BMJ case reports
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Case Reports
Anaesthetic management of hip arthroplasty in an individual with trisomy 21 and Eisenmenger's syndrome.
A 49-year-old man with trisomy 21 and Eisenmenger's syndrome presented for hip arthroplasty. Eisenmenger's syndrome is defined by the presence of obstructive pulmonary vascular disease secondary to long-standing left-to-right shunt causing pulmonary hypertension, eventually leading to shunt reversal in to right-to-left direction. ⋯ The choice of anaesthetic technique in these patients is therefore not straightforward. A successful outcome was achieved with general anaesthesia supplemented with nerve blocks.
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Case Reports
A case of Takotsubo cardiomyopathy induced by accidental hypothermia and diabetic ketoacidosis.
Takotsubo cardiomyopathy is known to be triggered by some stress. We report the first case of Takotsubo cardiomyopathy induced by hypothermia and diabetic ketoacidosis (DKA). A 59-year-old woman was brought to our emergency department. ⋯ An ECG demonstrated a J wave (V(4-5)) and ST-segment elevation (V(3-5)), and an ultrasound cardiogram revealed contractile failure of the left ventricular wall at the apex with hypercontraction of the basal segment. Coronary artery disease was ruled out by coronary angiography, and the diagnosis of Takotsubo cardiomyopathy was confirmed. Physicians should keep in mind that Takotsubo cardiomyopathy can be induced by accidental hypothermia and DKA.