Marijuana-induced ST-elevation myocardial infarction in adolescents and young adults: A case report and comprehensive review of literature

As per the Centers for Disease Control and Prevention (CDC), the incidence of myocardial infarction (MI) is reported to be 805,000 cases annually in the United States (US). Although commonly occurring in elderly individuals with underlying cardiovascular comorbidities or younger generations with familial predispositions serving as risk factors, it is extremely rare for an isolated event to occur in teenagers with a history of marijuana use. In this article, we report a rare case of ST-elevation myocardial infarction (STEMI) in a 19-year-old male with no past medical history that was attributed to marijuana use. This case report and review of literature depict a potential association between marijuana use and STEMI. We also highlight potential clinical implications to aid healthcare professionals in making an early diagnosis and achieving a timely management strategy.

Acute Acalculous Cholecystitis Due to COVID-19, an Unusual Presentation

Although the Coronavirus Disease 2019 (COVID-19) infection mainly affects the lung, its gastrointestinal (GI) involvements are also well-known, especially hepatic involvement presenting as mild to moderate transaminitis. However, COVID-19 infection presenting with gall bladder involvement with acalculous cholecystitis is extremely rare in the medical literature. So far, only two cases have been reported, and herein, we are reporting the third case of a patient who developed COVID-19 presenting as an acute acalculous cholecystitis.

Severe Pulmonary Hypertension and Cholestatic Liver Injury: Two Rare Manifestations of Graves’ Disease

Graves’ disease is seen in the majority of patients diagnosed with hyperthyroidism. The usual symptoms of Graves’ disease are tremors, weight loss, sweating, exophthalmos, pretibial edema, anxiety, and palpitations. However, there could be unusual manifestations such as hepatic failure and pulmonary hypertension. We present the case of a 31-year-old female with Graves’ disease with these two rare complications, which resolved with medical management in about three months. To the author’s knowledge, this is the second case of a patient with this type of presentation.

A Sporadic Case of Disseminated Fusobacterium Causing Pylephlebitis and Intracranial and Hepatic Abscesses in a Healthy Young Patient

Fusobacterium species is known for being a causative agent for Lemierre’s syndrome, which is characterized by thrombophlebitis of the jugular vein. However, Fusobacterium species causing Lemierre’s variant gastrointestinal syndrome has only been reported in case reports. We present a case of Fusobacterium causing hepatic vein pylephlebitis, multiple brain abscesses, and hepatic abscess. To the best of our knowledge, there have only been four other case reports of Fusobacterium causing hepatic abscesses with associated septic pylephlebitis in the literature.

Diagnosis and Management of 1:1 Atrial Flutter in the Setting of Aortic Valve Endocarditis and Embolic Stroke

Atrial flutter is a rapid, regular atrial tachyarrhythmia that occurs most commonly in patients with underlying structural heart disease. Spontaneous 1:1 conduction of atrial flutter is indeed rare, but its diagnosis and management is of critical importance. We describe a case of a 65-year-old man with hypertension, preserved ejection fraction heart failure, end-stage renal disease, Parkinson’s disease, and Alzheimer’s dementia, in whom atrial flutter was associated with 1:1 atrioventricular conduction. Our patient was hemodynamically unstable with aortic valve endocarditis and recent septic embolic stroke. This case report emphasizes the importance of recognition and management to avoid hemodynamic compromise.