Coronary subclavian steal syndrome causing myocardial Infarction.

Coronary subclavian steal syndrome (CSSS) is a rare complication of the internal mammary artery (IMA) grafting in coronary artery bypass surgery. The technical definition is myocardial ischemia due to the reduced flow of blood, or flow reversal in the IMA graft. This in most cases results from hemodynamically significant proximal subclavian artery stenosis.

Hemopericardium in a Sirolimus-Treated Renal Transplant Patient.

Sirolimus is an immunosuppressant frequently prescribed to prevent graft-vs-host disease in renal transplant patients. Pericardial effusion is recognized as a rare and potentially lethal side effect of this medication. Hemopericardium, specifically, is an even rarer complication that has yet to be reported in the literature.

Gerbode defect formation two decades after tetrology of fallot repair.

Although most intracardiac defects are congenital, a small fraction may be acquired during life. The Gerbode defect is an abnormal anatomical connection between the left ventricle and the right atrium. We describe herein a patient who initially underwent repair of tetralogy of Fallot (TOF).

Sternal osteomyelitis by in an immunocompetent patient after open heart surgery.

Gordonia is a catalase-positive, aerobic, nocardioform, Gram-positive staining actinomycete that also shows weak acid-fast staining. Several Gordonia species are commonly found in the soil. The bacterium has been isolated from the saliva of domesticated/wild dogs as well.

The dilemma of the "ischemic-looking" electrocardiogram: Pulmonary embolism or acute coronary syndrome?

Pulmonary embolism (PE) may be potentially fatal if not diagnosed and treated in time. Although specific electrocardiogram (ECG) findings often suggest the diagnosis of PE, occasionally, the ECG may mimic that of an acute coronary syndrome (ACS). We report an interesting case of a 45-year-old female presenting with sudden onset chest pain and shortness of breath with widespread ST depression in anterior precordial leads.

Unusual Sign from an Unusual Cause: Wellens' Syndrome due to Myocardial Bridging.

It is vital to recognize correctly, chest pain of cardiac etiology. Most commonly, it is because of blood supply-demand inequity in the myocardium. However, the phenomenon of myocardial bridging as a cause of cardiac chest pain has come to attention reasonably recently.

Venous Thromboembolism and Cancer.

Purpose Of Review: This review aims to summarize the epidemiology, current pathophysiologic understanding, and state-of-the-art treatment of venous thromboembolism (VTE) in cancer patients.

Recent Findings: The risk of VTE varies among cancer patients. Recently introduced prediction models better identify those at high risk of VTE.

Biological pacemakers: Concepts and techniques.

The sinoatrial (SA) node is the dominant pacemaker of the heart which initiates the process of impulse generation in the cardiac tissue, thereby defining the rate and rhythm of cardiac contraction. The automaticity of the conduction cells in the SA node is due to ion channels which are inter-linked by molecular, histological and electrophysiological mechanisms causing spontaneous diastolic depolarization and generation of an impulse. The SA nodal action potentials are then transmitted to the ventricles by electrical coupling of the myocytes in different areas of the heart.

Jet lag: Heuristics and therapeutics.

Jet lag is one of those common medical problems, to which most people don't give a serious thought. However, it is intricately intertwined with our normal circadian rhythm. It is classified as a sleep disorder.

Cardiogenic Shock: A Rare Complication of Influenza.

We have presented a case of 41-year-old male who presented to the hospital with worsening shortness of breath, fatigue and flu-like symptoms. On admission to hospital, the patient was in severe cardiogenic shock secondary to acute perimyocarditis. He was admitted to the cardiac intensive care unit for close monitoring and aggressive hemodynamic support.

Strongyloides Hyperinfection and Miliary Tuberculosis Presenting with Syndrome of Inappropriate Antidiuretic Hormone Secretion in a Malnourished Patient.

Strongyloides stercoralis (S. stercoralis) is an intestinal nematode endemic to tropical regions. An accelerated infection, known as a hyperinfection, occurs in immunocompromised patients, most commonly those treated chronically with glucocorticoids or those who have human T cell leukemia virus-1 (HTLV-1) infection.

New daily persistent headache: An evolving entity.

New daily persistent headache (NDPH) is characterized by an abrupt onset of headache that becomes a daily entity, is unremitting and continuous from the onset, and lasts for more than 3 months. Dr Walter Vanast first described NDPH in the year 1986. Originally, it was proposed as a chronic daily headache but it was placed under "other primary headaches" in the International Classification of Headache Disorder Second Edition (ICHD 2nd edition).

Severe Pulmonary Hypertension Due to Adult-Onset Still's Disease.

A 29-year-old female with adult-onset Still's disease (AOSD) presented with progressive shortness of breath both on rest and on exertion, increased abdominal girth, and swelling in both legs. She was on oral prednisone and was recently started on canakinumab (interleukin-1 antagonist) for joint pain and rash of AOSD. Echocardiogram showed severely dilated right ventricle, dilated pulmonary artery, moderately reduced right ventricular systolic function, but with normal left ventricular systolic function.

Mixed Adenoneuroendocrine Carcinoma of the Gastroesophageal Junction: A Rare Find.

Neoplastic lesions that demonstrate neuroendocrine features are rare. However, esophageal tumors containing both adenocarcinomatous and neuroendocrine components are exceedingly rare. Mixed adenoneuroendocrine carcinomas (MANECs) are gastrointestinal tumors with both adenocarcinomatous and neuroendocrine differentiation.

Recurrent Bacteremia in a Patient With Leukemia.

species are a commensal flora of the human gastrointestinal and the female genitourinary tract. especially the species, are common components of commercial probiotics. They are rarely associated with pathology in immunocompetent people, but they have been known to cause dental caries, bacteremia, and endocarditis in patients with suppressed immune function.

Multicompartmental Primary Spinal Extramedullary Tumors: Value of an Interdisciplinary Approach.

Background: Primary extramedullary tumors involving multiple compartments around the spine are a technically demanding group of tumors whose extent traverses beyond the normal confines of those anatomical regions which fall in the common domain of neurosurgeons. In the following series, we present 12 patients who were diagnosed with primary spinal extramedullary tumors with multicompartmental extension, and whose surgical management was facilitated by a combined multidisciplinary approach involving surgeons of other superspecialties. This multidisciplinary assistance from the inception to the culmination of surgical management helped in achieving a better surgical removal, thereby resulting in better surgical outcomes.