Medicine and Health Sciences Commons^™

Low Dose Clenbuterol Toxicity: Case Report And Review Of Literature, Kenneth Lan, Adarsh Saheba, Paul Mathew

HCA Healthcare Journal of Medicine

Clenbuterol is a long-acting β-agonist used in oral and inhaled form for asthma treatment outside the U.S. and in veterinary medicine within the U.S. It is also used off-label for anabolic effects worldwide. Toxicity with clenbuterol is increasingly seen in U.S. hospitals, primarily in younger individuals using the drug for competitive athletics or bodybuilding. We present a case of a young patient who presented after an intentional overdose and discuss the relevant literature. Presentations do not correlate with the dosage ingested. Signs and symptoms can range from simple nausea to myocardial ischemia, rhabdomyolysis and cardiogenic shock. Treatment of overdose is …

Infective Endocarditis Caused By Klebsiella Oxytoca In A Patient With Hemodialysis: A Care-Compliant Case Report And Review Of The Literature, Hanane Aissaoui, Youssef Hdidou, Ramia Bougrine, Nabila Ismaili, Noha Elouafi

Journal of the Saudi Heart Association

The rarity of endocarditis due to Klebsiella species limits its recognition. We report the case of a 63-year-old man, known to have a tight calcified aortic stenosis presenting with acute heart failure associated with high fever. Klebsiella oxytoca endocarditis was diagnosed based on three sets of positive blood cultures together with fluttering vegetation (11 mm x 14 mm) on the middle segment of the anterior leaflet of the mitral valve. After 6 weeks of intravenous ceftriaxone and gentamicin bi-therapy, the patient had completely recovered. This case illustrates how sporadic this condition is, for which early assessment and proper treatment are …

A Fatal Rectus Sheath Hematoma After A Myasthenia Crisis Case Report, Robert G. Michaud, Lesley B. Gordon

Journal of Maine Medical Center

Introduction: Rectus sheath hematomas (RSH) generally occur due to damage to the inferior epigastric artery. They are rare causes of abdominal pain or acute blood loss anemia, but are an important diagnostic consideration because they can be cryptic and are potentially fatal.

Clinical Findings: An 85-year-old female who had been admitted to the hospital for 10 days with a myasthenia crisis was found to be abruptly hypotensive with a tender abdominal mass in the left lower quadrant subtly crossing midline. She was on prophylactic anticoagulation during her hospitalization.

Main diagnosis, therapeutics, interventions, and outcomes: The patient was initially stabilized with …

Ultraslow Thrombolytic Therapy In Stuck Mechanical Aortic Valve, Case Report, And Review Of The Literature, Hesham Abdo Naeim, Osama Amoudi, Amjad Karam, Abeer Mahmood, Ahmed Albagi, Ibraheem Alharbi, Reda Abuelatta

Journal of the Saudi Heart Association

Background: Stuck mechanical heart valves had a debate about the management plan. There is debate regarding the type, dose, and rate of administration of various thrombolytic agents. We report a case with successful thrombolysis using an ultraslow regimen.

Case summary: A 43-year-old female with a history of aortic valve (AV) and mitral valve replacement (bi-leaflet metallic valves), and tricuspid valve repair (MINI band) at 10/2017. Physical examination showed normal metallic first heart sound and weak metallic second heart sound. Laboratory investigations were normal except low INR, hematocrit, and hemoglobin level ( 9gm/L due to iron deficiency anemia). Transthoracic echocardiogram (TTE) …

Left Ventricular Aneurysmectomy In A Young Female Of Unknown Etiology With Pseudoaneurysm: A Case Report, Tariq Ashraf, Rashid Aziz, Amin M. Khuwaja, Syed M. Afaque, Musa Karim

Journal of the Saudi Heart Association

A left ventricular pseudoaneurysm is formed when there is free wall rupture of the myocardial wall with discontinuity and roof covered by pericardium mural thrombus or fibrous tissue without any myocardium. A left ventricular pseudoaneurysm is a rare and life-threatening event. We report a young 22-year-old female with unknown etiology of a pseudoaneurysm, who was previously managed as a psychiatric case and for musculoskeletal pain. On subsequent investigation and confirmation with cardiac magnetic resonance imaging, aneurysmectomy was done. This is a rare case in a young 22-year-old woman with a ventricular pseudoaneurysm of unknown etiology. Considering the high risk for …

Treatment Of Severe Mitral Regurgitation That Mimics A Para-Ring Mitral Regurgitation After Failed Annuloplasty Ring With Mitraclip: A Case Report, Hesham Abdo Naeim, Waleed Saeed, Abeer Mahmood, Lamiaa Khedr, Ramy Elrowiny, Reda Abuelatta

Journal of the Saudi Heart Association

Background: Progressive remodelling of the left ventricle with lateral and apical displacement of one or both papillary muscles can lead to recurrence of severe mitral regurgitation (MR) in the presence of the mitral valve (MV) ring. The MitraClip (Abbott, USA) is the only option in cases with annuloplasty rings too large for implantation of a Sapien prosthesis in high surgical-risk patients. We present a case where the MR jet was directed toward a para-ring hole, and the MitraClip system was used successfully to treat this severe MR. Case summary: An 80-year-old woman underwent coronary artery bypass surgery plus MV repair …

Fresh Fruits And Vegetables Really Do Keep The Doctor Away: Symptomatic Vitamin Deficiency In A Middle Aged Man, Matthew J. Turnquist Md, Christina Holt Md, Msc

Journal of Maine Medical Center

Introduction

We present a clinical case of symptomatic vitamin deficiency typically seen only in resource limited environments or alcoholics, presenting in an adult male with frequent oral intake, but limited diet of prepared foods, as well as co-occurring pernicious anemia.

Clinical Findings

The patient presented with complaints of ascending paresthesia leading to near syncope, lower extremity edema and hyperpigmentation on his anterior legs bilaterally which had been present for years.

Diagnosis and interventions

He was found to have mixed B12, thiamine, and folate deficiency. These were attributed to a combination of nutritional deficiency due to a diet of exclusively cooked …