Acquired bilateral atrio-ventricular valvular stenosis in a complex single-ventricle physiology following superior cavo-pulmonary connection.

A young female in her early 20s with complex congenital heart disease, previously treated with pulmonary valvotomy and a bidirectional Glenn procedure (for hypoplastic right ventricle, severe pulmonary stenosis and ASD) presented with worsening dyspnoea (NYHA IV), anasarca, fever and cough. Examination revealed atrial fibrillation, hypotension, cyanosis, anasarca and a mid-diastolic murmur. 2D transthoracic echocardiography showed bi-atrial enlargement with thickened mitral and tricuspid valves with severe mitral and tricuspid stenosis.

Massive Hemothorax Following Transradial Coronary Angioplasty.

Hemothorax is a rare complication following coronary angioplasty. We report a case of a young adult who presented with anterior wall myocardial infarction, underwent coronary angioplasty, and subsequently developed massive right-sided hemothorax. It was suspected clinically and a chest radiograph and contrast-enhanced computer tomography (CECT) of the thorax confirmed the diagnosis.

Retrieving a Peripherally Dislodged Coronary Stent: A Last Resort Approach.

A middle-aged man in his 50s with a history of percutaneous coronary intervention (PCI) in the left main coronary artery (LMCA) and right coronary artery presented with worsening exertional angina. Invasive coronary angiography revealed a significant diffuse lesion distal to the LMCA stent in the proximal left anterior descending (LAD) artery, prompting a decision to proceed with PCI. During the procedure, the stent detached from the balloon and became lodged at the proximal LMCA stent, resulting in hemodynamic collapse.

Clenbuterol-induced myocardial infarction in a young bodybuilder.

A professional bodybuilder in his 20s presented to the cardiology emergency with acute, retrosternal chest pain and diaphoresis lasting 3 hours. He reported using clenbuterol, a sympathomimetic drug known for its anabolic and lipolytic effects, at escalating doses up to 180 µg daily. ECG revealed normal sinus rhythm with ST-segment elevation in the anterior leads with raised serum troponin levels.

Fingers on the Wrist and Taming the Funny Current, Rejuvenate the Wounded Heart: Ivabradine-Responsive Atrial Tachycardia.

A 19-year-old male presented with dyspnea on exertion (New York Heart Association [NYHA] class II) and occasional palpitations for six months. He had initially been evaluated at another facility and diagnosed with dilated cardiomyopathy. Despite treatment, there was no improvement in his symptoms.

A Rare Case of Loperamide-Induced Cardiac Arrest.

Loperamide (Imodium) is an opioid receptor agonist available over-the-counter and can be used for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, depression of the central nervous system, and cardiotoxicity. It may also be used for its euphoric effects and potentially to alleviate opioid withdrawal.

Adherence to the United States Preventative Services Task Force Female Screening Guidelines: An Internal Medicine Residency Program Experience.

Background Various guidelines exist for female preventative screening tests and medical resident physician adherence to the United States Preventive Services Task Force (USPSTF) guidelines varies. National screening rates for breast cancer and osteoporosis have improved but they are still below the expected target. Material and methods Ambulatory medical clinic records of female patients from the period July 2015 to December 2017 were reviewed for breast cancer and osteoporosis screening.

Effective and safe reduction of blood pressure with the combination of amlodipine 5 mg and valsartan 160 mg in hypertensive patients not controlled by calcium channel blocker monotherapy.

Introduction: The addition of an angiotensin II receptor blocker to calcium channel blocker-based antihypertensive therapy may be associated with enhanced efficacy and reduced risk of adverse events.

Methods: This 8-week, open-label, single-arm trial evaluated the efficacy and tolerability of the combination of amlodipine and valsartan in patients not responding adequately to treatment with amlodipine or felodipine alone. Patients aged > or =18 years with moderate essential hypertension (defined as mean sitting systolic blood pressure [MSSBP] > or =160 and <180 mmHg) were treated for 4 weeks with once-daily amlodipine 5 mg or felodipine 5 mg.