BMJ case reports
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Fetal supraventricular tachycardia (SVT) is the most common form of fetal tachycardia. If started early in pregnancy, it can cause non-immune fetal hydrops. Echocardiography is the preferred method for the diagnosis with simultaneous pulsed Doppler recording from the superior vena cava and ascending aorta. ⋯ We present a case of fetal SVT detected at 26 weeks of pregnancy. Digoxin therapy restored the rhythm initially, but later paroxysms of fetal SVT persisted necessitating the addition of second antiarrhythmic medication which was discussed with the parents. The couple chose to proceed for premature delivery at 32 weeks.
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We describe a 73-year-old man with Crohn's disease and previous sternotomies, who developed Salmonella sternoclavicular osteomyelitis subsequent to a Salmonella enteritidis sepsis and closed fracture of his clavicle. We include evidence from several cases related to sternoclavicular osteomyelitis, and Salmonella osteomyelitis. We continue by summarising the aetologies of these diseases, and risk factors that predispose to them.
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Case Reports
Intubating laryngeal mask airway combined to fibreoptic intubation in subglottic stenosis.
We reported a successful airway management in a patient with unknown tracheal stenosis admitted in the emergency room for benzodiazepine overdose. The use of intubating laryngeal mask airway in combination with fibreoptic intubation was easy and safe in this patient; procedures such as ventilatory control and patient oxygenation were continued during intubation attempts, lessening the likelihood of desaturation. This method allowed the diagnosis of tracheal stenosis and soft endotracheal intubation.
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A patient presented with symptoms consistent with non-ST elevation myocardial infarction (NSTEMI) and was given appropriate antiplatelet and anticoagulant therapy. Despite treatment of the NSTEMI and fluid resuscitation the patient remained persistently hypotensive. ⋯ Post surgery the patient had an uneventful recovery. We present this case to highlight the importance of considering dissection as a differential in patients presenting with chest pain and the lack of symptoms a patient with such a severe dissection can display.