Open Access DOI:10.23937/2474-3682/1510154
Dilated Pulmonary Artery Containing Swirling Smoke (SEC)
Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS
Article Type: Image Article | First Published: September 23, 2020
Cases of dilatation of pulmonary artery in medical literature are not very uncommon. However presence of swirling smoke in dilated pulmonary arteries is very rare. Detection and management of such cases are very urgent to prevent fatal complications. Here I have reported one such rare case of dilated pulmonary artery with spontaneous echo contrast/smoke in a case of idiopathic pulmonary artery dilatation. 55-year-old female presented with shortness of breath on minimal exertion for last 4 months...
Open Access DOI:10.23937/2474-3682/1510153
Subperiosteal Abscess with Pediatric Acute Osteomyelitis
Yuki Yoshida, MD and Atsushi Yoshida, MD
Article Type: Image Article | First Published: September 13, 2020
A previously healthy 9-year-old girl presented with a 3-day history of high fever (> 40 °C) and acute pain in the right shoulder. A blood chemical profile showed a C-reactive protein level of 9.7 mg per liter and a white cell count of 12,500 per cubic millimeter. Shoulder radiographs were normal, but magnetic resonance imaging showed acute osteomyelitis around proximal humeral epiphyseal plate and a subperiosteal abscess around the humeral neck (Figure 1). Vancomycin was empirically started aft...
Open Access DOI:10.23937/2474-3682/1510152
Pacemaker Lead Vegetation
Sudeb Mukherjee
Article Type: Image Article | First Published: September 10, 2020
Pacemaker implantation has a very fascinating history. Since the first implantation of human pacemaker technological advancement has helped tremendously in the evolution of different types of pacemaker. Dedicated work by different scientist at different times has enriched the knowledge of several aspects of implantation gradually. Over the time the technology has been modernized to adapt the need of pacing in different clinical situations. However one thing remained constatnt throughout this lon...
Open Access DOI:10.23937/2474-3682/1510151
Type A Aortic Dissection Presenting with Paraplegia & Urinary Retention
Sun Yong Lee, MD and Siamak Mehdizadehseraj, MD
Article Type: Image Article | First Published: August 31, 2020
A 60-year-old female with history of hypertension presented to the emergency department following a sudden fall while walking 3 hours prior. The patient was unable to move her both legs and unable to void. During evaluation, she also developed a sudden onset of sharp mid-sternal chest pain. Her blood pressure was 213/126 mmHg in right arm and 170/131 mmHg in left arm and heart rate was tachycardic at 110. Bilateral lower extremities motor strengths were not present with intact sensory functions....
Open Access DOI:10.23937/2474-3682/1510150
Left Atrium Swirling Smoke (SEC) in TEE
Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS
Article Type: Image Article | First Published: August 20, 2020
24-year-old male with very severe mitral stenosis of rheumatic etiology presented with one episode of transient left sided hemiparesis with full recovery within 24 hours. He was on optimum medical management that includes diuretics, beta blocker and digoxin. Her heart rate was 62/minutes and BP was 110/64 mm of Hg. She was also receiving injection benzathine penicillin once every three weeks. Transthoracic Echocardiography (TTE) was done which revealed thickened anterior and posterior mitral lea...
Open Access DOI:10.23937/2474-3682/1510149
Septal CRT-D Pacemaker
Sudeb Mukherjee, MBBS, MD, DM
Article Type: Image Article | First Published: August 08, 2020
CRT-D implantation has become a standardised treatment for patients suffering from Heart Failure with reduced Ejection Fraction (HFrEF). Patients with left ventricular ejection fraction (LVEF) below 35% along with Left Bundle Branch Block (LBBB) pattern with wide QRS duration are the most benefitted one post placement. Implantation of CRT-D needs expertise so that proper left ventricular lead placement can be done. It also depends on anatomical suitability of Coronary Sinus (CS)....
Open Access DOI:10.23937/2474-3682/1510148
Wandering Left Atrium Clot Ball
Sudeb Mukherjee, MBBS, MD, DM
Article Type: Image Article | First Published: August 06, 2020
43-year-old lady presented with shortness of breath for past 7 months. She had history suggestive of Paroxysmal Nocturnal Dyspnoea (PND). She had also few episodes of palpitations. She had no history of rheumatic fever in the past. On physical examination mid diastolic rumbling murmur was audible at the apex which changed with posture. There was no history of fever and/or any embolic manifestations. Electrocardiogram revealed left atrial abnormalities. Transthoracic Echocardiogram was done which...
Open Access DOI:10.23937/2474-3682/1510147
Vitamin-K Dependent Protein Deficiency and Pseudoxanthoma Elasticum
Manish Kumar
Article Type: Image Article | First Published: July 25, 2020
27-year-old male referred from Dental clinic, due to asymptomatic incidental abnormal coagulation parameters. Clinical examination showed loose skin folds of axilla, anterior abdominal wall and chest which were suggestive of Pseudoxanthoma Elasticum. Rest systemic examinations WNL. Patient has similar family history. Coagulation profile showed PT-46 seconds, (control 12.50), INR 4.64 seconds, APTT 61.30 seconds (control 23.80), Mixing Studies-PT 13.8 seconds, PTT-29.7 Seconds....
Open Access DOI:10.23937/2474-3682/1510146
A Rare Case of Idiopathic Petrified Ear or Calcified Pinna
Ranjit Meher, MBBS, MD, Varsha M Khalkho, MBBS, DNB, and Anwesha D Patel, MBBS, MDRD
Article Type: Image Article | First Published: July 23, 2020
Calcification or ossification of the auricular cartilage, also known as “petrified ears”, was first described by Bochdalek in 1866. In our article, a seventy-two years-old male was evaluated for stiffed left ear over few years. No obvious cause was demonstrated on laboratory tests. Calcification or ossification of the left external auricular cartilage was demonstrated on non-contrast temporal bone Computed Tomography (CT) scan and therefore a rare case of idiopathic petrified left ear was di...
