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Subvalvular aortic stenosis typically manifests at a young age and rarely presents in adulthood. It may cause left ventricular outflow tract stenosis, which requires surgical treatment in severe cases. The coexistence of discrete subvalvular aortic stenosis and quadricuspid aortic valve is a highly unusual finding.

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Unlabelled: Cytomegalovirus (CMV) is a human herpes virus with a worldwide seroprevalence of 60-100%, mainly known to cause severe life-threatening disease in immunocompromised patients. In immunocompetent hosts (IMCh), CMV causes a self-limiting mononucleosis-like infection, and severe pictures are less recognized. We report a case of a previously healthy 62-year-old woman evaluated in the Internal Medicine outpatient clinic for 3 weeks of progressive fatigue, generalised inflammatory arthralgias, hypogastric discomfort and daily persistent fever.

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Unlabelled: Upper extremity deep vein thrombosis (UEDVT) is relatively rare, and much less as an initial presentation of systemic lupus erythematosus (SLE). Primary UEDVT should be considered in individuals with unilateral arm swelling where the brachial, axillary, and subclavian veins are frequently involved. SLE is a chronic autoimmune disease that predominantly affects women of childbearing age and of African descent.

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Unlabelled: Sinusoidal obstruction syndrome (SOS) is a distinctive and potentially fatal form of hepatic injury that mainly occurs after hematopoietic-stem cell transplantation but also due to many other conditions including drug or toxin exposure. Recently, immune checkpoint inhibitors (ICIs) have revolutionised the treatment of many solid organ malignancies. Furthermore, as their use has become more widespread, rare toxicities have emerged.

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Adenosine is extensively utilized in myocardial stress perfusion imaging for the detection and risk stratification of coronary artery disease. It has a well-established safety profile. The majority of the undesirable effects experienced during adenosine infusion are transient (owing to its brief half-life of ~10 s) and arise from the stimulation of receptors in the atrio-ventricular (AV) node (AV block) and bronchial smooth muscles (bronchospasm).

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