Blocking the Sympathetic Storm: Adjunctive Left Stellate Ganglion Block for Refractory Ventricular Tachycardia After Inferolateral Myocardial Infarction - Cureus

Selenium deficiency is a rare but reversible cause of cardiomyopathy increasingly recognized as a late nutritional complication of bariatric surgery, yet it is not consistently included in routine postoperative surveillance. This report describes a 40-year-old woman who presented three years after Roux-en-Y gastric bypass (RYGB) with progressive dyspnea, weakness, lower extremity edema, and dizziness in the setting of nonadherence to postoperative nutritional supplementation. She was hypotensive and bradycardic with jugular venous distension, elevated B-type natriuretic peptide (BNP), and chest imaging showing cardiomegaly with a right-sided pleural effusion. Echocardiography revealed severe, isolated right ventricular and atrial dilation with reduced right-sided systolic function, and further evaluation identified a markedly low serum selenium level (25 µg/L) with normal thyroid function and other trace elements. She was treated with intravenous selenium repletion (150 µg/day) alongside inotropic and diuretic support, with rapid hemodynamic improvement and complete resolution of right ventricular and atrial dilation on repeat echocardiography within one week. This case illustrates

Selenium deficiency is a rare but reversible cause of cardiomyopathy increasingly recognized as a late nutritional complication of bariatric surgery, yet it is not consistently included in routine postoperative surveillance. This report describes a 40-year-old woman who presented three years after Roux-en-Y gastric bypass (RYGB) with progressive dyspnea, weakness, lower extremity edema, and dizziness in the setting of nonadherence to postoperative nutritional supplementation. She was hypotensive and bradycardic with jugular venous distension, elevated B-type natriuretic peptide (BNP), and chest imaging showing cardiomegaly with a right-sided pleural effusion. Echocardiography revealed severe, isolated right ventricular and atrial dilation with reduced right-sided systolic function, and further evaluation identified a markedly low serum selenium level (25 µg/L) with normal thyroid function and other trace elements. She was treated with intravenous selenium repletion (150 µg/day) alongside inotropic and diuretic support, with rapid hemodynamic improvement and complete resolution of right ventricular and atrial dilation on repeat echocardiography within one week. This case illustrates

A brain abscess is a potentially life-threatening intracranial infection that usually requires individualized management. The possible source of infection may remain unclear when microbiological confirmation is unavailable. A 48-year-old man developed headache, fever, chills, and agitation approximately two weeks after self-extraction of a carious tooth. However, an odontogenic source was not microbiologically confirmed, and the temporal association alone did not establish causality. He also reported a history of swimming in a public pool, although the timing and characteristics of this exposure were unclear. After receiving empirical antimicrobial therapy at a local hospital without substantial improvement, he presented to Beijing Tiantan Hospital with a six-day history of fever and headache. Contrast-enhanced brain magnetic resonance imaging (MRI) showed a right frontal lesion radiologically consistent with a brain abscess and abnormalities of the left lateral ventricle and ependyma suggestive of ventriculitis, with possible intraventricular empyema. The suspected ventriculitis and intraventricular empyema were based on imaging findings and were not microbiologically confirmed. C

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Acute hemorrhage within the thyroid gland is uncommon but can cause rapid neck swelling and, in severe cases, airway compromise. We report a 65-year-old woman with hypertension and a history of partial thyroidectomy performed more than 25 years earlier who presented with painful neck swelling that developed overnight. The swelling was associated with pain on swallowing, without shortness of breath, voice change, drooling, fever, or recent neck trauma. She was hemodynamically stable with an oxygen saturation of 99% on room air. Examination showed marked neck swelling, thyromegaly, thyroid tenderness, and left-sided neck induration. Contrast-enhanced computed tomography (CT) demonstrated a multinodular thyroid with a large heterogeneous mass in the left thyroid lobe causing mass effect and rightward tracheal deviation. Subsequent ultrasonography demonstrated a heterogeneous intrathyroidal collection consistent with hematoma. The patient remained clinically stable and was discharged after approximately five hours of observation. At otolaryngology follow-up 10 days later, repeat ultrasonography showed a progressively enlarging left thyroid nodule, and fine-needle aspiration cytology wa