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Introduction: Primary central nervous system angiitis is a rare idiopathic vasculitis that is limited to the central nervous system. It has a wide range of clinical presentations that can mimic other vasculopathies. Case presentation: A 24-year-old female patient presents with various non-specific neurological complaints in a progressive course. After a challenging diagnostic work-up, she was diagnosed by tissue biopsy to have primary central nervous system angiitis. Discussion: Although primary central nervous system angiitis has been reported increasingly recently, its pathogenesis is still unknown, and its diagnosis is still very challenging. No universal criteria have been adopted, and there is no laboratory test or imaging modality with sufficient sensitivity and specificity to confirm the diagnosis and exclude other mimickers. Conclusion: To prevent misdiagnosis, clinicians treating patients with suspected primary central nervous system angiitis should be aware of its differentials.
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Introduction: Acute coronary syndrome (ACS) in young individuals (≤45 years) is increasingly recognized as a significant health concern, yet research in this demographic remains limited, particularly within the Palestinian context. This study aims to bridge this gap by comprehensively investigating the clinical characteristics, age-specific profiles, gender disparities, treatment modalities, and angiographic patterns of ACS in young patients compared to their older counterparts. Materials and methods: A multi-centre observational study was conducted, enroling 468 participants aged 18-55 diagnosed with ACS and admitted to three prominent Palestinian hospitals. Data were collected from medical records, and statistical analysis was performed to assess demographic characteristics, clinical presentations, risk factors, treatment strategies, and outcomes. Results: The majority of participants were male (87%), with a higher proportion in the older age group (>45 years). Clinical presentations varied, with non-ST segment elevation myocardial infarction (NSTEMI) being the most common diagnosis (48%). Risk factors such as smoking, hypertension, and diabetes were prevalent, with notable gender and age-specific differences. Percutaneous coronary intervention (PCI) was the predominant treatment strategy (83%), with consistent medication use across age groups. Conclusion: ACS in young patients poses a significant public health challenge in Palestine, necessitating tailored preventive strategies and comprehensive management approaches. Understanding the unique demographic and clinical characteristics of young ACS patients is crucial for informing targeted interventions and policies aimed at reducing the burden of cardiovascular disease in this population. These findings contribute valuable insights to the existing literature and underscore the importance of further research in this area to improve outcomes and mitigate the impact of ACS in young individuals globally.
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Cardiac myxomas are the most common primary cardiac neoplasms, with only a small percentage being found in the left ventricle. Herein, we describe a 25-year-old male who presented with a complaint of chest pain for almost three months and was found to have a 2x2 cm encapsulated tumor attached by a 2-3 mm stalk to the mid-septum, 5 cm below the aortic annulus, via echocardiography. Additionally, a chest CT angiography was performed and revealed a small defect in the left ventricle with a low attenuation density originating from the septum. The tumor was later managed surgically with a median sternotomy approach, and left ventricular myxoma was confirmed histopathologically. Even though cardiac myxomas are incredibly uncommon, they are usually located in the left and right atria and are very unlikely to present in the left ventricle. This incident highlights the importance of taking cardiac myxoma into account as a potential differential diagnosis in cases of chest pain to prevent any further complications.
