scholarly journals Case Report: Pheochromocytoma in a 59-Year-Old Woman Presenting With Hypotension

2021 ◽  
Vol 8 ◽  
Author(s):  
Hao-Yu Wu ◽  
Tian-Jiao Gao ◽  
Yi-Wei Cao ◽  
Lei Liang
Keyword(s):  
Blood Pressure ◽  
Vital Signs ◽  
Qt Prolongation ◽  
St Segment ◽  
Adrenal Pheochromocytoma ◽  
History Of ◽  
Artery Disease ◽  
Normal Urine ◽  
Enhanced Computed Tomography ◽  
Catecholamine Levels

Background: Pheochromocytoma patients who present with shock are extremely rare. Here, we report a patient who presented with shock and was diagnosed with pheochromocytoma.Case Summary: A 59-year-old woman with a history of hypertension without any treatment for 5 years presented with chest tightness. Vital signs on arrival indicated blood pressure of 78/50 mmHg. Twelve-lead electrocardiogram indicated ST-segment depression in leads II, III, aVF, and V3–V6 and QT prolongation. Coronary angiogram revealed no evidence of coronary artery disease. Contrast-enhanced computed tomography demonstrated an inhomogeneous right adrenal mass (2.5 × 3.0 cm). Her 24-h urinary norepinephrine and catecholamine levels were elevated. The patient underwent laparoscopic right adrenalectomy. Histopathology confirmed adrenal pheochromocytoma with residual necrosis. The patient was diagnosed with pheochromocytoma. During the 2-year follow-up, the patient was asymptomatic, and her blood pressure remained normal without medication. ECG showed that the ST-segment depression in leads II, III, aVF, and V3–V6 and the QT prolongation had disappeared. The patient showed no signs of recurrence, with normal urine norepinephrine and catecholamine levels.Conclusion: Patients with pheochromocytoma can present with hypotension or even shock. Clinicians should suspect pheochromocytoma when a patient with a history of hypertension has sudden hypotension or even shock.

scholarly journals STEMI due to septic embolism from prosthetic aortic valve Aspergillus spp. Endocarditis in an immunocompetent patient.

2021 ◽  
Author(s):  
coral Serrano Arroyo ◽  
Luis Sánchez Trujillo ◽  
Alan León Bojórquez ◽  
José Leal Franco ◽  
Amalia Castro Rodríguez ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Immunocompetent Patient ◽  
Artery Occlusion ◽  
Etiologic Agent ◽  
Pathology Report ◽  
St Segment Elevation ◽  
Replacement Surgery ◽  
St Segment ◽  
History Of ◽  
Artery Disease

A 65-year-old man with a history of aortic valve replacement surgery and non-coronary artery disease was admitted to the emergency department with acute ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed left anterior descending (LAD) artery occlusion, which was treated successfully with angioplasty. The patient developed obstructive valvular dysfunction, and large vegetation was observed on echocardiography. The patient subsequently developed irreversible septic shock and died several days later. The pathology report identified Aspergillus as the etiologic agent.

scholarly journals Rumpel-Leede Phenomenon: A Case Report

1970 ◽  
Vol 9 (4) ◽  
Author(s):  
Rehman HU, MBBS, FRCPC ◽  
Kambo J, MD
Keyword(s):  
Complete Blood Count ◽  
Vital Signs ◽  
Liver Function Tests ◽  
Left Hand ◽  
Lower Base ◽  
Associated Symptoms ◽  
Chest Auscultation ◽  
History Of ◽  
Artery Disease ◽  
The Right

A 72-year-old woman presented with a one-week history of fever, non-productive cough, and three unwitnessed syncopal episodes, with no other associated symptoms. She had poor recollection of the episodes, but denied urinary/fecal incontinence, tongue biting, numbness, parasthesias, or weakness. Her medical history was significant for hypertension, dyslipidemia, leg ulcers, psoriasis, stress incontinence, and gastroesophageal reflux disease. She did not have diabetes, coronary artery disease, or peripheral vascular disease. Her medications included Atorvastatin, Enalapril, Hydrochlorothiazide, Lansoprazole, and Calcium. She did not smoke or drink. On examination, her vital signs were stable and she was afebrile. Chest auscultation revealed crackles in the right lower base. She developed an erythematous, lacy sharply demarcated rash on her left hand that lasted for 3–4 hours after her blood pressure was taken on the same arm (Figures 1 and 2). Blood tests were unremarkable and included glucose, complete blood count, electrolytes, urea, creatinine, liver function tests, and coagulation studies.

scholarly journals Effectiveness of Conservative Treatment without Early Colonoscopy in Patients with Colonic Diverticular Hemorrhage

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Hirosato Doi ◽  
Keita Sasajima ◽  
Masanori Takahashi ◽  
Taira Sato ◽  
Iichirou Ootsu ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Confidence Interval ◽  
Previous History ◽  
Vital Signs ◽  
Hazard Ratio ◽  
Recurrent Bleeding ◽  
Diverticular Hemorrhage ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
Colonic Diverticular Hemorrhage

Aim. This study was aimed to clarify the effectiveness of conservative treatment without performing early colonoscopy and the indications for early colonoscopy in patients with colonic diverticular hemorrhage. Methods. This retrospective study included 142 participants who were urgently hospitalized due to bloody stools and were diagnosed with colonic diverticular hemorrhage between April 2012 and December 2016. At the time of hospital visit, only when both shock based on vital signs and intestinal extravasation on abdominal contrast-enhanced computed tomography were observed, early colonoscopy was performed within 24 hours after hospitalization. However, in other cases, patients were conservatively treated without undergoing early colonoscopy. In cases of initial treatment failure in patients with shock, interventional radiology (IVR) was performed without undergoing early colonoscopy. Results. Conservative treatment was performed in 137 (96.5%) patients, and spontaneous hemostasis was achieved in all patients. By contrast, urgent hemostasis was performed in five (3.5%) patients; three and two attained successful hemostasis via early colonoscopy and IVR, respectively. There were no significant differences between two groups in terms of early rebleeding (7.3% vs. 0%,P=0.690) and recurrent bleeding (22.7% vs. 20.0%, P=0.685). The factors associated with the cumulative recurrent bleeding rates were a previous history of colonic diverticular hemorrhage (hazard ratio 5.63, 95% confidence interval 2.68–12.0, P<0.0001) and oral administration of thienopyridine derivative (hazard ratio 3.05, 95% confidence interval 1.23–7.53, P=0.016). Conclusions. In this series, conservative treatment without early colonoscopy was successful in patients with colonic diverticular hemorrhage.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 24-25 ◽  
Author(s):  
Michael Cenkowski, MD ◽  
Amer M. Johri, MD ◽  
Raveen Pal, MD ◽  
Jennifer Hutchison, RDCS
Keyword(s):  
Blood Pressure ◽  
End Stage Renal Disease ◽  
Point Of Care ◽  
Vital Signs ◽  
Point Of Care Ultrasound ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

Gonococcal Periappendicitis and Salpingitis in a Prepubertal Girl

PEDIATRICS ◽  
1976 ◽  
Vol 58 (2) ◽  
pp. 287-288
Author(s):  
George L. Auman ◽  
Leopold M. Waldenberg
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Blood Pressure ◽  
Abdominal Pain ◽  
Case Report ◽  
Vaginal Discharge ◽  
Vital Signs ◽  
The United States ◽  
Prepubertal Girl ◽  
History Of

Gonorrhea is the most frequently reported infectious disease in the United States. Salpingitis and periappendicitis secondary to vaginal gonorrhea are not unusual in the mature woman, but are rare in the prepubertal girl. We are reporting a case of vaginal gonorrhea, acute salpingitis, and periappendicitis in a 5-year-old girl. CASE REPORT An acutely ill 5-year-old girl with a two-week history of a thick, nonpruritic vaginal discharge and an 18-hour history of fever, vomiting, and severe abdominal pain was admitted for evaluation. There was a negative history of dysuria, constipation, diarrhea, introduction of vaginal foreign body, coitus, and molestation. Vital signs on admission were: temperature, 39.7 C orally; pulse, 120 beats per minute; respiration, 36 breaths per minute; and blood pressure 100/60.

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