Charles A. Horwitz

Epithelioid Hemangioendothelioma of the Thoracic Aorta Resulting in Aortic Obstruction and Congestive Heart Failure

A54-year-old white woman was referred for cardiac consultation because of increased dyspnea with exertion and leg pain. The patient’s past medical history was significant for smoking and recent onset of hypertension. On physical examination, she was found to have a blood pressure of 180/90 mm Hg and a heart rate of 110 bpm. The lungs were clear to auscultation. The carotid upstrokes were bounding, and there were bilateral carotid bruits. The central venous pressure was not elevated. The cardiac examination was significant for a loud, harsh systolic murmur (II to III/VI) across the precordium with radiation to the back. There was a left ventricular lift and a third heart sound. The abdominal examination was normal, and stool guaiac was negative. There was no peripheral …

Chapter 13 HHV-6-induced mononucleosis-like illnesses

Publisher Summary This chapter discusses infectious mononucleosis (IM) having characteristics of reactive blood smears, exudative tonsillar pharyngitis, prominent posterior cervical lymphadenopathy, and serologically detectable heterophil antibodies with IM-specific differential absorption traits. Mononucleosis-like illnesses because of HHV-6 can be grouped into four different categories such as patients with tonsillar pharyngitis and cervical lymphadenopathy, patients with short-lived nonspecific viral-type illnesses, patients with viral type illnesses and very abnormal hepatic function thought to have active viral hepatitis (AVH), and patients with occasional febrile illnesses superimposed on underlying or evolving immune deficiency states. HHV-6 infections are worldwide, and an HHV-6-induced IM-like illness refers to only cases where Epstein–Barr virus (EBV) and cytomegalovirus (CMV) infections were excluded by appropriate serologic studies.