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D L McCarty

Publications and source records attributed to D L McCarty.

4 recordsLinked to original sources

Peripartum cardiac failure in a woman with Graves' disease.

A case of peripartum cardiac failure is reported in a 20-year-old gravida 3, para 3 black female. The patient was 6 weeks postpartum. Graves' disease had been diagnosed in the first trimester of her pregnancy. The patient presented to the emergency department with complaints of fever, abdominal pain, shortness of breath, and chest pain. Physical examination revealed signs of congestive heart failure and anasarca. Chest x-ray revealed bilateral pleural effusions, and an abdominal series was consistent with ascites. Bedside electrocardiogram revealed pan-hypokinesis of all four cardiac chambers. The authors believe that this is the first case reported in the literature of peripartum cardiac failure occurring in a patient with Graves' disease.

Adult

The antiphospholipid antibody syndrome in the emergency department setting--livedo reticularis and recurrent venous thrombosis.

We present the case of a 26-year-old man with an exacerbation of apparent chronic asthma with chronic peripheral vascular disease due to recurrent venous thrombosis. Localized livedo reticularis, new cutaneous infarctions, severe venous insufficiency, thrombocytopenia, renal failure, and cerebral supratentorial dysfunction were noted. During hospital admission, antibodies to phospholipids in high titer were present by three different testing methods. Renal biopsy demonstrated significant renal vasculature abnormalities characteristic of hemolytic endovasculopathy, and magnetic resonance imaging showed multiple cerebral infarctions. This case exemplifies the spectrum of presentations and management of the primary antiphospholipid antibody syndrome. The clue to its presence in this patient was the livedo reticularis rash, a cutaneous marker for this syndrome that was evident in the emergency department.

Adult