An 83-year-old man 2 days postoperative from L3 to L5 laminectomy developed sudden onset of chest pain. Initial ECGs demonstrated a tall R wave in V1 and ST-segment depression in leads V2-V5. A posterior ECG was performed, but failed to demonstrate ST elevations. The patient was initially treated as an non-ST-segment elevation myocardial infarction with weight-based enoxaparin. On further review, the patient's ECG was identified as a STEMI equivalent, and he underwent cardiac catheterisation. He was noted to have a near complete occlusion of the posterior descending branch of the right coronary artery (RCA). Bare-metal stents were placed in the proximal and distal RCA, with restored flow distal to the lesions. The patient was transferred to the intensive care unit for observation, and was noted to develop atrial fibrillation. Rate control was achieved with diltiazem, and the patient was started on dabigatran. Medical therapy including aspirin and clopidogrel was initiated, and the patient was discharged home.
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http://dx.doi.org/10.1136/bcr-2014-205923 | DOI Listing |
J Am Heart Assoc
January 2025
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and The Key Laboratory of Cardiovascular Remodeling-related Diseases, Ministry of Education, and Beijing Institute of Heart Lung and Blood Vessel Disease Beijing China.
Background: Acute type A aortic dissection (AAD) and acute type A intramural hematoma (AIMH) are life-threatening conditions with high mortality rates, and prognostic indicators are critical for guiding urgent treatment decisions. We assessed the prognostic significance of admission D-dimer levels in patients with AAD and AIMH.
Methods And Results: The prospective, multicenter, observational study in China recruited participants from 2013 to 2019.
Pain Rep
February 2025
Department of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Introduction: Management of pain associated with breast cancer surgeries is crucial in reducing incidence of postmastectomy pain syndrome. The pain distribution involves the anterior chest wall, axillary area and ipsilateral upper limb.
Objective: This study was designed to investigate the effect of bilevel erector spinae plane block (ESPB) with high thoracic block vs the conventional unilevel ESPB vs opioids in patients with cancer undergoing modified radical mastectomy regarding pain control and reducing pain in axilla.
Transl Cancer Res
December 2024
Department of Geriatric Respiratory Disease, Institute of Guangdong Provincial Geriatrics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Primary choriocarcinoma of the pulmonary artery is an exceedingly rare malignant neoplasm, which is often misdiagnosed due to its nonspecific clinical presentation. While this condition is characterized by the presence of trophoblastic cells, typically associated with gestational trophoblastic diseases, we encountered a case occurring in an extragenital location. The rarity of such tumors makes it challenging for clinicians to consider them in differential diagnosis, especially when the initial symptoms mimic more common conditions such as pulmonary thromboembolism (PTE).
View Article and Find Full Text PDFSisli Etfal Hastan Tip Bul
December 2024
Department of Cardiovascular Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a life-threatening condition that occurs during or after pregnancy, is rare and can be overlooked. It is one of the most important causes of pregnancy-related acute myocardial infarction. A 25-year-old female patient was admitted with a complaint of chest pain in her 37th week of pregnancy.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics and Gynecology, First Health Cluster, Dammam, SAU.
Mediastinal lymphangiomas are rare benign tumors arising from lymphatic system malformations, most commonly seen in pediatric populations. In adults, they are exceedingly rare and present diagnostic challenges due to nonspecific symptoms and imaging overlap with other mediastinal masses. Diagnosis is typically based on imaging, including CT and MRI, with histopathology confirming the diagnosis.
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