Myxedema Coma and the Heart: Would You Miss the Signs?

Myxedema Coma (MC) is a life-threatening medical emergency that occurs as a severe complication of untreated or poorly managed hypothyroidism. Prompt diagnosis is crucial as the condition can rapidly deteriorate and lead to life-threatening complications. Timely treatment of myxedema coma with intravenous levothyroxine is the cornerstone of treatment, along with glucocorticoids to support adrenal function. This condition is associated with cardiovascular manifestations that contribute to its high mortality rate. The heart in hypothyroidism typically shows reversible dysfunction that can be corrected with hormonal supplementation, and in some cases, requires inotropic and aminergic support. This case involves a patient who was admitted to the intensive care unit with suspected MC, and necessitated life-saving hormonal and cardiovascular support to manage the condition.

Right Heart Thrombus in Transit: Unusual Echocardiographic Finding in a patient with Acute Pulmonary Embolism.

Eighty year old male patient with heart failure preserved ejection fraction (EF), Obstructive sleep apnea, peripherovascular disease admitted with increasing shortness of breath and found with pulmonary emboli. Baseline 2D-echo-cardiogram performed demonstrated preserved ejection fraction and a right thrombus in transit. Anticoagulation with weight based-low molecular weight heparin was given for six days. Follow-up echo performed demonstrated complete dissolution of right heart thrombi. Since there was complete dis- solution of thrombi seen on right atrium, anticoagulation with Rivaroxaban was given instead.

Right Heart Thrombus in Transit: Unusual Echocardiographic Finding in a patient with Acute Pulmonary Embolism.

Eighty year old male patient with heart failure preserved ejection fraction (EF), Obstructive sleep apnea, peripherovascular disease admitted with increasing shortness of breath and found with pulmonary emboli. Baseline 2D-echocardiogram performed demonstrated preserved ejection fraction and a right thrombus in transit. Anticoagulation with weight based-low molecular weight heparin was given for six days. Follow-up echo performed demonstrated complete dissolution of right heart thrombi. Since there was complete dissolution of thrombi seen on right atrium, anticoagulation with Rivaroxaban was given instead.

Recurrent syncope episodes in a 33-year-old male patient: case report and review of literature.

Case report and review of literature of a 33-year-old-male patient who was suffering from recurrent events of loss of consciousness (syncope) found to have multiple events of sustained and non sustained left bundle-branch morphology ventricular tachycardia during Holter evaluation. Both, the echocardiographic and magnetic resonance studies demonstrated morphological changes as seen in Arrhythmogenic right ventricular cardiomyopathy. Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare cardiomyopathy characterized by life-threatening ventricular arrhythmias in the absence of apparent structural left heart disease, predominantly occurring within the male gender. Though it is mostly a hereditary condition, there are some sporadic cases. It is characterized by progressive degeneration and fibrous-fatty replacement of the right ventricular myocardium. The European Society of Cardiology and the International Society and Federation Task force is useful for the diagnosis of the condition because of the difficulties in as well as inaccuracies in tissue diagnosis. Patients with a diagnosis of ARVD who suffers from recurrent syncope events and ventricular arrhythmias an Implantable Cardiovertor-Defibrillator (ICD) is indicated to decrease their risk of sudden cardiac death events.