Hair thread tourniquet syndrome is a rare but previously well-documented presentation. It is described as
circumferential strangulation of distal or multiple distal appendages, which can lead to tissue ischaemia and
eventually necrosis without prompt treatment. Despite the characteristic presentation and potential for
serious complications, many healthcare professionals remain unaware of hair tourniquet syndrome and the
need for urgent management. We present the case of a 9-month-old infant who presented to the emergency
department. The parent noted a long hair emanating from the mouth but on attempts to remove it was unable
to do so. The child was otherwise stable. Examination on the oral cavity revealed the hair strand tightly
wrapped around an oedematous and congested uvula. Attempts to remove the ligature in the emergency
department were unsuccessful and a subsequent referral to otolaryngology was made. A decision was made
to take the child to the operating theatre, where the ligature was successfully removed with the distal uvula
remaining viable.
Conclusion Black HCM patients achieve a significantly lower% predicted peak power on CPET (24% lower) compared with white HCM patients. Black HCM patients also demonstrate a significantly lower% predicted peak VO 2 /kg (10% lower) compared to white HCM patients. Larger studies are required to corroborate these ethnic differences, however, this study suggests that the current standard cut-off of a peak VO 2 >120% predicted may be too high for a black athlete resulting in a false positive diagnosis of HCM.
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