Current Issue: Volume 20 - Number 5 - May 2012
Feature » Case Report
Breast Implant Herniation Mimicking Coronary Artery Disease in a Postmenopausal Woman
Since breast implants were first commercialized in the 1960s, breast reconstruction and cosmetic enhancement of the breasts with implants has become prevalent in American women. The overall risk of complications following breast implant surgery is high and increases in older age. However, there is a paucity of literature examining the impact of age-related changes on breast implants in older women. The authors report the first case of herniation of a left breast implant presenting with several misleading features of coronary artery disease (CAD) in a postmenopausal women. This report underscores the need to include late complications of breast implants in the differential diagnosis of any patient with breast implants who presents with chest pain or symptoms of CAD, but is not found to have a cardiac condition.
Feature » Special Article
Caring for Older Adults at 30,000 Feet
With older adults increasingly taking to the sky for longer flights, the likelihood is high that physicians will be asked to assist with inflight medical emergencies at some point during their careers. There is little education available, however, to prepare them for managing these emergencies onboard an aircraft. This article provides an overview of physicians’ responsibilities if called upon to assist during a medical emergency, outlines unique inflight environmental considerations, provides an overview of equipment contained in emergency medical kits, and notes various useful resources regarding emergency care at 30,000 feet. The author also makes recommendations on health concerns physicians should address with their older adult patients before they board an aircraft.
Feature » Case Report
Dissecting Thoracic Aortic Aneurysm With Left-Sided Hemothorax
Aortic aneurysm is defined as a swelling or bulging to more than 1.5 times the normal size in any section of the aorta. Dissecting thoracic aortic aneurysms are usually catastrophic events with acute symptoms, including severe chest pain; however, in older people the pain can be mild. The authors present the case of a dissecting aortic aneurysm in a 76-year-old man whose symptoms were atypical, resulting in a delayed diagnosis. The authors also review the anatomy and physiology of the aorta, discuss the risk factors for developing aortic aneurysm, and provide an overview of general management principles, including findings that should raise the clinical suspicion for this disorder, especially in older adults.
