The authors present a clinical case of coronary artery spasm in a 62-year-old woman undergoing elective aortic valve replacement surgery for aortic regurgitation. On admission at ICU, the patient developed marked hemodynamic and electrical instability. Emergent coronary angiography demonstrated a pronounced spasm of the distal portion of the right coronary artery, apparently related to compression of this vessel by a chest drain tube.
To describe the prenatal sonographic findings in 4 fetuses affected by microdeletion 17q21.31 (Sdr. Koolen de Vries). The introduction of microarray based technology enabled genome in prenatal diagnosis resulting in the detection of recurrent microdeletions in fetuses. We try to correlation between these ultrasound alterations and Koolen-de Vries syndrome. This syndrome is characterised by developmental delay, hypotonia, facial dysmorphisms, epilepsy, heart defects and kidney/urologic anomalies. We described the ecographic findings in four fetuses affected by Koolen de Vries syndrome. An ultrasound study was performed at 12, 20–22 and 32–24 weeks of gestation. Array-SNPs was performed on uncultured amniocytes. Array-SNPs were performed by HIScan Illumina, ES CYTOSNP850k. Only one of them had an increased nuchal translucency (4.2 mm). In all of them, the sonographic study on mild gestation was normal. 3 of them had ventriculomegaly mild to moderate in the third trimester, one of them presented a corpus callosum dysgenetic and growth restriction. The mild to moderate ventriculomegaly was the most constant ecographic finding in this syndrome. Only in the third trimester was possible to suspect this fetal anomaly.
Introduction Geriatric emergency department visits are most often for acute abdominal pain. More elderly patients with acute abdominal pain visit the ER as the elderly population grows. However, emergency physicians face more challenges. Elderly abdominal pain symptoms vary. However, disease manifestations, cognitive issues, and communication issues may delay diagnosis in elderly patients, increasing mortality. Indeed, early and accurate acute abdomen diagnosis in elderly patients greatly affects their outcomes.
Compartment syndrome is a critical condition characterized by elevated pressures within constricted myofascial compartments, leading to vascular compromise, hypoxia, and potential irreversible injury. While commonly affecting the forearm and lower leg, compartment syndrome of the hand is rare and poses unique diagnostic and therapeutic challenges. The pathophysiology involves increased intracompartmental pressure from various etiologies, such as trauma, edema, or external compression, culminating in a cycle of ischemia and worsening edema. Rhabdomyolysis, defined by rapid muscle tissue degradation and release of intracellular components into the bloodstream, is intricately linked to compartment syndrome, with each condition potentially exacerbating the other. Elevated serum creatine kinase and myoglobin levels are hallmark diagnostic markers of rhabdomyolysis. Hand compartment syndrome, despite its rarity, necessitates prompt identification and surgical intervention. The hand's complex anatomical structure comprises ten compartments, each at risk for ischemic injury under increased pressure. Clinically, hand compartment syndrome manifests as severe pain disproportionate to injury, edema, and abnormal posturing. Diagnosis relies on clinical suspicion, supported by intracompartmental pressure monitoring. Emergent fasciotomy remains the definitive treatment, requiring multiple incisions to decompress affected compartments. Magnetic resonance imaging (MRI) is valuable for assessing tissue damage and guiding management strategies. This review underscores the importance of early recognition and timely intervention in compartment syndrome and highlights the interdependent relationship between compartment syndrome and rhabdomyolysis.