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Laubry-Pezzi syndrome (L-PS) is a rare congenital heart disease characterized by a ventricular septal defect (VSD) and aortic valve prolapse. These cardiac lesions predispose individuals to infective endocarditis (IE), a life-threatening complication, especially in resource-constrained settings. A 17-year-old male presented with a three-week history of fever and headache, and a one-week history of abdominal pain, vomiting, and diarrhea. On presentation, he appeared toxic, was febrile, tachypneic, tachycardic, and blood pressure of 120/30 mmHg, and heart sounds were S1, S2. Abdominal examination revealed generalized tenderness. A provisional diagnosis of typhoid sepsis with intestinal perforation was considered. However, a thorough clinical evaluation led to the definitive diagnosis of L-PS complicated by right-sided IE, sepsis, acute kidney injury, acute heart failure, and haemoptysis. Despite significant improvement with appropriate antibiotics and adjunctive therapy, the patient's inability to afford surgical correction and subsequent non-adherence to medical advice he resorted to traditional medicine this led to readmission for heart failure. This case highlights the diagnostic and treatment challenges associated with L-PS with life-threatening complications, particularly in resource-constrained settings, where it may be misdiagnosed as common infections like typhoid sepsis with intestinal perforation. It emphasizes the importance of a comprehensive clinical approach, including a detailed history, meticulous physical examination, and targeted investigations, to ensure accurate diagnosis and timely intervention in patients with L-PS and its life-threatening complications. [ABSTRACT FROM AUTHOR]

Background: Focal seizure with impaired awareness, post-seizure Todd's phenomenon, and post-stroke recrudescence can all present with focal neurological deficits, mimicking stroke. As acute ischemic stroke mimics, they are distractors in the emergency setting where management is time-sensitive both for seizure and stroke. Nevertheless, a timely diagnosis can be made with exploration of the clinical features supported by investigation such as computerized tomographic perfusion. Case Report: Our patient was a 65-year-old woman who was known hypertensive, with type 2 diabetes mellitus, and previous intracerebral hemorrhage with minimal right-sided residual deficits, but still able to ambulate independently. She was brought to the Emergency Department because 1 hour prior to presentation, she had sudden worsening of weakness of the right limbs, aphasia, aggression, and confusion. An initial impression of repeat acute stroke, focal seizure with impaired awareness, Todd's phenomenon, and post-stroke recrudescence was considered. While CT angiography was suggestive of left middle cerebral artery occlusion, CT perfusion revealed extensive hypoperfusion patterns beyond the region of the occlusion, thus suggesting a different etiology from acute ischemic stroke. In view of her previous left hemispheric lesion coupled with the presentation, our working diagnosis was seizure with Todd's phenomenon, and she was started on an anti-epileptic drug. Her condition returned to baseline within 24 h of admission and was subsequently discharged. Conclusions: Our case demonstrates that adequate elucidation of clinical features in conjunction with CT perfusion, as a dual-purpose tool, can aid the diagnosis of both stroke mimics and acute ischemic stroke in the Emergency Department where rapid treatment is essential. [ABSTRACT FROM AUTHOR]

A 57‐year‐old man, with type 2 diabetes mellitus, was admitted with a hyperosmolar hyperglycemic state, who developed in‐hospital venous thromboembolism with huge free‐floating right heart thrombus, and there is no available optimal treatment option for the huge free‐floating right heart thrombus, except anticoagulation with warfarin and low molecular weight heparin with successful outcome. [ABSTRACT FROM AUTHOR]

Objective: Rare co-existance of disease or pathology Background: Ebstein's anomaly (EA) is a rare congenital cardiac abnormality with diverse anatomic and spectra of clinical presentations. This heart anomaly occurs in approximately 1 per 200 000 live births and accounts for <1% of congenital cardiac diseases. The main pathologic finding is "atrialization" of the basal region of the right ventricle. EA has been described extensively in the literature; however, to the best of our knowledge, this is the first reported case of EA presenting with "egg-on-stick" appearance. Case Report: A 42-year-old woman presented on account of 2 years of progressive abdominal swelling, early satiety, and progressive weight loss. There was an associated history of dyspnea on exertion, easy fatigability, paroxysmal nocturnal dyspnea, and orthopnea. General examination revealed egg-on-stick appearance: visible distended abdominal wall veins and massive ascites with no pedal edema. Overall, pertinent cardiovascular examination findings and echocardiographic features are in keeping with EA. Conclusions: We present the likely first case of egg-on-stick appearance as part of the presentation of EA, which posed a diagnostic dilemma. Echocardiography can help in unraveling this dilemma. [ABSTRACT FROM AUTHOR]