Oxford Medical Case Reports

https://academic.oup.com/omcr

List of Papers (Total 156)

Three vessel coronary artery-left ventricular multiple micro-fistulas: a rare angiographic finding

A 54-year-old woman presents with a long history exertional chest pain and was found to have left ventricular systolic dysfunction on trans-thoracic echocardiogram. Coronary angiography revealed no evidence of atherosclerotic coronary artery disease and showed multiple micro-fistulae draining from all three major coronary arteries to the left ventricle. This rare abnormality is...

Nonbacterial thrombotic endocarditis in a patient with primary antiphospholipid syndrome

Nonbacterial thrombotic endocarditis (NBTE) is described in patients with mucin-producing cancers and connective tissue disorders (usually SLE). We report NBTE in the setting of primary antiphospholipid antibody syndrome (APS). A 65-year-old female with APS was incidentally found to have thickened mitral leaflets on transthoracic echocardiogram with no signs of infection...

Craniopharyngeal canal, morning glory disc anomaly and hypopituitarism: what do they have in common?

A 14-year-old girl with a history of mid-line defects, basal encephalocele and morning glory disc anomaly presented with untreated growth hormone deficiency, pubertal delay and hypothyroidism. She was found to have a large craniopharyngeal canal based on MRI scan. Craniopharyngeal canal is an uncommon condition that has not been well described in the pediatric population...

Unilateral leg oedema due to spontaneous Achilles tendon rupture

This is a case of severe unilateral lower leg oedema in a 77-year-old man, due to a spontaneous, complete Achilles tendon rupture. What makes this case unusual is the absence of trauma in the patient’s history. The correct diagnosis was made only after magnetic resonance imaging. However, a thorough clinical re-examination of the patient revealed an inability to stand and walk on...

One down, one to go: coronary anomaly dual LAD blood supply with worsening chronic stable angina and 100% occluded left short LAD type IV variant

Although rare, usually asymptomatic, and without concurrent disease, dual left anterior descending arteries (LAD) poses great challenges. We describe a 55-year-old male with no history of coronary disease, who presented with worsening substernal chest pain with exertion, and was ruled out for myocardial infarction. On left heart catheterization and subsequent computed tomography...

Wernicke encephalopathy: (MRI) picture worth a thousand words

A 61-year-old gentleman, with a long-standing history of alcohol abuse presented with altered sensorium and unsteady gait for 2 weeks. A diagnosis of Wernicke encephalopathy (WE) was considered. The magnetic resonance imaging brain showed features consistent with the WE, thus supporting the diagnosis. He was treated with parenteral thiamine with good outcome.

A case of atenolol-induced sinus node dysfunction presenting as escape-capture bigeminy

Medications that are routinely used in clinical practice to treat hypertension such as beta blockers or non-dihydropyridine calcium channel blockers can depress sinus node function, resulting in symptoms and electrocardiographic changes consistent with sinus node dysfunction. In some patients, medications are potentially a reversible cause of apparent sinus node dysfunction. We...

Acute interstitial pneumonia as first presentation of anti-synthetase syndrome: an atypical case

Anti-synthetase syndrome is characterized by myositis associated with interstitial lung disease (ILD), the usual pattern of ILD being non-specific interstitial pneumonia type or usual interstitial pneumonia. We report a case of anti-synthetase syndrome presenting as acute interstitial pneumonia which is reported only once before. With this case, we emphasize the need to consider...

Life-threatening hemoptysis: case of Osler–Weber–Rendu Syndrome

Hereditary haemorrhagic telangiectasia (HHT), also known as Osler–Weber–Rendu syndrome, is a rare autosomal dominant vascular disorder. Patients with HHT may present with a wide spectrum of clinical manifestations, some considered to be life-threatening. We present the case of a 53-year-old male who presented with massive haemoptysis. Chest computed tomography scan was remarkable...

Refractory hyperparathyroidism with a T3 bony lesion—differential diagnoses

We report a case of severe hyperparathyroidism complicated by osteitis fibrosa cystica in an 83-year-old man post-myocardial infarction. The lesions were evident on magnetic resonance imaging only. A diagnosis of parathyroid carcinoma was considered due to clinical appearance of the parathyroid intraoperatively and the presence of an invasive T3 lesion mimicking metastatic...

Gastric schwannoma—a rare benign mimic of gastrointestinal stromal tumor

Schwannomas most commonly manifest as acoustic neuromas in the vestibulo-cochlear nerve (CN VIII). These may occur unilaterally as primary tumors, or bilaterally secondary to neurofibromatosis type 2. More rarely, they present in extra-cranial sites, including the gastrointestinal tract. Gastrointestinal schwannomas are believed to arise from Auerbach’s plexus in the muscularis...

Normal function of a 43-year-old Braunwald Cutter heart valve

We present the case of a 72-year-old woman diagnosed with rheumatic fever at the age of 6. In 1972, she was diagnosed with mitral valve insufficiency and mitral valve stenosis, then in 1974, a decision was made to perform mitral valve replacement surgery with a 32-mm Braunwald-Cutter ball cage prosthesis. An echocardiogram performed in 2014 revealed normal biventricular systolic...

Meckel Gruber syndrome associated with anencephaly—an unusual reported case

Meckel–Gruber syndrome (MGS) is a rare and lethal ciliopathic disorder, with the incidence ranging between 1 in 13 000–400 000 live births. MGS is characterized by multisystem developmental malformations with the classical features of renal cystic dysplasia, occipital encephalocele and post-axial polydactyly. Except for occipital encephalocele, the CNS abnormalities associated...

Mammalian meat allergy following a tick bite: a case report

The alpha-gal allergy is an emerging IgE-mediated reaction against the galactose-alpha-1,3-galactose carbohydrate found in mammalian meats. Patients with this condition will develop anaphylactic symptoms 3–6 h after the ingestion of mammalian meat food products such as beef, pork or lamb. The prevalence of this allergy is drastically increasing and severe reactions including...

Direct ICE imaging from inside the left atrial appendage during ablation of persistent atrial fibrillation

We present the case of a 59-year-old patient with persistent atrial fibrillation, referred for atrial fibrillation ablation. The procedure was performed with the help of NAVX 3D mapping system (Saint Jude Medical) and iLAB Ultra ICE Plus ultrasound imaging catheter (Boston Scientific). The catheter permits cross-sectional images perpendicular to catheter's long axis. From inside...