella lenta. This dangerous bacterium is difficult to culture, associated with high mortality and the patient may have mild symptoms on presentation.
View Article and Find Full Text PDFMoyamoya disease (MMD) primarily causes constriction of internal carotid artery, but it is known to extend to the middle and anterior cerebral arteries. Some of the symptoms caused by MMD include transient ischemic attack (TIA) and seizures. The etiology of MMD from Graves' disease (GD) is mostly caused by thyrotoxicosis, but our finding of leukocytosis indicates a new finding that may help physicians prepare for the pending outcome of MMD from GD with leukocytosis.
View Article and Find Full Text PDFWhen approaching the symptom of acute onset chest pain in a previously healthy 26-year-old male, anchoring heuristic presents a challenge to healthcare workers. This diagnostic error is the healthcare professional's tendency to rely on a previous diagnosis, and, in situations where a set of symptoms might mask a rare and deadly condition, this error can prove fatal for the patient. One such condition, Spontaneous Coronary Artery Dissection (SCAD), is an uncommon and malefic presentation of coronary artery disease that can lead to myocardial infarction and sudden death.
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