A patient fell into a coma after accidentally consuming Amanita muscaria, a mushroom with a distinctive red or orange cap and white plaques that is sometimes mistaken for edible species. Rapid identification of the mushroom allowed symptoms to regress, and the patient was discharged from the hospital on the fourth day after consumption. Amanita muscaria is highly poisonous, primarily affecting the central nervous system; severe poisoning can lead to coma and, rarely, death. Swift and correct identification is crucial for optimal risk assessment and therapy.
A 28-year-old woman with a 14-year history of twice-weekly ketamine use developed acute systolic heart failure with an ejection fraction (EF) of 15%, dilated left ventricle, and severe valve leakage. After treatment with diuretics, metoprolol, and sacubitril/valsartan, her EF improved to 25% at two weeks and to 54% with normal heart size at four months. The case suggests ketamine use disorder can cause severe, reversible heart failure through direct negative inotropic effects. Clinicians should screen for ketamine use in young adults with unexplained acute systolic heart failure.