Calcific constrictive pericarditis is an uncommon, yet severe manifestation of chronic pericardial inflammation, leading to diastolic heart failure through lower myocardial compliance secondary to pericardial stiffening. Its etiologies are diverse, including infectious, iatrogenic and autoimmune causes, with tuberculosis remaining a primary offender in endemic regions. We present the case of a 67-year-old male with a history of chronic obstructive pulmonary disease (COPD) and permanent atrial fibrillation, admitted with decompensated global heart failure. Chest radiography revealed extensive, circumferential pericardial calcifications, resembling a plate armour, and a large, calcified saccular collection. Echocardiography confirmed features of constriction, including septal bounce and annulus reversus. Computed tomography further delineated the “armored heart” morphology and a large, compressive, calcified collection over the right ventricle. Diagnostic pericardiocentesis yielded a smooth, “café au lait” coloured fluid. While microbiological analysis for Mycobacterium tuberculosis was negative, the pericardial fluid Adenosine Deaminase (ADA) level was exceptionally high at 952 U/L. The diagnosis of tuberculous effusive-constrictive pericarditis in its late, burnt-out fibrocalcific stage was thus established. This case provides a striking visual correlation between classic clinical signs of constriction and their underlying anatomical pathology, underscoring the diagnostic utility of ADA in culturenegative cases.
Artificial Intelligence (AI) has become a transformative tool in the armamentum of respiratory medicine, offering applications in diagnostics, risk stratification, and clinical decision support. Leveraging machine learning (ML) and deep learning (DL), AI systems analyse large datasets— from imaging to electronic health records — to assist clinicians in managing respiratory conditions. In diseases such as COPD, interstitial lung disease (ILD), lung cancer, and obstructive sleep apnea (OSA), AI has achieved diagnostic accuracy comparable to human experts. ML models predict COPD exacerbations and OSA severity, while convolutional neural networks (CNNs) enhance lung nodule detection and ILD classification. Despite promising results, most systems lack prospective validation and regulatory approval. The use of AI also raises critical ethical issues, including bias and fairness, algorithmic transparency, patient autonomy, data privacy, and liability in decision-making. To ensure trustworthy integration of AI into respiratory care, future development must be patient-centered, ethically grounded, and supported by robust regulatory frameworks.
Introduction Angiogenesis and neuroplasticity are biologically based mechanism that mediate stroke recovery and are critical in restoring cerebral perfusion and restructuring neural pathways after injury. Current technology in neuroimaging, such as perfusion-weighted imaging (PWI), diffusion tensor imaging (DTI), functional MRI (fMRI), and transcranial Doppler (TCD), can be used to determine these restorative processes in vivo. However, it is not yet well understood to what degree traumatic brain injury (TBI) alters such regenerative pathways. Material and Methods A comprehensive literature search was conducted in PubMed, Scopus, and ScienceDirect, including both clinical and preclinical studies published between 1999 and 2024. Search terms included “stroke,” “neuroplasticity,” “angiogenesis,” “traumatic brain injury,” “MRI,” “DTI,” “fMRI,” “PWI,” and “cerebral perfusion.” The studies were given priorities based on the inclusion of neuroimaging information pertinent to cerebral repair mechanisms post-stroke. Results The reviewed literature suggests that imaging markers of cerebral perfusion, white matter integrity, and functional connectivity are reliable measures of angiogenic and neuroplastic recovery following stroke. Patients with a history of TBI are often characterized by delayed or modified recovery patterns, which can be probably explained by chronic vascular impairment and impaired plastic capacity. Neuroimaging integration in post-stroke evaluation procedures aims to early detect unfavorable cases and develop more personalized rehabilitation plans. Conclusions Neuroimaging is a powerful stroke recovery assessment modality. The need to identify risks with accuracy and provide a specific line of treatment amplifies its utility among patients with antecedent TBI. The entire dynamics between pre-existing brain injury and post-stroke repair mechanism is invaluable in promoting improved clinical outcomes.
Behçet disease represents an inflammatory condition capable of affecting blood vessels in both venous and arterial circulations, a clinical pattern like the one encountered in antiphospholipid syndrome, although disease mechanisms differ. This case report presents the occurrence of an acute episode of paraparesis due to aortic thrombosis in a patient with a known history of Behçet disease, treated by way of a thromboembolectomy. There were no systemic inflammatory syndrome or other suggestive symptoms for a relapse of the patient’s underlying condition. A hypercoagulable workup revealed the presence of several prothrombotic factors, including antithrombin III and protein S deficiencies, alongside the confirmation of a positive lupus anticoagulant. This case highlights the clinical challenge that the aortic thrombosis posed, which was finally attributed to the particular association of prothrombotic factors, in a patient with an apparently inactive Behçet disease and an antiphospholipid syndrome that had probably played the most significant role in the acute presentation.
All acute coronary syndrome patients should be included in a comprehensive cardiac rehabilitation programme, which should be initiated as soon as possible after the acute event. Exercise-based cardiac rehabilitation is recommended in all subjects with coronary artery disease to reduce cardiac mortality and rehospitalization rate. We report the case of a 50 year old male patient, a professional athlete, martial arts and box fighter, with a history of anterior myocardial infarction in 2023, diagnosed with two-vessel coronary artery disease, treated with primary percutaneous coronary angioplasty with drug-eluting stent at the level of the left anterior descending artery (LAD), complicated with heart failure with reduced ejection fraction, who was included in the cardiac rehabilitation program after the acute event, with a significant improvement noted in terms of left ventricular ejection fraction and controlled physical exercise, as shown through repeated cardiopulmonary exercise testing. Regarding the return to sport after an acute coronary event, careful individual evaluation is required before starting high-intensity competitive sports. Despite proven benefits, the rates of referral to, participation in, and implementation of cardiac rehabilitation programmes are low.
