Adamsenpilegaard3505

To our knowledge, this is the first case of spontaneous neutropenic fever secondary to P. agglomerans bacteremia in an Afro-Caribbean adult male.Marijuana is the most widely used recreational drug across the United States. Ongoing efforts to legalize marijuana, as well as the drug's increasing popularity contribute to the marijuana's reputation as having a low risk profile. Marijuana's association with adverse cardiovascular events, such as arrhythmia and vasospasm is well-documented. We synthesized what is known about how marijuana use pertains to and is implicated endothelial cell damage and its effects on microcirculation. THC exerts effects through the cannabinoid receptors, CB1 and CB2. The downstream effects of CB1 activation point to a role for this receptor in atherogenesis and vasospasm, likely by precipitating oxidative stress. Endothelial cells, when exposed to reactive oxygen species, provide a stimulus for vasoconstriction with a diminished ability for vasodilation. This phenomenon has manifested itself in cases of coronary vasospastic angina, and coronary slow and no flow that have resulted from marijuana use, as confirmed by cardiac catheterization reports that showed no evidence of obstructive lesions that could otherwise be responsible for the patients' symptoms. Marijuana users suffer from acute ischemic stroke at higher rates than non-users. Several theories have been proposed to support this observation, namely marijuana induced reversible cerebral vasoconstriction syndrome, and mitochondrial damage caused by oxidative stress that disproportionately affects cerebral vasculature. As marijuana use continues to grow, so does the important of elucidating the drug's effect on endothelial cells and microcirculation. Further studies should investigate the temporal association between marijuana and endothelial damage, as well as the possibility of recovery from such injury, and whether there is therapeutic potential in cannabinoid receptors.

Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy characterized by increased trabeculation in one or more segments of the ventricle. LVNC presented with non-specific symptoms and highly variable clinical presentation ranging from asymptomatic to progressive heart failure and recurrent or life-threatening arrhythmias.

54-year-old Black man with a history of hypertension, diabetes and end-stage renal disease presented with one day palpitations and lightheadedness following a dialysis session. He denied any dyspnea or syncope. LY2228820 cost On examination, blood pressure was 175/91 mmHg with irregular pulse. No murmur, rubs or gallops were appreciated. Laboratory were unremarkable except increased creatinine and mild anemia with normal thyroid function test. Electrocardiogram (ECG) revealed atrial fibrillation with normal ventricular rate. Transthoracic echocardiogram revealed mildly increased left ventricular (LV) wall thickness with prominent trabeculation and ejection fraction of 55-60 percent, a pseudo-normal LV filling pattern, with concomitant abnormal relaxation and increased filling pressure, suggestive of LVNC. The patient was switched to apixaban. Genetic testing was recommended for family members.

LVNC is rare congenital cardiomyopathy with non-specific symptoms and should be considered among the possible diagnosis in patients presenting with arrythmia patients. Echocardiographic and cardiac magnetic resonance imaging can be utilized to establish diagnosis.

LVNC is rare congenital cardiomyopathy with non-specific symptoms and should be considered among the possible diagnosis in patients presenting with arrythmia patients. Echocardiographic and cardiac magnetic resonance imaging can be utilized to establish diagnosis.Coronary artery ectasia (CAE) is defined by the Coronary Artery Surgery Study (CASS)registry as the aneurysmal dilatation 1.5 times the diameter of a coronary artery compared to the adjacent normal coronary artery. CAE is reported with a prevalence of 1.2% - 4.9%. Most CAEs are attributed to atherosclerosis or post-percutaneous coronary intervention (PCI) vessel injury. Vasculitides and infection are uncommon etiologies. A review of 59,423 patients from the Danish registry demonstrated a 3-fold increase in the prevalence of abdominal aortic aneurysms in patients with concomitant severe psoriasis. We present a case of a 64-year-old male with severe plaque psoriasis complaining of substernal chest pain whose coronary angiography demonstrated CAE of the left anterior descending and circumflex arteries. Due to its pro-inflammatory state, psoriasis is associated with various systemic manifestations including cardiac and vascular complications. With possibly a similar underlying pathophysiological mechanism, we describe to the best of our knowledge the first case of CAE in a patient with severe psoriasis.Cardiac free wall rupture (CFWR) is an uncommon complication of myocardial infarction, cardiac-based procedures, and blunt chest trauma. Cardiac tamponade and shock which occurs as a result of CFWR results in a high mortality rate. Despite the high mortality rate, there is a window of opportunity for intervention in selected patients with acute or subacute free wall rupture. Hence, prompt diagnosis and intervention are key to prevent cardiac tamponade and death. Even though emergency surgical repair is the standard treatment for the CWFR, the catheter-based procedure has provided an alternative treatment option, especially, in the high-risk surgical patients. For instance, Amplatzer occluder® (AO), a device which is used in repairing congenital septal swall defect, is being used as an alternative method of treatment in CFWR. In this systemic review, we assessed the 19 cases of CFWR occurring after invasive cardiac procedures who underwent repair with the utilization of AO®. The study shows that the successful rate of percutaneous closure of CFWR was 84.3% (16/19) with a mortality rate of 15.7% (3/19) in this cohort. Therefore, the in-hospital mortality rate of CFWR closure is comparable with the average in-house mortality rate of emergency surgical repair which is 14%. Furthermore, we found that AO® placement technique has a lower mortality rate compared to the other less-invasive methods such as percutaneous intrapericardial fibrin-glue injection which has a mortality rate of 25%. In conclusion, employing AO® in CFWR repair not only serves as the treatment of choice in the high-risk surgical candidates but could also be applied as an alternative method in the general population. However, further studies are required to assess the outcome and mortality rate of using A® in CFWR to provide us with a more consistent and accurate data.