The American journal of emergency medicine
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A 28-year-old-man admitted to emergency department with ventricular tachycardia. Patient had drunk 3 cans of 250-mL energy drink 5 hours before the basketball match; he had palpitation and nausea before the match. After 30 minutes of the match, during the break, patient lost his consciousness. ⋯ Energy drinks generally contain caffeine, taurine, various vitamins, glucose, and herbal extracts such as guarana and ginseng. Especially in high doses, caffeine can cause palpitations and supraventricular and ventricular arrhythmia. Energy drink consumers should be informed about their severe adverse effects in case of overuse.
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Case Reports
Takotsubo cardiomyopathy after anti-influenza vaccination: catecholaminergic effects of immune system.
Takotsubo cardiomyopathy (TTC) is a well-known condition, which leads to sudden transient regional systolic dysfunction. It mostly affects aging women and is usually precipitated by emotional or physical stress. ⋯ In our case, an elderly woman presented with an acute episode of TTC 24 hours after anti-influenza vaccination without any obvious stressor for sudden rise in the catecholamine level. Sudden postvaccination change in the cardiac sympathetic discharge is the most likely precipitant of TTC in this case.
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The preexcitation syndrome may either simulate myocardial infarction (MI) or mask it. The rapid anterograde conduction through accessory pathway may obscure atrioventricular (AV) block of the normal AV-nodal tract. ⋯ We report a complex case of preexcitation syndrome presenting with first-degree and transient third-degree AV blocks in both normal and accessory pathways after acute MI. Subsequently, we further discuss the diagnosis of MI in preexcitation syndrome and analyze the electrocardiographic character of AV block in preexcitation syndrome.
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Household stoves are a common source of injury in the United States. ⋯ This is the first comprehensive study of stove-related injuries in the United States using a nationally representative sample. Strategies to prevent stove-related injuries should address the multiple mechanisms of injury.
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A case of herpetic rash in an immunocompetent patient is described, which was present in multiple dermatomes at the same time. First, patient was thought to have immunodeficiency, but further workup turned out to be negative for it. ⋯ Later, the patient responded well to the acyclovir therapy and was discharged home without any sequel. This case illustrates the need for emergency physicians to be extra vigilant for involvement of other dermatomes in case a patient presents with herpetic rash in 1 dermatome because patients with multidermatomal/disseminated herpetic rash need to be started on airborne isolation in addition to contact precautions to prevent the transmission of disease in health care settings.