Pulmonary Sequestration Mimicking Symptoms of Ischemic Heart Disease.

Pulmonary sequestration is a rare congenital abnormality characterized by the presence of a nonfunctional lobe of the lung being separated in both blood flow and function from the rest of the lung. The condition may go unrecognized on prenatal imaging and present during adolescence and young adulthood with cough, chest pain, shortness of breath, and recurrent pneumonia. However, some patients may remain asymptomatic until later adulthood and be diagnosed based on incidental imaging findings. Surgical resection is the recommended treatment for this condition, although controversy exists regarding its use in asymptomatic patients and adults. In this case report, we present a case of a 66-year-old man who presented with progressively worsening dyspnea on exertion and atypical chest pain and underwent an ischemic workup to rule out coronary artery disease. The extensive diagnostic evaluation led to the diagnosis of nonobstructive coronary artery disease and left-sided pulmonary sequestration. The patient subsequently underwent surgical resection of the left lower pulmonary lobe, resulting in a significant improvement in symptoms.

Generalised myoclonus associated with COVID-19 infection.

Postinfectious generalised myoclonus has been reported after many viral and bacterial infections in the past. Recently, some case reports have described it in the context of COVID-19 infection. Most patients described in these case reports are either critically ill and intubated or have concurrent respiratory symptoms. Herein, we present a case of a 79-year-old man, who was recovering from a recent COVID-19 infection, presented with isolated generalised myoclonus. The patient was treated with levetiracetam, a short course (10 days) of dexamethasone, and required extensive rehabilitation. Outpatient follow-up at 2 months suggested complete resolution of symptoms and levetiracetam was subsequently discontinued. This case highlights that generalised myoclonus can occur as a delayed complication of COVID-19 infection.

Leptomeningeal Carcinomatosis in Epithelial Ovarian Cancer: A Diagnostic Challenge.

Leptomeningeal carcinomatosis (LCM), also known as neoplastic meningitis, is a rare entity. It is generally seen in solid tumors. Ovarian cancers can infrequently cause LCM. The clinical presentation is variable. Diagnosis is made by a lumbar puncture that shows malignant cells in the cerebrospinal fluid (CSF) and usually correlates with imaging findings. Given the low individual sensitivities of lumbar puncture (55%) and magnetic resonance imaging (70%), it is recommended to combine both modalities for optimal diagnostic results. Treatment options vary depending on the type of primary carcinoma, however, the prognosis is guarded. We report a case of LCM in a patient with stage IV epithelial ovarian cancer in remission, which became a diagnostic challenge due to a lack of imaging findings.

A Rare Case of Cavernous Hemangioma of the Mitral Valve Presenting As Multifocal Embolic Brain Infarcts.

Primary cardiac tumors (PCTs) are rare and represent a heterogeneous group of tumors, potentially arising from various parts of the heart. The majority of these tumors are benign (90%), with myxoma being the most common subtype. Cardiac hemangiomas are rare vascular tumors that constitute 1-2% of all benign heart neoplasms. We present a rare case of a 79-year-old woman presented with multifocal embolic brain infarcts secondary to cavernous hemangioma of the mitral valve (MV). Cavernous hemangioma was successfully resected with follow-up imaging at six months, demonstrating no regrowth. There are no pathognomonic signs or findings to suggest cavernous hemangioma of the MV on clinical examination or imaging studies. Surgical resection and histopathologic analysis remain the gold standard for diagnosis and treatment, respectively. Following complete resection, the prognosis is generally favorable with a low recurrence rate, but periodic echocardiography is recommended to detect any potential recurrence.