BMJ case reports
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Angioedema secondary to the use of ACE-inhibitors is well recognised, with a high rate of airway intervention required. Several treatments have been described, but little evidence exists for any of them. We describe the successful use of fresh frozen plasma in two cases.
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A 3-year-old man with an implanted cardioverter-defibrillator (ICD) for type 2 Brugada syndrome was admitted to coronary care unit with ventricular fibrillation electrical storm and consequent appropriate recurrent ICD shocks. The rhythm did not settle with conventional antiarrhythmics such as β-blockers and amiodarone. ⋯ He has remained free of problems for 1 year. This case-report summarises these novel treatments for electrical storm in Brugada syndrome and the mechanism behind them.
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Case Reports
Unsuspected pheochromocytoma of the urinary bladder: reminder of an important clinical lesson.
Bladder pheochromocytoma creates an extremely rare situation (0.06% of all bladder tumours). We came across a case with a complaint of intermittent episodes of haematuria. Cystoscopy revealed a solid, bluish submucosal growth with increased vascularity. ⋯ The histopathology report came out to be pheochromocytoma of the bladder. Later, partial cystectomy was carried out under general anaesthesia and histopathology confirmed the same. Thus, a surgeon/urologist should have a high index of suspicion for bladder pheochromocytoma while dealing with such cases if he comes across the characteristic symptoms of sharp headache, hypertension, palpitation, sweating, fainting or blurring of vision immediately after voiding or during the cystoscopic manipulation of tumour or cystoscopic findings of a submucosal supratrigonal vascular tumour with a bluish hue.