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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




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| 55 years old, male admitted due
| Alzheimer's disease
to


* Fever,
| Chronic, gradually progressive neurodegenerative disease. <ref name="McKhannDrachman1984">{{cite journal|last1=McKhann|first1=G.|last2=Drachman|first2=D.|last3=Folstein|first3=M.|last4=Katzman|first4=R.|last5=Price|first5=D.|last6=Stadlan|first6=E. M.|title=Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease|journal=Neurology|volume=34|issue=7|year=1984|pages=939–939|issn=0028-3878|doi=10.1212/WNL.34.7.939}}</ref>
* Cough
* Shortness of breath with suspected [[COVID-19]].


| Developed [[chest pain]] 48 hrs after coming to the hospital
* Slow onset of dementia,
 
* No motor, sensory or deficits in co ordination early in the disease
|[[Peripheral arterial disease|Peripheral artery disease]]


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


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


* [[Coronary angiography|Coronary angiogram]] :
|Lew Body Dementia
**Posterior descending artery is occluded
**Presence of  [[epicardial]] collateral from the left anterior descending artery
**Intimal tear is present in the mid-right coronary artery with a spontaneous dissecting coronary [[hematoma]]


* Optical coherence tomography ([[Cardiac Optical Coherence Tomography (OCT)|OCT]]):
|
** Intimal rupture of right coronary artery
**Spontaneous dissecting coronary [[hematoma]]


|
|
*[[Aspirin]], [[Statins]], and [[Beta blockers|Beta-blockers]].


* Coronary angiogram was planned.
|-


|Frontotemporal Dementia<br />
|
|-
|Vasculitis
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|Hashi moto encephalopathy
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|-
|Electrolyte Imbalance
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|Vitamin B1 deficiency
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|-
|Wilson's disease
|
|-
|Heavy metal intoxication
|
|-
|-
 
|Hepatic Encephalopathy
|70-year-old, male
|
 
|-
|Severe, persistent chest pain ( 8/10), which started 3 hrs before admission
|HIV- related mental status change
 
|
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* Smoking
|-
* [[Hypertension]]
|Lyme disease
* Type 2 [[diabetes]]
 
* History of [[percutaneous coronary intervention]] (PCI) with implantation of a [[Drug eluting stent|drug-eluting stent]] (DES)
 
|
|
* EKG: [[Precordium|precordial]] leads shows new ST-T abnormalities that were not present previously.
|-
 
|Syphilis
[[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.
 
|
|
*[[Heparin]], [[Nitroglycerin (Sublingual tablet)|Sublingual nitroglycerin]], and [[Clopidogrel]]
*[[Angiogram]] was performed
|-
|-
 
|CNS malignancy
|48‐year‐old, female
 
* History of severe chest pain that awoke her from sleep
|Severe retrosternal chest pain,9/10, pain radiates to the neck, and both arms.
 
|
|
* [[Migraine]]
|-
* [[Hyperlipidemia]]
|Psychiatric conditions
 
|
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* Elevated Troponin I from  <0.01 to  0.5 ng/ml (Normal: <0.80 ng/ml)
|-
* [[Electrocardiogram]]: No  changes or signs of ischemia
|Paraneoplastic limbic encephalitis
* [[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 />

Revision as of 11:32, 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. [1]
  • Slow onset of dementia,
  • No motor, sensory or deficits in co ordination early in the disease
Lew Body Dementia
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
  1. ↑ McKhann, G.; Drachman, D.; Folstein, M.; Katzman, R.; Price, D.; Stadlan, E. M. (1984). "Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group* under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease". Neurology. 34 (7): 939–939. doi:10.1212/WNL.34.7.939. ISSN 0028-3878.
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