Project description:A 43-year-old Caucasian man was admitted to hospital due to shortness of breath, right lumbar pain and lower left limb swelling. Arterial blood gas sample showed mild hypoxemia and respiratory alkalosis. CT scan confirmed pulmonary embolism, splenic and bilateral renal ischemic lesions. Echocardiography showed right ventricular and coronary sinus (CS) dilatation. Using contrast echocardiography, a superior sinus venous atrial septal defect and persistent left superior vena cava (PLSVC) draining in CS were suspected. Cardiac CT confirmed the diagnosis and showed overriding right superior vena cava (RSVC) draining in both atria. The patient underwent successful surgical correction.
Project description:IntroductionThe perception of negative health consequences is a common motive for quitting smoking, but specific information on the immediate health effects of occasional smoking among young adults is limited.MethodTo examine the relationship between cigarette use and symptoms of (a) cough or sore throat and (b) shortness of breath or fatigue after regular activities among young adults, we performed online health screening of a random sample of 25,000 college undergraduates. The screening survey assessed demographic characteristics, smoking and related health behaviors, and respiratory symptoms in the previous 30 days.ResultsThe response rate was 26% (6,492/25,000). Among individuals reporting no smoking in the prior 30 days and smoking on 1-4, 5-10, 11-20, or 21-30 days, the prevalence of one or more days of cough/sore throat increased from 62.5% to 68.3%, 72.0%, 71.4%, and 73.7%, respectively (p < .001). Similarly, the prevalence of shortness of breath/fatigue increased from 42.7% to 47.1%, 56.2%, 59.5%, and 64.6%, respectively (p < .001). After controlling for demographics, other important health behaviors (e.g., days consuming alcohol and getting adequate sleep), and environmental tobacco smoke (ETS) exposure, reporting symptoms of cough/sore throat was associated with smoking on at least 21 days, whereas shortness of breath/fatigue was associated with smoking on 5 or more days. Among those reporting symptoms, increased number of days with respiratory symptoms was associated with smoking on most days as well as ETS exposure.DiscussionIn conclusion, this cross-sectional study found that occasional smoking and ETS exposure were associated with an increase in the rate of respiratory symptoms (cough/sore throat and shortness of breath/fatigue) among young adults.
Project description:We present an interesting case of a 38-year-old woman who presented with a history of left-sided chest pain, dyspnoea and palpitations. The symptoms have been occurring since age 18, and were previously diagnosed as costochondritis. Because of the suspicious history, the patient underwent further cardiac investigations. The echocardiogram demonstrated an abnormal structure adjacent to the aortic valve. A diagnostic coronary angiogram revealed a large left circumflex artery fistulating into the right atrium. Surgery was performed to ligate the fistula. The patient recovered well and has been asymptomatic since.
Project description:A 71-year-old woman presented with dysphagia and acute shortness of breath. Surgical history included a prior thoracotomy overseas for a bronchogenic mesothelial cyst 19 years before. Computed tomography demonstrated a mass within the posterior mediastinum measuring 69 × 70 × 74 mm. A median sternotomy was performed, and after removal of the cyst, repair of the left atrium and pulmonary vessels was undertaken due to the invading nature of the cyst. Intrapericardial bronchogenic cysts are a rare form of congenital cysts arising from the primitive foregut. The cardiac primordia are in close proximity to the foregut and primitive tracheobronchial tree, and thus, abnormal budding of the tracheobronchial tree can arise in a myocardial location. Irrespective of the method of approach in redo surgery, complete resection must be performed in order to minimize the chance of recurrence, relieve symptoms, eliminate risk of infection, and prevent malignant degeneration.