Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of...Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of a coronary angiography. However, sometimes it can have serious presentation like unstable angina, coronary steal or ventricular arrhythmia. We present a rare case of coronary cameral fistula arising from left circumflex artery (LCx) draining in to left ventricular (LV) apex and presenting as unstable angina.展开更多
Dyke Davidhoff Masson syndrome (DDMS) was first described by Dyke Davidhoff and Masson in 1933 in a series of 9 patients [1]. It’s a very rare condition presenting in childhood ranging from infancy to late adolescenc...Dyke Davidhoff Masson syndrome (DDMS) was first described by Dyke Davidhoff and Masson in 1933 in a series of 9 patients [1]. It’s a very rare condition presenting in childhood ranging from infancy to late adolescence [2]. It is characterised by cerebral hemiatrophy, unilateral ventriculomegaly, calvarial thickening, skull and facial asymmetry, sometimes even contralateral hemiplegia in childhood and seizures [2]. An adult presentation is seen in late adolescence or teen age. However in literature the latest presentation reported so far is at 19 years of age [3]. We report a case of Dyke Davidhoff Masson syndrome who presented first time at the age of 28 years which is probably the oldest presentation of this rare entity reported in the literature.展开更多
We report clinical, CT, invasive coronary angiography and intra-operative findings of a symptomatic elderly man with anomalous origin of left coronary artery from pulmonary artery (ALCAPA). ALCAPA is a rare syndrome w...We report clinical, CT, invasive coronary angiography and intra-operative findings of a symptomatic elderly man with anomalous origin of left coronary artery from pulmonary artery (ALCAPA). ALCAPA is a rare syndrome with anomalous origin of left main coronary artery (LMCA) from main pulmonary artery (MPA). Survival into adulthood is rare and our case is probably the oldest survivor who has undergone two coronary system repairs for this anomaly. The unique features of our case include: 1) Absence of “q” wave myocardial infarction on ECG;2) Absence of significant mitral regurgitation;3) Demonstration of stress induced perfusion defects in nuclear imaging which as per our knowledge has been done for the first time in the literature;4) A unique technique of closing anomalous LMCA origin by a pericardial patch, sutured on the internal aspect of MPA is the hallmark of this case.展开更多
Hemophagocytic lymphohistiocytosis syndrome (HPS) is a potentially fatal hyperinflammatory response characterized by a generalized histiocytic proliferation with marked hemophagocytosis in bone marrow [1]. Hemophagocy...Hemophagocytic lymphohistiocytosis syndrome (HPS) is a potentially fatal hyperinflammatory response characterized by a generalized histiocytic proliferation with marked hemophagocytosis in bone marrow [1]. Hemophagocytic syndrome has been associated with genetic mutations, autoimmune diseases, hematological malignancies or infections [2,3]. According to the data from Centre for Disease Control and prevention (CDC) Plasmodium falciparum has been associated with HPS but not the Plasmodium vivax [4-7]. We report a case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria which is a rare presentation according to the data. This patient presented with high grade fever with chills (P. vivax positive), fever however did not respond to anti-malarials. The patient continued to have high grade fever with altered sensorium and deranged liver function with pancytopenia. Since she fulfilled the criteria of (HPS), patient was put on injectable steroids and responded dramatically. Hemophagocytic syndrome is a potentially fatal syndrome and therefore high index suspicion and early treatment is the key to reduce the mortatlity.展开更多
Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic fai...Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic failure, pulmonary hemorrhages and cardiac arrhythmias. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed. Cardiac manifestations may vary from minor rhythm abnormalities to fatal ventricular arrhythmias. We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department with epigastric pain and congestive cardiac failure with rhythm disturbances and selective myocardial involvement mimicking as Non ST elevation Inferior wall myocardial infarction (NSTEMI). The Cardiac manifestations of Leptospirosis need meticulous intensive care management as the mortality rate is very high in this subset of patients. Index suspicion and early treatment remains the mainstay of this life threatening zoonotic disease.展开更多
文摘Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of a coronary angiography. However, sometimes it can have serious presentation like unstable angina, coronary steal or ventricular arrhythmia. We present a rare case of coronary cameral fistula arising from left circumflex artery (LCx) draining in to left ventricular (LV) apex and presenting as unstable angina.
文摘Dyke Davidhoff Masson syndrome (DDMS) was first described by Dyke Davidhoff and Masson in 1933 in a series of 9 patients [1]. It’s a very rare condition presenting in childhood ranging from infancy to late adolescence [2]. It is characterised by cerebral hemiatrophy, unilateral ventriculomegaly, calvarial thickening, skull and facial asymmetry, sometimes even contralateral hemiplegia in childhood and seizures [2]. An adult presentation is seen in late adolescence or teen age. However in literature the latest presentation reported so far is at 19 years of age [3]. We report a case of Dyke Davidhoff Masson syndrome who presented first time at the age of 28 years which is probably the oldest presentation of this rare entity reported in the literature.
文摘We report clinical, CT, invasive coronary angiography and intra-operative findings of a symptomatic elderly man with anomalous origin of left coronary artery from pulmonary artery (ALCAPA). ALCAPA is a rare syndrome with anomalous origin of left main coronary artery (LMCA) from main pulmonary artery (MPA). Survival into adulthood is rare and our case is probably the oldest survivor who has undergone two coronary system repairs for this anomaly. The unique features of our case include: 1) Absence of “q” wave myocardial infarction on ECG;2) Absence of significant mitral regurgitation;3) Demonstration of stress induced perfusion defects in nuclear imaging which as per our knowledge has been done for the first time in the literature;4) A unique technique of closing anomalous LMCA origin by a pericardial patch, sutured on the internal aspect of MPA is the hallmark of this case.
文摘Hemophagocytic lymphohistiocytosis syndrome (HPS) is a potentially fatal hyperinflammatory response characterized by a generalized histiocytic proliferation with marked hemophagocytosis in bone marrow [1]. Hemophagocytic syndrome has been associated with genetic mutations, autoimmune diseases, hematological malignancies or infections [2,3]. According to the data from Centre for Disease Control and prevention (CDC) Plasmodium falciparum has been associated with HPS but not the Plasmodium vivax [4-7]. We report a case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria which is a rare presentation according to the data. This patient presented with high grade fever with chills (P. vivax positive), fever however did not respond to anti-malarials. The patient continued to have high grade fever with altered sensorium and deranged liver function with pancytopenia. Since she fulfilled the criteria of (HPS), patient was put on injectable steroids and responded dramatically. Hemophagocytic syndrome is a potentially fatal syndrome and therefore high index suspicion and early treatment is the key to reduce the mortatlity.
文摘Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic failure, pulmonary hemorrhages and cardiac arrhythmias. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed. Cardiac manifestations may vary from minor rhythm abnormalities to fatal ventricular arrhythmias. We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department with epigastric pain and congestive cardiac failure with rhythm disturbances and selective myocardial involvement mimicking as Non ST elevation Inferior wall myocardial infarction (NSTEMI). The Cardiac manifestations of Leptospirosis need meticulous intensive care management as the mortality rate is very high in this subset of patients. Index suspicion and early treatment remains the mainstay of this life threatening zoonotic disease.
