A&A practice
-
Preeclampsia presenting as severe hyponatremia is an enigma of modern obstetric practice. The hyponatremia can cause severe maternal neurological morbidity, including cerebral edema and seizures. ⋯ Despite this, the literature remains ambiguous about its incidence, the pathophysiology is poorly understood, and guidelines on preeclampsia (including those of the American College of Obstetricians and Gynecologists) do not discuss the issue. This case of preeclampsia associated with severe hyponatremia in a laboring woman highlights these issues.
-
Case Reports
Pulmonary Artery Catheter Thrombus in a Patient With Essential Thrombocytosis: A Case Report.
Essential thrombocytosis (ET) is a rare chronic myeloproliferative disorder characterized by elevated platelet counts. The management of patients with ET undergoing coronary artery bypass graft remains unclear. Often, patients who are deemed "high risk" for thrombotic events receive cytoreductive therapy before surgery, while patients deemed "low risk" do not receive cytoreductive therapy. Here, we present a case of a patient with ET with only a mild elevation in platelets deemed "low risk" for thrombotic complications who was found to have a small intracardiac thrombus around the pulmonary artery catheter before initiation of cardiopulmonary bypass.
-
Case Reports
Relocation of an Infected Cardiac Pacemaker Generator Under Ultrasound-Guided Pectoralis Nerve Block: A Case Study.
Reports on pacemaker placement/relocation surgery under pectoralis nerve block are limited. We herein report a case involving a 74-year-old woman with an infected cardiac pacemaker generator who underwent pacemaker relocation surgery under an ultrasound-guided pectoralis nerve block. On preoperative evaluation, she had congestive heart failure, type 2 diabetes mellitus, and a pacer-dependent heart rhythm. ⋯ Thus, an ultrasound-guided pectoralis nerve block was planned. The surgery was completed successfully, without notable complications. Our findings might help in the management of patients who require pacemaker implantation/relocation.
-
Case Reports
Case Report of Accelerated Idioventricular Rhythm in the Interventional Radiology Suite: A Sticky Situation.
Embolization is a well-established method of treatment of arteriovenous malformations. Most procedures are performed under general anesthesia due to the painful nature of some sclerosing agents, procedure duration, and need for immobilization to allow precise injection. Familiarity with the possible side effects of these agents is important for the anesthesiologist to facilitate timely and successful management of intra- and postprocedural complications. This case report describes an unusual presentation of systemic migration of glue-lipiodol mixture during embolization of a calf arteriovenous malformation in an adolescent that resulted in accelerated idioventricular rhythm and its successful management leading to complete resolution.