Spontaneous Hemopericardium Associated With Apixaban Use With Newly Diagnosed Malignancy and Acute Kidney Injury: A Case Report.

Direct oral anticoagulants have simplified the use of anticoagulation for patients and clinicians. These medications now have indications for non-valvular atrial fibrillation and venous thromboembolism and carry a lower risk of bleeding than warfarin. While bleeding complications are common amongst all anticoagulants, spontaneous hemopericardium is a rarely reported side effect of direct oral anticoagulants, previously reported in patients with concomitant malignancy or kidney injury. We present a case of a patient with recently diagnosed renal malignancy and atrial fibrillation on apixaban who developed a spontaneous hemopericardium that required a pericardial window.

Methicillin-Resistant Staphylococcus aureus Cellulitis Causing Meningitis From Hematogenous Dissemination: A Case Report.

Methicillin-resistant Staphylococcus aureus meningitis is commonly associated with surgical procedures that closely interact with the central nervous system; however, hematogenous spread via bacteremia is rarely reported. Here, we present a case of methicillin-resistant Staphylococcus aureus meningitis as a complication of a diabetic foot infection that disseminated into a bloodstream infection causing infective endocarditis, discitis, vertebral osteomyelitis, and meningitis that was successfully treated with intravenous daptomycin and rifampin.

Transcatheter Aortic Valve Replacement Complicated by Aorto-Right Ventricular Fistula Repaired Via Valve-in-Valve Replacement.

A 59-year-old man with a history of severe aortic stenosis with transcatheter aortic valve replacement (TAVR) presented with worsening heart failure. Echocardiography showed a fistula between the aorta and the right ventricle with mild to moderate paravalvular regurgitation. He underwent a valve-in-valve TAVR with symptomatic improvement and decreased flow through the fistula.

A Rare Case of Incidental Catamenial Pneumothorax With Endometriosis-Related Ascites and Pelvic Endometriosis.

Endometriosis is characterized by the ectopic implantation of a functional uterine lining outside of the uterus. Commonly, it occurs in the fallopian tubes, ovaries, uterosacral ligaments, and gastrointestinal tract. Less commonly, it may occur in the pericardium, pleura, and central nervous system. Thoracic endometriosis syndrome includes multiple presentations, most commonly catamenial pneumothorax. We present a case of a catamenial pneumothorax that was incidentally found on imaging after the patient presented with complaints of abdominal pain and weight loss.

Atorvastatin-Associated Eosinophilic Spongiosis: A Case Report and a Relevant Literature Review of Dermatological Manifestations.

Atorvastatin, a widely prescribed 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (HMG-CoA reductase inhibitor), is associated with various adverse effects, including many dermatologic manifestations. We present the case of a 73-year-old man who developed eosinophilic spongiosis shortly after initiating atorvastatin therapy, an adverse effect which to our knowledge has not yet been reported in association with atorvastatin. Our investigation explores the clinical and histopathologic characteristics of eosinophilic spongiosis induced by atorvastatin, delving into potential mechanisms behind statin-induced eosinophilia. A literature review, focusing on atorvastatin's dermatological side effects, revealed a limited number of relevant studies, emphasizing the scarcity of documented cases. Our aim is to raise awareness of eosinophilic spongiosis as a potential side effect of atorvastatin, emphasizing its impact on patients' quality of life. This case prompts further research into the mechanisms underlying such dermatologic reactions, contributing to a better understanding of atorvastatin's diverse adverse effects.

Severe Coronary Vasospasms in Asymptomatic COVID-19.

Since the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, we have witnessed its multi-organ system involvement, not limiting itself to the lungs. We present a case of a patient with asymptomatic coronavirus disease 2019 (COVID-19) infection who developed ST-elevation myocardial infarction (STEMI) due to coronary artery vasospasm. The patient exhibited symptoms of acute coronary syndrome, elevated troponins, and electrocardiographic changes consistent with STEMI. He was found to have significant coronary vasospasm on angiography that responded well to nitroglycerin. This case highlights the potential cardiovascular complications of COVID-19 infection, even when asymptomatic, and the importance of considering vasospasm as a possible mechanism in patients presenting with acute coronary syndrome. We also elaborate on some potential pathophysiological mechanisms in which COVID-19 may lead to coronary vasospasm.

Mitral Valve Prolapse With Mitral Annular Disjunction Causing Ventricular Tachycardia During a Stress Test: A Case Report.

Mitral valve prolapse (MVP) is a relatively common valvular disorder characterized by displacement of one or both mitral valve leaflets into the left atrium (LA) during systole. Mitral annular disjunction (MAD) is an associated abnormality where a portion of the mitral valve annulus attaches superiorly in the left atrial wall. Although MVP is often considered benign, it can rarely lead to serious complications such as ventricular arrhythmias, especially when MAD is present. Herein, we present a case of a 63-year-old male with MVP and MAD who experienced sustained ventricular tachycardia (VT) during cardiac stress testing. This case underscores the importance of recognizing MVP with MAD as a potential substrate for ventricular arrhythmias, notably under heightened physiological or induced periods of stress.