RESUMEN
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but detrimental syndrome that has been most commonly reported after the administration of vaccination for the prevention of viral infections. VITT often presents with thrombosis at unusual sites such as cerebral venous sinuses, portal, splanchnic or hepatic veins, in association with thrombocytopenia and elevated anti-platelet factor 4 (aPF-4) antibodies. We describe the case of a young male patient who developed thrombocytopenia, cerebral sinus venous thrombosis, and intracerebral bleed 12 days after receiving the Ad26.COV2.S (Janssen/Johnson&Johnson) COVID-19 vaccine.
RESUMEN
[This corrects the article DOI: 10.7759/cureus.33318.].
RESUMEN
Cannabis is a commonly used illicit drug worldwide with many noted adverse effects and medical properties. It has been previously used in medicine for the management of chemotherapy-induced nausea and vomiting. The chronic use of cannabis is well-known to be associated with psychological and cognitive adverse effects, however, cannabinoid hyperemesis syndrome is a less commonly recognized complication of chronic long-term use of cannabis, though it does not occur in the majority of chronic cannabis users. Here we present the case of a 42-year-old male who presented with classical clinical features of cannabinoid hyperemesis syndrome.
RESUMEN
Infective endocarditis (IE) is an infection of the heart's endocardial surface, heart valves, or implanted cardiac devices, with the most common causative organism being Staphylococcus aureus. The clinical presentation of IE can be variable, with some patients presenting with multisystemic complications, including renal, pulmonary, cutaneous, and neurologic complications. Cerebral infarction is the most common complication of IE. Here we present a case of a young male with S. aureus IE of a native cardiac valve who developed multiple complications during his clinical course.
RESUMEN
Long QT syndrome (LQTS) occurs when there is an abnormality of myocardial repolarization characterized specifically by a prolonged QT interval on an electrocardiogram (ECG). This can be particularly dangerous as it is associated with an increased risk of polymorphic ventricular tachycardia and a life-threatening arrhythmia otherwise known as torsades de pointes (TdP). We present a case of a 40-year-old Indian female whose medical history was significant only for anemia and depression/anxiety that presented in a ventricular fibrillation cardiac arrest after becoming dyspneic and light-headed while dancing. Of relevance, she was taking sertraline 50mg once daily, a class of medications known to prolong the QT interval as well as having low serum calcium on presentation. Both her initial and subsequent electrocardiograms illuminated significantly prolonged QTc intervals. She subsequently sustained a ventricular tachycardia cardiac arrest, which degenerated into ventricular fibrillation in the cardiac intensive care unit two days later. Ultimately, the patient was pronounced brain-dead by the end of the week. We concluded this to be a case of LQTS predisposing to TdP, which then would degenerate into ventricular fibrillation. This case highlights multiple risk factors that are known to predispose to the aforementioned etiology. Further research is needed not only on common medications and their dose-dependent relationship on the QT interval across different ethnic groups but also on educating providers regarding multiple risk factors they may or may not have the power to control.
RESUMEN
Stroke is a common complication of cardiac surgery, and carotid artery stenosis is an established risk factor for stroke. Therefore, patients with carotid artery stenosis who are undergoing cardiac surgery require proper management of the former either simultaneously or before cardiac surgery. We present a challenging case of a 67-year-old male patient who presented with generalized weakness, severe aortic stenosis, and significant bilateral carotid artery stenosis. The coexistence of these findings sparked a debate about whether to perform a carotid endarterectomy first or an aortic valve replacement. Moreover, a past history of percutaneous coronary intervention and coronary artery bypass grafts made the decision more challenging. Multiple approaches have been employed for the management of coexisting carotid artery stenosis with cardiac surgery; however, no definitive guidelines exist, especially for surgeries other than coronary artery bypass grafts or where the carotid stenosis is bilateral and severe.
RESUMEN
Although isolated superior mesenteric artery dissection is a rare disease entity, it possesses high mortality. The pathophysiology remains a mystery. In this case, we report a 68-year-old male with compromised coronary circulation been evaluated for coronary artery bypass surgery (CABG) and who developed a sudden, localized, right-sided abdominal pain. It was diagnosed on a computer tomography arteriogram (CTA), revealing a short segmental dissection involving the superior mesenteric artery (SMA). Vascular surgery was consulted and the decision was made to conservatively manage this patient's condition with anticoagulation. He was seen subsequently in the outpatient setting with a resolution of abdominal pain and a repeat computer tomography scan of the abdomen revealed resolution of previously seen colitis changes. Abdominal discomfort is a common complaint for which patients are seen in a variety of therapeutic settings, it is critical to bring attention to this case in order to raise awareness of the possibility of isolated SMA dissection as one of the underlying causes.