Interventional medicine & applied science
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Interv Med Appl Sci · Sep 2018
Case ReportsAcute myocardial infarction and concomitant ischemic stroke as an unusual presentation of native mitral valve endocarditis.
ST-elevation myocardial infarction (STEMI) due to septic coronary embolism is a rare complication of infective endocarditis (IE) and is associated with high mortality rates. When common signs of IE are often overlooked on admission, the diagnosis may be established through complications, which may cause prominent symptoms. Here, we report a case of native mitral valve endocarditis with an unusual presentation with STEMI and concomitant ischemic stroke, which was due to multiple coronary and cerebral septic embolisms.
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Interv Med Appl Sci · Dec 2014
Impact of the insulin and glucose content of the postoperative fluid on the outcome after pediatric cardiac surgery.
The aim of this study was to investigate the role of the insulin and glucose content of the maintenance fluid in influencing the outcomes of pediatric patients undergoing heart surgery. ⋯ Insulin treatment appeared to decrease mortality, and lower glucose content was associated with lower occurrence of adverse events.
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Pneumothorax (PTX) is the presence of an excessive amount of air between the two layers of the pleura. The clinical results depend on the extent of lung collapse. Bedside lung ultrasonography (BLUS) is a valuable way to diagnose PTX in the emergency department. ⋯ The patient was followed up with BLUS. Evidence of PTX was absent in BLUS after 6 h, and the patient was discharged for follow-up by a respiratory physician. In this case, the lung point in BLUS helped us make an accurate diagnosis of primary spontaneous PTX and invasive management of disease was arranged accordingly.
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Interv Med Appl Sci · Dec 2013
Case ReportsWhen does a D-dimer test help make the diagnosis of aortic dissection?
We present a case of an 84-year-old woman who presented with vague abdominal discomfort and syncope secondary to a type A acute aortic dissection. In pursuit of the diagnosis, multiple tests were ordered after the history and physical exam were complete. ⋯ A diagnostic testing algorithm being used in our institution using D-dimer, ultrasound, and other tests are provided in patients presenting with possible acute aortic dissection. In this case, bedside ultrasound helped us to rapidly make the diagnosis of acute aortic dissection and arrange for further inpatient care.
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Interv Med Appl Sci · Dec 2013
Atypical clinic presentation of pandemic influenza A successfully rescued by extracorporeal membrane oxygenation - Our experience and review of the literature.
The novel pandemic influenza A (H1N1) caused an epidemic of critical illness, and some patients developed severe acute respiratory distress syndrome (ARDS) or severe cardiopulmonary failure despite the use of conventional management. Extracorporeal membrane oxygenation (ECMO) support may successfully rescue these severely ill patients. We demonstrate the causative role of H1N1 in refractory ARDS of a previously healthy 15-year-old man who presented to the intensive care unit with a hypoxic and persistent cardiogenic shock refractory to conventional management as the leading symptom of influenza A. ⋯ The patient, after 6 days of ECMO, recovered completely and was successfully weaned from the mechanical ventilator on the 9th day after admission. The patient was discharged from the hospital on the 15th day. This experience showed that ECMO can be lifesaving for severe H1N1 infection also in patients with atypical clinical presentation of influenza.