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Case of Reversible Complete Heart Block

    A previously healthy Caucasian 22-year-old man presented to a southern Quebec community hospital with syncopal episodes for 1 week. He was found to be hypotensive and bradycardic (heart rate 36 beats per minute), owing to third-degree atrioventricular (AV) block, which did not respond to atropine. A perfusion of isoprenaline was started, and the […]

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Hemispheric Cerebral Edema

  A 67-year-old previously healthy man was admitted in November after a seizure. Examination showed normal vital signs, right hemiparesis and facial palsy, global aphasia, and right upper motor neuron signs but no meningeal irritation. Results from chest X-ray, electrocardiogram, and laboratory tests were normal. Neuromaging revealed left hemispheric cerebral edema without evidence of vascular […]

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surgical instruments laid out for use

The Complexities of Iron Deficiency in Patients After Bariatric Surgery

  To the Editor: Iron deficiency is one of the most common micronutrient deficiencies after bariatric surgery and is often overlooked by healthcare providers when patients present with vague symptoms or laboratory results do not demonstrate straightforward iron-deficiency anemia. Thus, it is imperative that providers order tests and interpret laboratory results carefully so they can […]

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Cough Syncope

Although cough is a common clinical symptom, the vasomotor effects on the heart and systemic circulation are often underappreciated. A healthy 42-year-old man without significant medical history presented with repetitive episodes of syncope during coughing. His examination, electrocardiogram, laboratory studies, and echocardiography results were normal, and carotid massage did not provoke any adverse response. During […]

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Immunotherapy in Squamous Cell Skin Carcinoma: A Game Changer?

  A 74-year-old white male was diagnosed with squamous cell carcinoma in 2013. Six months after Mohs surgery, he underwent a left superficial parotidectomy, left neck dissection, and excision of the left postauricular lymph node after confirmation of lymphatic spread. Pathology from the left parietal scalp lesion revealed multifocal invasive squamous cell carcinoma. Extranodal tumor […]

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