Catastrophic Antiphospholipid Syndrome as a Complication of COVID-19 Infection.

COVID-19 infection has been found to precipitate hypercoagulability and transiently increase antiphospholipid antibodies. However, it is yet to be determined how likely these transient changes contribute to thrombotic events and antiphospholipid syndrome. We present a case in which antiphospholipid antibodies were detected in the presence of significant thromboses. The patient was subsequently treated for suspected catastrophic antiphospholipid syndrome following COVID-19 infection.

Arterial Line Placement Pitfalls Can Be Demonstrated and Visualized With an Inexpensive, Wearable Trainer.

BACKGROUND: Radial arterial line placement is commonly performed in various clinical settings, including the emergency department. However, learners are successful on the first attempt only half of the time. Simulation can provide learners with procedure practice opportunities outside of clinical practice to increase confidence and chances of success. OBJECTIVES: We set out to build an arterial line trainer that would be inexpensive and reusable, wearable, anatomically realistic, and echogenic to allow for ultrasound use. We also hoped to devise a clear option that would allow for demonstration of procedure pitfalls. DISCUSSION: The arterial line trainer requires 4 hours of assembly time and costs $160. This includes enough material to make 48 tissue pads. The ballistics gel pad is echogenic; it can be customized with clear gel for direct anatomic visualization or dyed gel for more realism. The trainer also has a pulsatile artery for practice using anatomic landmarks. Visualization of the following important arterial line placement pitfalls is possible: suboptimal angle of approach, inadequate advancement of the catheter, and through-and-through vessel puncture. CONCLUSIONS: Our inexpensive trainer can help physicians and physicians in training conceptualize, practice, and troubleshoot the pitfalls of arterial line placement. Training programs looking to help learners understand the mechanics of arterial line placement may find it a useful tool.

Cardiac involvement in hydrocarbon inhalant toxicity - role of cardiac magnetic resonance imaging: A case report.

BACKGROUND: We report a patient who was diagnosed with toxic myopericarditis secondary to hydrocarbon abuse using cardiac magnetic resonance imaging (CMR). CASE SUMMARY: A 25-year-old male presented to emergency department with chest pain for 3 d. Patient also reported sniffing hydrocarbon containing inhalant for the last 1 year. Labs showed elevated troponin and electrocardiography was suggestive of acute pericarditis. Echocardiogram showed left ventricular (LV) ejection fraction (EF) of 40%. Given patient's troponin elevation and reduced EF, cardiac catheterization was performed which showed normal coronaries. CMR was performed for myocardial infarction with non-obstructive coronary arteries evaluation. CMR showed borderline LV function with edema in mid and apical LV suggestive of myocarditis. CONCLUSION: CMR can be used to diagnose toxic myopericarditis secondary to hydrocarbon abuse.