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! align="center" style="background: #4479BA; color: #FFFFFF |Patient
! align="center" style="background: #4479BA; color: #FFFFFF |Disease name


! align="center" style="background: #4479BA; color: #FFFFFF |Symptoms
! align="center" style="background: #4479BA; color: #FFFFFF |Symptoms


! align="center" style="background: #4479BA; color: #FFFFFF |Past medical history and risk factors
! align="center" style="background: #4479BA; color: #FFFFFF |Laboratory findings


! align="center" style="background: #4479BA; color: #FFFFFF |Laboratory findings


! align="center" style="background: #4479BA; color: #FFFFFF |Treatment


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| 55 year old, male admitted due
| Alzheimer's disease
to
 
* Fever,
* Cough
* Shortness of breath with suspected [[COVID-19]].


| Developed [[chest pain]] 48 hrs after admission
| Chronic, gradually progressive neurodegenerative disease.


|[[Peripheral arterial disease|Peripheral artery disease]]
* Slow onset of dementia,
* No motor, sensory or deficits in co ordination early in the disease


|
|On CSF exam:
* [[The electrocardiogram|EKG]]: Inferior leads shows Inverted T waves.
*Elevated  [[Troponin I]]  from 355 ng/l --->70 ng/l 3 h later (Normal values <7 ng/l))


* [[Transthoracic echocardiography]]
* Elevated Tau protein
**Left ventricular [[ejection fraction]] :60%
**No abnormalities in wall motion.
**Absence of [[Diastole|diastolic]] dysfunction
**Presence of mild [[mitral regurgitation]]


* [[Coronary angiography|Coronary angiogram]] :
[[Neurofibrillary tangle|Neurofibrillary tangles]]
**Posterior descending artery is occluded with presence of  [[epicardial]] collateral from the left anterior descending artery.
**Intimal tear is present in mid-right coronary artery with a spontaneous dissecting coronary [[hematoma]]


* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):  Spontaneous dissecting coronary [[hematoma]] with presence of an intimal rupture of right coronary artery
[[Senile plaques|Senile (neuritic) plaques]]
 
|
*[[Aspirin]], [[Statins]], and [[Beta blockers|Beta-blockers]].
 
* Coronary angiogram was planned.


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|70-year-old, male
|Lewy Body Dementia
 
|Severe , persistent chest pain ( 8/10), which started 3 hrs before admission


|
|
* Smoking,
* Dementia  with cognitive impairment
* [[Hypertension]]
* Visual hallucinations
* Type 2 diabetes


* History of [[percutaneous coronary intervention]] (PCI) with implantation of a [[Drug eluting stent|drug-eluting stent]] (DES)
* Parkinsonism


|
|
* EKG: [[Precordium|precordial]] leads shows new ST-T abnormalities which was not present previously.


[[Image:70yr.png|thumb|700px|right|frame|ST-T abnormalities in the precordial leads.]]
|-
 
 
* [[Echocardiography|Echocardiogram]]:
**Left ventricular [[ejection fraction]] :  40–45%
**Old [[akinesia]] in the left circumflex artery territory
**Severe [[Hypokinesia|hypokinesis]] in the left anterior ascending (LAD)
* [[Coronary angiography|Coronary angiogram]]:
**Moderate in-stent restenosis present on left circumflex artery-OM
**Right coronary artery (RCA) is stenosed.


|Frontotemporal Dementia
|
|
|-
|Vasculitis
|
|
|-
|Hashi moto encephalopathy
|
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|-
|Electrolyte Imbalance
|
|
|-
|Vitamin B1 deficiency
|
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|-
|Wilson's disease
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|-
|Heavy metal intoxication
|
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|-
|Hepatic Encephalopathy
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|-
|HIV- related mental status change
|
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|-
|Lyme disease
|
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|-
|Syphilis
|
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|-
|CNS malignancy
|
|
|
*[[Heparin]], [[Nitroglycerin (Sublingual tablet)|Sublingual nitroglycerin]], and [[Clopidogrel]]
* Angiogram was performed
|-
|-
 
|Psychiatric conditions
|48‐year‐old, female
|
 
* History of severe chest pain that awoke her from sleep
|Severe retrosternal chest pain,9/10,pain radiates to neck and both arms.
 
|
|
* [[Migraine]]
|-
* [[Hyperlipidemia]]
|Paraneoplastic limbic encephalitis
 
|
|
* Elevated Troponin I from  <0.01 to  0.5 ng/ml (Normal: <0.80 ng/ml)
* [[Electrocardiogram]]: No  changes or signs of ischemia
* [[Echocardiogram|Transthoracic echocardiogram]] :
**Left ventricular [[ejection fraction]] 45–50%
**Akinesia in distal anteroseptal and apical segments
* [[Angiogram|Computed tomography coronary angiogram]]:mid‐to‐distal LAD dissected
|
|
* Aspirin, [[Nitroglycerin (Sublingual tablet)|Sublingual nitroglycerin]]
|}
|}
<references />
<references />

Latest revision as of 15:10, 31 July 2020

  • Here is a table presenting symptoms of the reported cases:
Disease name Symptoms Laboratory findings


Alzheimer's disease Chronic, gradually progressive neurodegenerative disease.
  • Slow onset of dementia,
  • No motor, sensory or deficits in co ordination early in the disease
 On CSF exam:
  • Elevated Tau protein

Neurofibrillary tangles

Senile (neuritic) plaques

Lewy Body Dementia
  • Dementia with cognitive impairment
  • Visual hallucinations
  • Parkinsonism
Frontotemporal Dementia
Vasculitis
Hashi moto encephalopathy
Electrolyte Imbalance
Vitamin B1 deficiency
Wilson's disease
Heavy metal intoxication
Hepatic Encephalopathy
HIV- related mental status change
Lyme disease
Syphilis
CNS malignancy
Psychiatric conditions
Paraneoplastic limbic encephalitis
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