Nicholas Suraci
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View article: Active Paradoxical and Pulmonary Emboli in a First Trimester Pregnancy
Active Paradoxical and Pulmonary Emboli in a First Trimester Pregnancy Open
Capturing a paradoxical embolism in real-time has been a challenge in recent literature. We present the unique case of a 33-year-old, G3P2 female at 8 weeks gestation presenting with dyspnea. An active thrombus through an undiagnosed paten…
View article: Left Ventricular Chordae Tendinae Myxoma Causing Stroke
Left Ventricular Chordae Tendinae Myxoma Causing Stroke Open
A 52-year-old woman presented with dysarthria and right-sided weakness in her upper and lower extremities prompting thrombolytic therapy with mild resolution of symptoms. Further work-up revealed (the source) a left ventricular myxoma on t…
View article: Thrombus in transit across a patent foramen ovale in a patient with cerebrovascular accidents, pulmonary embolism, and deep vein thrombosis
Thrombus in transit across a patent foramen ovale in a patient with cerebrovascular accidents, pulmonary embolism, and deep vein thrombosis Open
The diagnosis of paradoxical emboli remains elusive in many cases. The causal association between the thrombotic source, the intracardiac shunt, and the final emboli location is seldom demonstrated. We present the case of a 42-year-old wom…
View article: Biventricular Apical Thrombi in a Patient Presenting with New-Onset Dilated Cardiomyopathy
Biventricular Apical Thrombi in a Patient Presenting with New-Onset Dilated Cardiomyopathy Open
The diagnosis of an apical left ventricular thrombus in the setting of a dilated cardiomyopathy is not uncommon. However, biventricular apical thrombi in this setting is unusual. We present a case of a 67-year-old man who was admitted with…
View article: Parachute mitral valve
Parachute mitral valve Open
An asymptomatic 30-year-old male was referred for a transthoracic echocardiogram because of a systolic murmur that was noted on a pre-employment physical exam. Transthoracic imaging demonstrated a single papillary muscle from which the cho…
View article: Incidentally found guidewire during bacterial endocarditis workup
Incidentally found guidewire during bacterial endocarditis workup Open
A 67-year-old female with recent hospitalization for pneumonia was transferred to our facility for high fevers and positive blood cultures for staph aureus. During her treatment for pneumonia, central venous catheter was placed. A systolic…
View article: Left Ventricular Pacemaker Wire through Patent Foramen Ovale
Left Ventricular Pacemaker Wire through Patent Foramen Ovale Open
A 53-year-old male status post pacemaker placement three months prior for sinus bradycardia presented with worsening dyspnea, holosystolic murmur, and a ventricular-paced right bundle branch block on electrocardiogram. Transesophageal echo…
View article: Right ventricular outflow tract obstruction due to a leiomyosarcoma
Right ventricular outflow tract obstruction due to a leiomyosarcoma Open
A 65-year-old female presenting with worsening dyspnea and notable weight loss were found to have a systolic murmur on physical examination. On workup with computed tomography (CT) angiogram, a solid mass was found extending from the infer…
View article: Inferior vena cava filter removal – Hope for the best and prepare for the worst: An anesthesiology perspective
Inferior vena cava filter removal – Hope for the best and prepare for the worst: An anesthesiology perspective Open
A patient presented to our institution for an elective removal of an inferior vena cava (IVC) filter under local anesthesia. Once removed, it was noticed that the filter had a missing secondary leg. The patient had a chest CT done which sh…
View article: Persistent left superior vena cava identified by transesophageal echocardiography
Persistent left superior vena cava identified by transesophageal echocardiography Open
A 70-year-old female with severe aortic stenosis presented for aortic valve replacement and underwent routine preoperative Swan-Ganz catheter placement. Transesophageal echocardiography demonstrated a dilated coronary sinus with a catheter…
View article: Quadricuspid aortic valve associated with aortic insufficiency contributors
Quadricuspid aortic valve associated with aortic insufficiency contributors Open
A 51-year-old male presented with a wound in his right hand that was suspicious for possible septic emboli of cardiac origin. With transesophageal echocardiography, the patient was found to have a rare quadricuspid aortic valve. This quadr…
View article: The Cardiovascular effects of chocolate
The Cardiovascular effects of chocolate Open
The antioxidants as polyphenols, especially flavanols present in cocoa, exert a favorable effect on endothelium vasodilation, modulate inflammatory markers, and decrease platelet aggregation, lipid oxidation and insulin resistance. Recent …
View article: TAP Blocks: A Recent Review of Anesthetic Combinations
TAP Blocks: A Recent Review of Anesthetic Combinations Open
Multimodal analgesia is an approach to optimize pain relief by treating pain through several mechanisms along multiple sites of the nociceptive pathway. This approach not only improves pain, but also patient satisfaction. It also decreases…
View article: Bombay blood phenotype: Laboratory detection and transfusions recommendations
Bombay blood phenotype: Laboratory detection and transfusions recommendations Open
Four main blood types routinely identified today are A, B, AB, and O. Universal donors have type "O" blood, and have no "A" or "B" antigens. In turn, no blood reactions will occur in recipients. Conversely, universal recipients having type…