Electroconvulsive Therapy-Induced Paroxysmal Atrial Fibrillation in Healthy Young Male.

Electroconvulsive therapy (ECT) is a widely used and highly effective treatment for psychiatric disorders. This is an overall safe option for the management of antidepressant-resistant depression; however, there are known possibilities of cardiac complications. The majority of documented cardiac-related complications due to ECT are found in patients who are middle-aged or older and generally have comorbidities, including prior myocardial infarction, known arrhythmias, hypertension, obesity, diabetes mellitus, family history of cardiac disease, alcohol abuse, and smoking. We present a case of an overall healthy, 21-year-old male with no prior cardiac disease who developed paroxysmal atrial fibrillation (AF) after a routine ECT treatment, his evaluation in the emergency department, treatment, and follow-up.

Hyperbaric Oxygen Therapy for Vascular Air Embolism From Iatrogenic Intravenous Infusion of Air in a Patient With Atrial Septal Defect: A Case Report.

Vascular air embolism (VAE) is an important complication of some routine medical procedures, particularly intravenous access for the administration of fluids or medications. The capillary bed of the pulmonary circulatory system is capable of compensating for small amounts of air entrained into a vein. However, large amounts of air can overwhelm that system and lead to complications ranging from cough, chest pain, or shortness of breath to cardiopulmonary collapse. Additionally, air entrained directly into the arterial system, or that which crosses from the venous system to the arterial system through a shunt can cause the acute coronary syndrome, loss of consciousness, arrhythmias, altered mental status, stroke, or limb ischemia. We present a case in which a patient with a known atrial septal defect had a moderate volume of air entrained through an intravenous catheter requiring hyperbaric oxygen therapy.

A Case of Possible Monosodium Glutamate-Dependent, Exercise-Induced Anaphylaxis.

A 24-year-old Asian-American male presented to the Emergency Department with his third episode of anaphylaxis in a one-year period. Based on the clinical history provided by the patient regarding each of these episodes, the trigger for the patient's anaphylaxis appears to be the consumption of monosodium glutamate followed by physical exertion within the subsequent two to three hours. The case presented here represents a rare, but life-threatening, disorder. Identification of the triggers is important so that steps can be taken to prevent recurrence.