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Sarate, N.
- Left Ventricular Endomyocardial Fibrosis with Underlying Connective Tissue Disease Presenting as Left Upper Limb Monoparesis (Embolic Stroke)
Authors
1 Department of Medicine, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-400022, IN
Source
The Indian Practitioner, Vol 68, No 10 (2015), Pagination: 40-44Abstract
Endomyocardial fibrosis is a restrictive cardiomyopathy of uncertain aetiology characterizsed by fibrin deposits over the endocardial surfaces of apices or inflow tract of either or both ventricles. We report here a case of thirty six years old female who presented to the emergency medical services with sudden onset left upper limb weakness. On enquiry she gave history of bilateral, symmetrical multiple joint pain (small and large) and hair loss since 8 years, loss of weight since 6 months, breathlessness on exertion and low grade fever since 1 month, non-exertional chest pain not associated with diaphoresis or palpitation since 15 days. There was no significant history of acute coronary syndrome in past.
On investigations, Chest X ray revealed cardiomegaly, 2 D Echo and Colour Doppler revealed layered homogenous mass attached to posterolateral left ventricle and extending to LV apex with anechoic region within, involving papillary muscle. There was associated restricted motion of left ventricular wall. Doppler showed mild MR. There was mild pericardial effusion.
Cardiac MRI revealed Lamellar thrombus along mid anteroseptal and posterolateral wall with no contrast enhancement and was isointense to myocardium on T1 and T2 w images hypointense to myocardium on BFFE images, subendocardial scarring of basal mid-anterior, antero-sepal and lateral wall of LV associated with hypokinesia on cine images.
In view of significant history of multiple (small and large) joint pain and hair loss her Anti-nuclear Antibody (ANA) test was done which was positive.
Endomyocardial biopsy revealed fibrin thrombus with entrapped neutrophils compatible with thrombotic stage of endomyocardial fibrosis.
Thus, we present a case of Endomyocardial Fibrosis (EMF) with connective tissue disorder.
Keywords
Endomyacardial Fibrosis, Connective Tissue Disorder, Embolic Stroke.
- Young Patient with Right Sided Pleuro-Pancreatic Fistula-An Unusual Presentation
Authors
1 Dept. of Medicine, Seth G S Medical College & KEM Hospital, Mumbai, IN
Source
The Indian Practitioner, Vol 70, No 8 (2017), Pagination: 28-30Abstract
Hydrothorax secondary to a pancreaticopleural fistula (PPF) is a rare complication of acute pancreatitis. In patients with a history of pancreatitis, diagnosis is made by detection of amylase in the pleural exudate. Imaging like CT&MRCP aids in the detection of pancreatic ductal disruption. Management includes thoracocentesis and pancreatic duct drainage or pancreatic resection procedures. We present a case of massive right hydrothorax secondary to a PPF due to recurrent acute pancreatitis. Patient was successfully managed by ERCP guided sphincterotomy with removal of stone followed by stenting of pancreatic duct.References
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- Septic Arthritis and Deep Vein Thrombosis
Authors
1 Dept of Medicine, Seth G S Medical College & KEM Hosptital, Parel, Mumbai-400012, IN
Source
The Indian Practitioner, Vol 70, No 9 (2017), Pagination: 46-47Abstract
Acute osteoarticular infections are common in children and rarely complicated with deep vein thrombosis (DVT). This complication can cause significant morbidity and may even be fatal. Herein we report a fourteen year boy presenting with left knee pain and fever since 1 week with acute onset shortness of breath on day of admission. A left lower extremity venous doppler showed deep vein thrombosis of left popliteal vein. MRI knee suggestive of osteomyelitis of left tibia. High-Resolution Computed Tomography showed multiple patchy areas of consolidation with cavitations suggestive of septic emboli. He required prolonged hospital admission and was managed with surgical debridement, antibiotics and anticoagulation.References
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