‘Heart-stopping sex,’ plus other surprising case reports
Key Takeaways
Have you ever had a patient who went into cardiac arrest triggered by sex? What about a patient with "thunderclap headaches" caused by eating a super-hot chili pepper? Or a patient who could have died from watching TV for way too long? As uncommon as these cases are, they can—and do—happen. Take a look at these surprising and sometimes baffling cases, and hope that you never see them in your office.
Heart-stopping sex, literally
(Photo: Masterpiece PBS)
Cardiac arrest due to sex sounds like a scenario straight out of an episode of The Golden Girls or even Downton Abbey. Fortunately, the risk of sex as a trigger for sudden cardiac arrest is extremely low, according to researchers. They found that only about 1 in 100 men and 1 in 1,000 women experience sudden cardiac arrest during sexual activity. Interestingly, odds of receiving CPR and odds of surviving cardiac arrest were better in sex-related cases than in other cases of cardiac arrest. Find out more, such as how sex can reveal undiagnosed cardiac conditions, in this article.
Binge-watching TV can kill you
A 59-year-old woman with leg swelling presented to the emergency department (ED) after watching TV for 2 days straight. Her swollen leg and prolonged inertness raised the possibility of deep vein thrombosis (DVT) and pulmonary embolism (PE). "Taking her symptoms at face value, she definitely had the risk factors for DVT and PE," said the assistant director of the ED. "We've known about a Japanese study associating binge TV watching with DVT, but we were amazed to diagnose one in the flesh because it's rare to see it." Read more about this patient's case and how too much TV can be lethal.
Joni Mitchell's mysterious illness
(Photo: Pino D'Amico; CC BY 2.0)
Iconic folk singer Joni Mitchell revealed she feels as if she were being "eaten alive" by Morgellons disease. But what is Morgellons disease? It's described as a rare dermopathy with multicolored, fiber-like filaments occurring either under, in, or projecting from the skin. Other symptoms are sores and crawling sensations. But the condition is controversial—some skeptics think it may be the result of mental illness. Unfortunately for Mitchell, no Big Yellow Taxi will drive this disease away. Learn more about Joni Mitchell and Morgellons disease in this article.
Beware the 'Dragon's Breath'
(Photo: Stilfehler; CC-BY-SA-4.0)
A 13-year-old boy visiting an amusement park in Korea was rushed to the ED with complaints of severe abdominal pain and shortness of breath. He had just eaten a novelty treat—a cup of multicolored cereal puffs that emanated wisps of fog, created by a splash of liquid nitrogen. "Our 13-year-old patient was in critical condition and has been left with a 20-cm scar on his abdomen," wrote the case report authors. "As seen in this case, it can be hazardous to accidentally ingest liquid nitrogen." Despite such hazards, these dessert treats are still widely available and are sold without any official regulation. And this boy's case hasn't been the only one. Dig into this dessert debacle here.
Apartment-dwelling patient 'ticked off' by pigeons
Emergency medical personnel responded to a call of a 44-year-old man experiencing nocturnal anaphylaxis. The man was confused and exhibited diffuse erythema and wheals, along with angioedema of the lips and eyelids. First responders administered epinephrine and transferred him to the hospital, where he was treated and later described a history of "bug bites" on his hand. Physicians eventually deduced that the patient suffered an anaphylactic reaction to tick bites. The ticks came from pigeons living on the roof of the man's apartment building. Uncover more about this underdiagnosed condition, now spreading in cities across Europe and possibly the United States.
Hot peppers cause huge headaches
(Photo: Dale Thurber; CC BY-SA 3.0)
After gobbling down a "Carolina Reaper"—the world's hottest chili pepper—in an eating contest, a 34-year-old man experienced several brief but excruciating "thunderclap headaches" over the next few days. He presented to the ED with complaints of severe pain, and CT angiography revealed narrowing of four vessels that supply blood to the brain. A follow-up scan 5 weeks later showed his blood vessels had returned to normal. This isn't the first report of hot peppers causing this condition. In most cases, patients recover well—but it has caused deadly strokes in a few. Find out what spicy ingredient is at the root of this condition.
The case of the monstrous megacolon
(Photo: Mütter Museum, CC BY-NC-SA 3.0)
Beginning before he was 2 years old, the boy (identified only as J.W.) developed an enlarged abdomen, along with irregular bowel movements and constipation. The size of his abdomen increased, along with the severity of his constipation. By age 16, he could go for up to a month without any bowel movement. At age 20, J.W. was employed as a human exhibit—the "Balloon Man"—at a freak show. When he died in 1892 at age 29, an autopsy revealed that his colon was 8 feet long and contained 40 pounds of feces. Although his condition was a medical mystery at the time, it's now known to have been caused by congenital aganglionic megacolon, or Hirschsprung's disease. Today, the condition is usually identified and surgically treated in infancy. But the Balloon Man's legacy lives on—click here to discover how (and where).
Chernobyl linked to rare cases of eye cancer in New York City
In New York City, researchers found that a cluster of cases of vitreoretinal lymphoma (VRL)—a rare and unusual diagnosis—may be linked to the 1986 Chernobyl nuclear disaster. Over a 4-year period, 10 patients in New York City were diagnosed with ultra-rare VRL at four ophthalmology and oncology practices. Six of the 10 patients had one thing in common: they had all lived close to the Chernobyl nuclear power plant near Pripyat, Ukraine, in the Soviet Union at the time of the infamous radioactive accident in 1986. Seven of the 10 patients were also of Ashkenazi Jewish ancestry. Researchers suspect, but can't definitively confirm, that exposure to nuclear radiation may have caused VRL in these patients, perhaps in combination with genetic and environmental factors. Learn more about these patients and their connection to the Chernobyl nuclear disaster here.
The 'baffling problem' that led to a legendary career
(Photo: Wellcome Collection, CC BY 4.0)
In December 1901, a 16-year-old seamstress presented to Johns Hopkins Hospital, Baltimore, MD, with complaints of back pain, dizziness, and headache. Vision testing revealed a suspicious blurring of the nasal half of her visual fields. About 2 months later, her vision suddenly worsened, indicating an intracranial mass. Intrepid young surgeon Harvey Cushing, MD, who would later become known as the father of American neurosurgery, performed the first of three brain surgeries on what he described as his "most baffling problem." The first two procedures relieved the girl's hydrocephalus and resolved her optic disc edema. But her condition worsened, and a third exploratory surgery proved unsuccessful. She died 6 weeks later. Autopsy revealed a golf ball-sized tumor encroaching on the pituitary gland. Read more about this case and why it was the catalyst that led Dr. Cushing to a pursuit of knowledge about the pituitary gland.
A common case of chickenpox—or is it 'hot tub' rash?
Some children still present with chickenpox (varicella zoster virus) despite the development of a chickenpox vaccine. The most common symptom is an itchy rash that turns into small, fluid-filled blisters and then scabs. But there's another skin condition that has a similar appearance: hot tub rash (pictured here), which manifests as itchy spots on the skin that become a bumpy red rash with pus-filled blisters around hair follicles. The rash (also known as water slide rash and Pseudomonas folliculitis or dermatitis) is typically worse on skin covered by a swimsuit. It's a community-acquired skin infection resulting from prolonged exposure to water—in a hot tub, pool, or water slide—that's contaminated with Pseudomonas aeruginosa. The best way for kids (and adults) to avoid hot tub rash is to change out of swimsuits after getting out of the water and then shower with soap. Find out about other difficult-to-diagnose health hazards and their look-alikes.
Keep an eye out for more interesting and unusual case reports from MDLinx.