Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis.

We present a rare case of a 49-year-old female with very severe hypertriglyceridemia (HTG) having a total triglyceride (TG) count of \u3e 10,000 mg/dL in the absence of pancreatitis. Based on literature review, this is one of the highest recorded TG counts in an adult without evidence of pancreatitis. HTG is a common occurrence in clinical practice, but rarely do numbers exceed 2000 mg/dl. It is crucial to evaluate and rapidly lower TG levels to prevent potentially life-threatening complications such as severe pancreatitis. Removal of potential predisposing medications, control of underlying diseases known to cause HTG, and maintenance therapies are essential to prevent reoccurrence

Anomalous Left Main Coronary Artery Arising from the Right Sinus of Valsalva in a Young Man Presenting with Recurrent Syncope and Myocardial Infarction

A 19-year-old man with the left main coronary artery (LMCA) arising from the right sinus of Valsalva presented with recurrent episodes of syncope and myocardial infarction (MI). Anomalous aortic origin of a coronary artery (AAOCA) is an uncommon but extremely important differential diagnosis that should not be missed in patients presenting with syncope, MI, ventricular arrhythmias, or cardiac arrest. A definitive diagnosis with coronary angiography and prompt surgical intervention is imperative in such symptomatic patients

Anomalous Left Main Coronary Artery Arising from the Right Sinus of Valsalva in a Young Man Presenting with Recurrent Syncope and Myocardial Infarction.

A 19-year-old man with the left main coronary artery (LMCA) arising from the right sinus of Valsalva presented with recurrent episodes of syncope and myocardial infarction (MI). Anomalous aortic origin of a coronary artery (AAOCA) is an uncommon but extremely important differential diagnosis that should not be missed in patients presenting with syncope, MI, ventricular arrhythmias, or cardiac arrest. A definitive diagnosis with coronary angiography and prompt surgical intervention is imperative in such symptomatic patients

Incidental descending thoracic aortic thrombus: the conundrum of medical versus surgical therapy

Background: A mural thrombus in the descending thoracic aorta frequently leads to distal organ and acute limb ischemia, increasing overall morbidity and mortality. Early diagnosis is imperative as thrombi are usually discovered after end organ damage has taken place. The formation of a mural thrombus in descending aorta has not been fully explained; however, the principle of Virchow’s triad for thrombogenesis (hypercoagulability, stasis of blood flow and endothelial injury) remains the likely pathophysiologic mechanism. Case Presentation: We present a case of a descending aortic thrombus incidentally detected on computed tomography scan in a 65-year-old female and successfully treated with anticoagulation, preventing subsequent complications. Conclusions: Suspicion for an aortic thrombus should arise when the origin is not known for acute onset distal limb or organ ischemia