Mahmoud Abdelghany

Kounis syndrome: A review article on epidemiology, diagnostic findings, management and complications of allergic acute coronary syndrome

Kounis syndrome (KS) is a hypersensitivity coronary disorder induced by exposure to drugs, food, environmental and other triggers. Vasospastic allergic angina, allergic myocardial infarction (MI) and stent thrombosis with occluding thrombus infiltrated by eosinophils and/or mast cells constitute the three main variants of this syndrome. We reviewed 175 patients who fulfilled the definition of one of the three types of KS. The epidemiology, diagnostic findings, management and complications were reviewed in this article.

Klebsiella oxytoca Endocarditis With Complete Heart Block

Gram-negative bacterial endocarditis causes 5% of all bacterial endocarditis. Among gram-negative bacteria, Klebsiella species are rare causes of native valve endocarditis. Klebsiella oxytoca is an extremely rare subspecies that can infrequently cause endocarditis and is associated with poor outcome. We report a case of Klebsiella oxytoca endocarditis in an elderly man who initially presented with stroke but later developed sepsis and heart block secondary to endocarditis.

Fibromuscular Dysplasia Presented With Spontaneous Dissection of the Left Main Artery

A 31-year-old woman with a history of trisomy 10, subarachnoid hemorrhage, and previous myocardial infarction presented with asystolic cardiac arrest preceded by chest pain and shortness of breath. After return of spontaneous circulation, electrocardiogram showed ST-segment elevation in the

Left ventricular aneurysms in hypertrophic cardiomyopathy with midventricular obstruction: A systematic review of literature

Hypertrophic cardiomyopathy (HCM) with or without left ventricular apical aneurysm (LVA) had been studied in the past. Midventricular obstruction associated with HCM and LVA is a unique entity that has not been distinguished previously as a separate phenotypic disease in HCM patients.

Congenital inferior sinus venosus defect associated with pulmonary valve stenosis: A late presentation of a rare disease

Congenital inferior sinus venosus defect (SVD) is a rare congenital heart disease. Proper diagnosis of this disease is challenging and requires understanding of cardiac hemodynamics. Here, we discuss a patient with a late presentation of combined congenital inferior SVD associated with congenital pulmonary stenosis.

Stent Fracture and Hypersensitivity

Mori el al. [(1)][1] hypothesized that stent fracture accelerates release of metal ions leading to a focal hypersensitivity reaction and stent thrombosis. Although reasonable, we propose an opposite theory regarding the relationship between stent fracture and hypersensitivity. Kounis syndrome (KS)

Chest Pain in an 18-Year-Old Man

An 18-year-old man presented to our hospital reporting sudden onset right-sided chest pain followed by dyspnea and syncope. On arrival of the emergency medical services, the patient was awake and in respiratory distress. He was afebrile with a blood pressure 95/66 mm Hg, heart rate 121 beats/min, respiratory rate 38 breaths/min, and oxygen saturation of 88% improved to 98% on 4-L oxygen supply. Heart sounds were normal with no significant murmur. Pulses were intact bilaterally. Lung examination revealed rapid, shallow breathing with decreased air entry. ECG is shown in Figure 1. iSTAT Troponin-I was 0.39 ng/mL (normal <0.08 ng/mL). What is the most appropriate next step? Figure 1. ECG showing sinus tachycardia with ST-segment elevation in leads II, III, aVF and reciprocal ST-segment depression in I, aVL. 1. Emergent cardiac catheterization 2. Portable chest x-ray 3. Thrombolytic therapy 4. Contrast esophagogram Please turn the page to read the diagnosis. The correct answer …