This case report includes an extremely rare and intriguing presentation of takotsubo cardiomyopathy (TCM), triggered by forceful vomiting in the setting of gastroparesis, a condition characterized by delayed gastric emptying. TCM is a reversible form of cardiomyopathy that typically occurs following a severe emotional or physical stressor. In this exceptional case, we present a patient with an acute severe episode of gastroparesis, followed by TCM, devoid of any recognizable emotional or physical stressors.
View Article and Find Full Text PDFSARS-COVID-19 is known to manifest with a wide variety of symptoms, most of which are respiratory. Myalgias are a common symptom of COVID-19, but cases of severe virus-induced inflammatory muscle injury leading to rhabdomyolysis and polymyositis have also been reported. Here, we present and discuss a case of a 56-year-old woman who presented with an initial presentation of COVID-19 infection with inflammatory polymyositis leading to rhabdomyolysis.
View Article and Find Full Text PDFA 59-year-old man with a history of severe aortic stenosis with transcatheter aortic valve replacement (TAVR) presented with worsening heart failure. Echocardiography showed a fistula between the aorta and the right ventricle with mild to moderate paravalvular regurgitation. He underwent a valve-in-valve TAVR with symptomatic improvement and decreased flow through the fistula.
View Article and Find Full Text PDFInsulinomas are a rare cause of recurrent hypoglycemia in non-diabetic patients. Diagnosis requires hypoglycemia (plasma glucose <50 mg/dL), neuroglycopenic symptoms, and prompt relief of symptoms following the administration of glucose, known as Whipple's triad. The gold standard diagnostic tests are measuring insulin, C-peptide, and glucose during a 72-hour fast.
View Article and Find Full Text PDFAngiotensin-converting enzyme inhibitors (ACE-I), such as lisinopril, are used as first-line therapy in the treatment of hypertension, heart failure with reduced ejection fraction, and proteinuric chronic kidney disease due to their beneficial effects on reducing morbidity and mortality. Commonly cited adverse effects of lisinopril include hyperkalemia, acute kidney injury, and angioedema, and while uncommon, there have been reports of lisinopril-induced necrotizing pancreatitis in the literature. The true incidence of drug-induced pancreatitis is unknown since establishing a causal relationship between medication's adverse effects and disease occurrence is difficult; however, there are validated tools such as the Adverse Drug Reaction Probability Scale that can aid in determining causality.
View Article and Find Full Text PDF