Variegate porphyria (VP) is an autosomal dominant disorder of porphyrin metabolism. We report a case of a 21-year-old male collegiate athlete who complained of recurrent headache and fatigue. Extensive testing after initial presentation failed to identify a cause. Months later, his grandmother was diagnosed with VP after being hospitalized; hence, he was tested. He was positive for a heterozygo...

Apical hypertrophic cardiomyopathy (ApHCM) is a rare variant of hypertrophic cardiomyopathy, characterized by a spade-like left ventricular cavity. A 58-year-old African-American female with past medical history of hypertension presented for evaluation of recurrent exertional chest tightness, palpitations and headache. Prior workup including multiple stress tests and angiogram was non-conclusiv...

The pathophysiology of primary benign exertional headache (EH) is not still clearly defined. Some researchers have suggested an impaired vascular response as the etiology of this disorder. In this study we investigated whether there are any differences in blood pressure (BP) and heart rate (HR) of the subjects in course of the static and dynamic exercises and the treadmill stress test between t...

The prevalence of headache decreases with older age (Table 12-1) (1). Although 90% of headaches in younger patients are of the primary type, only 66% of those in the elderly are primary (2). There are numerous causes of new-onset headaches in those over 50 years of age (Table 12-2) (3). Although new-onset tension-type headaches are fairly common, migraine and clustertype headaches uncommonly be...

Although most of the patients presenting with ischemic heart disease have chest pains, there are other rare presenting symptoms like cardiac cephalgia. In this report, we present a case of acute coronary syndrome with an only presentation of exertional headache. It was postulated as acute presentation of coronary artery disease, due to previous history of similar presentation associated with so...

Pulmonary and cardiocirculatoiy function were studied in 21 ambulatory patients with rheumatic heart disease. A pattern of pulmonary function was observed which deviated from normal to a degree insufficient to account for the exertional dyspnea of these patients. The pathogenesis of this symptom is, therefore, discussed in relation to the observed cardiocirculatory abnormalities which were ofte...

Tracheobronchopathia osteochondroplastica (TBO) is a rare disease of unknown etiology characterised by a formation of multiple, cartilaginous and osteocartilaginous submucosal nodules in the trachea and major bronchi. The course of the disease is usually benign but the narrowing of the respiratory tract can lead to chronic non-specific clinical symptoms. We present a case of a 50-year old man w...

There are infrequent instances when cardiac beats with the electrocardiographic characteristics of the pre-excitation type appear occasionally in an otherwise normal tracing (Sanghvi and Misra, 1958). A recent observation helped us to clarify the problem of diagnosis and interpretation, and we present the following case history because of its practical and theoretical interest. B. T., a 48-year...

Bronchoalveolar carcinoma presenting as non-resolving consolidation is an uncommon presentation. The typical presentation of bronchoalveolar carcinoma is asymptomatic (solitary nodule) and remains without symptoms even as disease disseminates. We report a case of bronchoalveolar carcinoma presenting as non-resolving consolidation in a young male with productive cough, exertional breathlessness ...

Can you diagnose this case of exertional breathlessness in a patient who underwent radical neck dissection? http://ow.ly/YvbN30dxyfs.