BMJ case reports
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Myocarditis is assumed to involve both ventricles equally. Right ventricular predominant involvement is rarely described. ⋯ Anti-Coxsackie A9 virus neutralising IgM-type antibodies titre was elevated. This case emphasises that manifestations of myocarditis can be limited to the right ventricle and should be considered in the differential diagnosis of right ventricular enlargement.
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Case Reports
Successful low-dose spinal anaesthesia for lower segment caesarean section in a patient with Takayasu arteritis.
Takayasu arteritis is a rare, chronic idiopathic, occlusive inflammation of the aorta and its major branches. It is a rare form of non-specific obliterative panarteritis of unknown aetiology. ⋯ We report a 26-year-old woman multigravida who was diagnosed with Takayasu arteritis who underwent an emergency caesarean section under spinal anaesthesia. In this case study, the whole course of anaesthesia and operation was uneventful due to thorough systemic evaluation and planned anaesthetic management.
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Traumatic injuries of the elbow in children pose a diagnostic challenge. They demand precise knowledge of radiographic anatomy, growth characteristics of healthy and injured bones as well as specific fracture dynamics in this age group. Dislocation of the elbow is rare in children, accounting for 3-6% of all childhood elbow injuries. ⋯ Diagnosis and recognition of the injury pattern was fundamental in the successful management of this case. We recommend the use of CT with three-dimensional reconstructions, to fully understand the fracture pattern and dictate subsequent reduction manoeuvres during closed manipulation. Thus preventing open surgical techniques and their associated morbidities.
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Case Reports
Wellens' syndrome: a classical electrocardiographic sign of impending myocardial infarction.
We describe a case of previously healthy 72-year-old man, who presented with rest angina. The ECG revealed sinus rhythm, biphasic T waves with preserved R waves in V1-V4 precordial leads. Subsequent evaluation revealed the normal serum cardiac marker levels and echocardiography with the coronary angiography showing a critical lesion in the proximal left anterior descending artery. ⋯ In our case, we highlight the subtle though classical ECG findings of Wellens' syndrome and its specific angiographic correlation. It can be of vital importance to identify these changes and intervene in time appropriately so as to avoid the development of myocardial infarction that carries a substantial morbidity and mortality. Important aspects of diagnosis and management have also been reviewed.
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Case Reports
Unilateral visual loss after spine surgery in the prone position for extradural haematoma in a healthy young man.
This case reports a patient who developed central retinal artery occlusion following spinal surgery in the prone position. When placed in this position, especially as a result of malposition of the head, the patient may develop external compression of the eye which leads to central retinal artery occlusion. Therefore, a special precaution must be given for adequate eye protection during prolonged prone-positioned spine surgery.