SAGE Open Medical Case Reports最新文献

{"title":"A case report of complex acute coronary syndrome presentation: Plaque rupture and mild coronary artery ectasia presenting as de Winter T-waves morphing into anterior ST-elevation myocardial infarction in a young adult male.","authors":"Momena A Daas, Maryam A Almasaabi, Eman M Abdrabou, Mohammed Elmahal, Abdul-Majeed O Mahdi, Eva A Tello, Ousama Mahdi, Abdulrahman E Alayyaf, Ahmad J Aladwani, Mahmoud M Ramadan","doi":"10.1177/2050313X251331733","DOIUrl":"10.1177/2050313X251331733","url":null,"abstract":"<p><p>This case report details a rare presentation of acute coronary syndrome in a young adult male with no significant medical history. A 24-year-old male presented with acute chest pain, and his initial ECG revealed the rare de Winter pattern, an underrecognized ST-elevation myocardial infarction (STEMI) equivalent. The de Winter T-wave morphology evolved into anterior STEMI, emphasizing the critical need for prompt recognition and intervention. Coronary angiography demonstrated mild coronary artery ectasia (CAE) with slow blood flow in the left anterior descending (LAD) and left circumflex arteries, alongside intramuscular bridging. Advanced imaging via optical coherence tomography identified ruptured plaque and mild spontaneous dissection as the underlying pathology. Initial treatment involved dual antiplatelet therapy, beta-blockers, statins, and low-molecular-weight heparin, leading to clinical stabilization and normalization of cardiac function. This case underscores the diagnostic challenges associated with CAE, particularly in young patients, and highlights the utility of advanced imaging modalities in personalizing treatment strategies. CAE, affecting 1%-5% of patients undergoing coronary angiography, is characterized by aneurysmal coronary dilation. It poses unique therapeutic challenges due to its association with turbulence, thrombus formation, and vulnerability to ischemic events. The findings revealed that even mild CAE, when coupled with structural abnormalities such as ruptured plaque, can result in significant ischemic complications. The case demonstrates the importance of multidisciplinary care and individualized management, combining medical therapy with advanced diagnostic tools. It also emphasizes the need for familiarity with the de Winter ECG pattern to facilitate timely reperfusion therapy and mitigate adverse outcomes. Further research into CAE pathophysiology, including genetic, inflammatory, and hemodynamic aspects, is essential to enhance risk stratification and optimize treatment approaches for this complex condition.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251331733"},"PeriodicalIF":0.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative and postoperative imaging as a surgical strategy and feedback on abdominal aortic aneurysm with horseshoe kidney: Case report.","authors":"Shizuko Iwasa, Takeshi Katsube, Azumi Hamasaki","doi":"10.1177/2050313X251332501","DOIUrl":"10.1177/2050313X251332501","url":null,"abstract":"<p><p>A 77-year-old man was diagnosed with an infrarenal abdominal aortic aneurysm coexisting with a horseshoe kidney detected on a computed tomography (CT) scan. Since the presence of three accessory renal arteries was confirmed, reconstruction for renal protection was done by performing transperitoneal laparotomy instead of endovascular treatment. After performing anastomosis of a Y-shaped artificial graft, the major accessory renal artery was reconstructed under intraoperative renal perfusion. We report a successful surgical repair without renal isthmus division, where only autologous blood transfusion was performed. Although a postoperative CT scan showed partial renal infarction, creatinine levels, indicative of renal function, were comparable to preoperative levels. Horseshoe kidney is the most common fusion defect of the kidneys with aberrant accessory renal arteries. Thus, clearly constructed images are key to establish an effective operative strategy. Furthermore, comparing preoperative and postoperative CT images could also provide important feedback on the accuracy of treatment strategy.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251332501"},"PeriodicalIF":0.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unexpected case of frontal headache: Silent corticotroph pituitary neuroendocrine tumor presenting as a sphenoid sinus mass.","authors":"Marie-Michelle McNicoll, Lamiae Himdi, Marc Tewfik, Salvatore Di Maio, Marie-Christine Guiot, Vincent Larouche","doi":"10.1177/2050313X251332081","DOIUrl":"10.1177/2050313X251332081","url":null,"abstract":"<p><p>We report the case of a 43-year-old male who presented with a 2-year history of frequent frontal headaches, initially attributed to sinus disease. Magnetic resonance imaging revealed a 30 mm mass in the right sphenoid sinus with extension into the cavernous sinus, encasing the internal carotid artery, and invading the sella turcica. Differential diagnosis based on imaging included sphenoid meningioma, low-grade carcinoma, or lymphoma. An endoscopic sphenoid sinus biopsy identified the lesion as a silent corticotroph pituitary neuroendocrine tumor/adenoma (SCA), confirmed by positive immunostaining for ACTH and T-PIT. The patient underwent a successful transsphenoidal resection, followed by a transient postoperative central adrenal insufficiency and diabetes insipidus, which resolved within eight months. Eighteen months postoperatively, the patient retains normal pituitary function with minimal residual tumor. This case illustrates the diagnostic challenge posed by SCAs when presenting as sphenoid sinus masses and highlights the importance of considering SCAs in similar cases.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251332081"},"PeriodicalIF":0.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formication with destruction of the nasal septum: A rare case report.","authors":"Michele White, Dwayne Evans, Gary Frey, Cleverick Cd Johnson, Ben F Warner","doi":"10.1177/2050313X251322873","DOIUrl":"10.1177/2050313X251322873","url":null,"abstract":"<p><p>Delusions of parasitosis are known by several names, one of which is formication. It is an uncommon psychiatric disorder listed in the DSM V under the classification of delusional disorders. Patients experience an established, incorrect belief that they have an infection of living organisms such as parasites. There are two types of delusions of parasitosis, primary and secondary. In the primary form, the symptom is the delusion of a parasitic infection without secondary cause. The secondary form includes this symptom as well as additional psychiatric disorder, drug abuse, or medical illness. Patients often seek consultation with dental providers for dental pain with underlying medical conditions. This is a case report of a 35-year-old male with comorbid HIV and Hepatitis B disease, as reported by the patient, who sought care with a dental urgent care clinic with a chief complaint of dental pain and a presentation of collapse, atrophy, and ebbing of the nasal septum due to patient admitted formication. An accurate and complete medical was not obtainable from the patient who was subsequently lost to follow-up. Patient symptoms, clinical examination, and differential diagnosis rationale are presented. Further, information on cocaine and methamphetamine is also discussed. Followed by the conclusion that advocates for the usefulness of this case report for primary medical and dental providers. Recognition of concurrent medical and dental conditions will expedite collaborative care, patient referral, and treatment options that support best practices in patient care.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251322873"},"PeriodicalIF":0.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of acquired acrodermatitis enteropathica in a 91-year-old man.","authors":"Yi Shen, Siyi Sun, Yuqiu Chen, Yanmin Zhou","doi":"10.1177/2050313X251330701","DOIUrl":"10.1177/2050313X251330701","url":null,"abstract":"<p><p>This report is a care experience of acrodermatitis enteropathica caused by inadequate zinc intake. The male patient is 91 years old, he had been fasting caused by recurrent acute pancreatitis, and intravenous nutrition lacking zinc. The case was based on multidisciplinary treatment, reviewing clinical data, and making a definitive diagnosis. Zinc supplementation is based on monitoring serum zinc levels, and for the skin wound condition to choose timely and effective dressing changes, life care, keep the wound dry, control the exudate seepage, and promote the healing of the patient's wound. With treatment and care, the patient's skin damage was brought under control and the prognosis was favorable.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251330701"},"PeriodicalIF":0.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periorbital edema and phototoxic rash associated with dasatinib: A case report.","authors":"Bera Omer Ugurlu, Umit Yavuz Malkan","doi":"10.1177/2050313X251330969","DOIUrl":"10.1177/2050313X251330969","url":null,"abstract":"<p><p>Dasatinib is an effective agent in the treatment of bcr-abl positive acute lymphoblastic leukemia and chronic myeloid leukemia cases. Various skin reactions may occur when tyrosine kinase inhibitors are used. The severity of side effects increases in phototoxic reactions with sunlight. In this case, a phototoxic rash that developed in a 78-year-old bcr-abl positive acute lymphoblastic leukemia patient is presented. This case supports that phototoxic reactions may occur with dasatinib and emphasizes that clinicians should be alert for this side effect.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251330969"},"PeriodicalIF":0.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac tamponade due to massive hemopericardium caused by spontaneous rupture of a non-aneurysmatic coronary artery: A rare case report.","authors":"Arijit Datta, Abhishek Das, Nandini Das, Preeti Tiwari, Dhara Goswami, Prashant Verma","doi":"10.1177/2050313X251330192","DOIUrl":"10.1177/2050313X251330192","url":null,"abstract":"<p><p>Cardiac tamponade is a medical condition that occurs when there is an accumulation of blood, pus, fluid, or gas in the area around the heart (i.e. the pericardial cavity), leading to increased pressure within the pericardium. In forensic practice, sudden natural deaths are mostly related to cardiovascular conditions including cardiac tamponade. Owing to the sudden and rapid nature of its progression and fatal outcome, CT is often diagnosed during postmortem examination. In this case report, we discuss the sudden death of a 54-year-old male deceased due to a sudden collapse. No external or internal injuries were observed. On internal examination, in the mediastinum, a \"Blue dome\" sign of the heart was present; 600 g of liquid and clotted blood were present in the pericardial cavity. The etiology was not ventricular free wall rupture; rather, it was coronary artery rupture, which is a rare cause of such tamponade. Postmortem histopathology revealed significant atherosclerotic changes in the coronary arteries, leading to atherosclerotic plaque rupture. This etiology was first reported in this case, causing fatal cardiac tamponade.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251330192"},"PeriodicalIF":0.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal aortic injury, increasingly diagnosed, and still potentially difficult to manage: A case report.","authors":"Cornelia S Carr, Fajer Al-Ishaq, Girish Rao","doi":"10.1177/2050313X251330164","DOIUrl":"10.1177/2050313X251330164","url":null,"abstract":"<p><p>A 50-year-old man fell 4 m, sustaining multiple fractures involving the pelvis and chest. There was no previous medical history or family history of note. Computerized tomography showed a small filling defect in the ascending aorta, as well as multiple rib and pelvic fractures. Due to the minimal nature of the aortic injury, he was managed conservatively. Repeat CT scans at 1 month and 3 months showed complete resolution of the lesion. We discuss the case and the phenomenon of \"minimal aortic injury.\"</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251330164"},"PeriodicalIF":0.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive isolated pneumomediastinum in a ventilated patient with COVID-19 pneumonia managed with the insertion of a novel mediastinal drain.","authors":"Ashani Ratnayake, Buddhika Dassanayake, Prabhashini Kumarihamy, Ayeshani Rajapaksha, Nirmitha Morel","doi":"10.1177/2050313X251329773","DOIUrl":"10.1177/2050313X251329773","url":null,"abstract":"<p><p>Spontaneous pneumomediastinum is associated with SARS-CoV-2 infection-related respiratory manifestations. Coexistence of pneumomediastinum with severe pneumonia may interfere with providing mechanical ventilation due to the possibility of the development of tension inside the mediastinum. We describe a case of severe COVID-19 pneumonia with spontaneous pneumomediastinum and subcutaneous emphysema who required mechanical ventilation. A novel drain was inserted into the mediastinum to decompress the large pneumomediastinum. A 47-year-old male with severe COVID-19 pneumonia required invasive ventilation due to respiratory failure. With the commencement of invasive ventilation, the patient developed a large pneumomediastinum with extensive subcutaneous emphysema. With the deterioration of COVID-19 pneumonia, it was necessary to increase respiratory parameters but was limited because of the possibility of tension pneumomediastinum. Two different drains were inserted, one to the subcutaneous space and the other to the mediastinum. A fenestrated suction drain with an outer protective sheath was created using a 24 Fr chest drain tube and a temporary peritoneal dialysis catheter increment of positive end-expiratory pressure was limited by the risk of development of tension pneumomediastinum. After the procedure, the patient slowly improved over the next few days. After 7 days of the procedure, the patient succumbed due to a secondary bacterial infection of the lung. This case report highlights that a simple technique using easily available equipment improves the condition and can assist in the escalation of ventilatory support in patients with pneumomediastinum.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251329773"},"PeriodicalIF":0.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative management of uncorrected tetralogy of Fallot presenting for emergent noncardiac surgery: A case report.","authors":"Matthew Campbell, Okola U Tull, Zulqar Islam, Ashish Sakharpe, Caryl Bailey","doi":"10.1177/2050313X251328764","DOIUrl":"10.1177/2050313X251328764","url":null,"abstract":"<p><p>With only about 3% of patients with uncorrected tetralogy of Fallot surviving past age 40, we describe the case of an uncorrected tetralogy of Fallot following a palliative, now obstructed, Blalock-Taussig shunt in a man who presented for emergent noncardiac surgery. Due to limited in-house records, managing this complex patient presentation required obtaining outside-hospital records, performing point-of-care diagnostic studies, and coordinating with the surgical team. We employed monitored anesthesia care with the option to convert to general anesthesia if needed. The patient was discharged after a 3-day intensive care unit stay and cleared for normal activity at his 3-week follow-up. This case highlights the importance of interdisciplinary collaboration, knowledge of prior surgical history, and understanding intraoperative hemodynamic goals for successful planning and perioperative management.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251328764"},"PeriodicalIF":0.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}