The Wellens pattern is an electrocardiographic finding seen in patients with chest pain and atherosclerotic coronary artery disease and is described as a symmetrical T-wave inversion or biphasic T-wave inversion in precordial leads. The deep inversion of the precordial T wave is a sign associated with various etiologies, including left ventricular hypertrophy, vasospasm, and pulmonary embolism. We present the case of a patient who debuts with chest pain and electrocardiographic findings consistent with the Wellens and McGinn-White patterns, who was subsequently diagnosed with intermediate-risk pulmonary embolism after ruling out obstructive coronary artery disease. We discussed the differential diagnostic approach to T-wave inversion as a sign associated with high-risk conditions.
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http://dx.doi.org/10.1016/j.jelectrocard.2023.08.016 | DOI Listing |
"Biliary-cast syndrome" ("BCS") is most often encountered in clinical practice as a complication after liver transplantation, there are also described cases of biliary-cast syndrome in patients who did not undergo liver transplantation, isolated cases of "BCS" developing in patients with acute pancreatitis, choledocholithiasis are described in literature. Ischemic damage to bile duct epithelium with development of cholestasis and retrograde biliary tract infection are considered as the main etiological factors. This work presents a clinical case of "Biliary-cast syndrome" in a patient with acute biliary pancreatitis and pulmonary embolism.
View Article and Find Full Text PDFClin Drug Investig
January 2025
Department of Cardiology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background: Primary percutaneous coronary intervention (PPCI) and fibrinolytic or thrombolytic therapy are common treatments for ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention is more effective than thrombolytic therapy, but fibrinolytic therapy is still a preferable option for patients with limited access to healthcare. Alteplase is a tissue plasminogen activator (tPA) used to treat acute myocardial infarction, acute ischemic stroke, and pulmonary embolism.
View Article and Find Full Text PDFJ Perioper Pract
January 2025
San Juan Veterans Affairs Medical Center, San Juan, Puerto Rico.
Case: An active healthy 68-year-old male sustained a bilateral quadriceps tendon rupture while running. He underwent a simultaneous bilateral quadriceps tendon repair in a dual-surgeon approach. The right quadriceps tendon was repaired with a tourniquet, while the left quadriceps tendon tear was repaired without one.
View Article and Find Full Text PDFCochrane Database Syst Rev
January 2025
Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.
Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.
Background: Despite the guidelines' appeal to treat patients with deep vein thrombosis and low-risk pulmonary embolism in outpatient settings, the real-world evidence shows a high prevalence of inpatient therapy leading to unwarranted health resource utilization. The study aimed to assess the efficacy and safety of rivaroxaban in outpatient settings compared to inpatient treatment.
Methods: A propensity score-matched comparison with a historical inpatient population was performed based on a retrospective analysis of patients with deep vein thrombosis and without pulmonary embolism treated as outpatients with oral rivaroxaban.
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