Internal medicine
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Review Case Reports
Acute onset of constrictive pericarditis due to acute myelomonocytic leukemia: A case and literature review.
We herein present a fatal case of constrictive pericarditis (CP) due to acute myelomonocytic leukemia (AMML) in a patient who initially complained of an acute onset of chest pain two days after coronavirus disease 2019 vaccination. An autopsy revealed pericardial infiltration of leukemic cells. ⋯ The etiology of CP in previous reports included leukemic infiltration, graft-versus-host disease, drug-induced, post-radiation, autoimmune, and otherwise unidentified. This case indicates that leukemic infiltration can cause CP and that clinicians should include leukemia in the differential diagnosis of CP.
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The year 2023 marked a significant change for Internal Medicine, as the number of submissions related to the novel coronavirus infection (COVID-19) declined significantly and interest shifted to other disease fields and research areas. Our journal published its first articles on artificial intelligence (AI) and machine learning (ML), and these articles have shown that AI may be useful for the early detection of potential cardiac diseases, while ML can be used to predict the risk of serious illness in patients hospitalized with COVID-19, providing new possibilities for diagnoses and treatment. In addition to touching on the above, the present article also highlights the status of submissions to the journal (including the number of submissions and acceptance rate) in 2023.
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Review Case Reports
Tension Pneumomediastinum in Anti-MDA5 Antibody-positive Dermatomyositis-associated Interstitial Lung Disease: A Case Report and Literature Review.
Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM)-associated interstitial lung disease (ILD) can sometimes be complicated by pneumomediastinum, although tension pneumomediastinum is extremely rare. We herein report a case of anti-MDA5 antibody-positive DM-ILD that worsened subcutaneous and mediastinal emphysema during treatment. ⋯ Mediastinal drainage under video-assisted thoracoscopic surgery promptly improved the patient's circulatory and respiratory status. Tension pneumomediastinum is a rare complication; however, it is a serious condition that may lead to hypotension or cardiac arrest and requires a prompt diagnosis and treatment.
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Review Historical Article
Blood Pressure Regulation and Hypertension in Obstructive Sleep Apnea Syndrome: A Historical Perspective.
In obstructive sleep apnea syndrome (OSAS), an underlying disease of secondary hypertension, repeated episodes of asphyxia due to obstructive sleep apnea (OSA), followed by arousal, lead to various cardiovascular consequences. Using a canine model of OSAS, it was found that a single load of OSA caused an abrupt increase in blood pressure (BP) (Apnea Surge in seconds), while multiple OSA episodes occurring nightly for 1-3 months led to a sustained elevation of BP during both nighttime and daytime. ⋯ The resonance of Apnea Surge in seconds and Morning Surge increases the risk of organ damage, triggers the cardiovascular events, and adversely affects the prognosis of hypertensive patients with OSAS. For ameliorating these risks, OSA should be treated with positive airway pressure properly.
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A 34-year-old transgender woman presented with ventricular tachycardia and was diagnosed with takotsubo cardiomyopathy. Further evaluation revealed an underlying diagnosis of multiple sclerosis (MS) with brainstem lesions that may have triggered takotsubo cardiomyopathy. In this report, we also systematically reviewed published cases of takotsubo cardiomyopathy and MS and found that basal type takotsubo cardiomyopathy was the most common, and most patients presented with brainstem involvement of MS. An awareness of these associations by physicians, along with multidisciplinary collaboration, may facilitate the early diagnosis and improve the prognosis of these patients.