Otorrhagia during cardiac surgery is rare. Otorrhagia combined with other signs of increased venous pressure in the upper body indicates the development of superior vena cava (SVC) syndrome. In this case, ear bleeding, facial engorgement, and conjunctival edema were noticed. The SVC cannula was displaced, leading to SVC syndrome. Repositioning of the cannula led to rapid recovery of the symptoms and an uneventful postoperative course. Providers should be vigilant about signs of SVC obstruction. Transparent coverings and surgical shelves should be used for constant examination of the head and neck to immediately detect changes.

Background: Severe anaphylactic reactions to midazolam and Clindamycin are exceedingly rare. Thorough surveillance, early recognition, and prompt intervention for these reactions are imperative due to the widespread use of both of these medications in the surgical setting. Case:We present the case of a 79-year-old male who was set to undergo an elective incisional hernia repair and received midazolam and clindamycin preoperatively, which was immediately followed by anaphylactic shock leading to cardiac arrest. His hospital stay was complicated by flash pulmonary edema and respiratory distress. On postoperative day eight, the patient's condition stabilized and was discharged. Conclusion:The widespread use of midazolam and clindamycin by anesthesia providers may make it appear that both agents are very safe for common use however, we highlight the rare but potentially disastrous adverse reactions that may occur from using these medications.Presented are the cardiovascular considerations of anaphylactic shock due to an unknown culprit and the appropriate interventions that took place to ensure the patient's survival.

We report a case of peripartum cardiomyopathy (PPCM) in an advanced maternal age (AMA), obese female with multiple risk factors. Early diagnosis and adequate treatment reduce significant patient mortality associated with this condition. In patients with multiple risk factors who present with symptoms of normal pregnancies, PPCM should be ruled out by echocardiogram and N-terminal pro b-type natriuretic peptide (NT-proBNP) quantification. Over a six-month period, the patient's left heart systolic function recovered slowly, although she was clinically asymptomatic. Because of her persistently low ejection fraction (EF) at the threemonth follow-up, we initiated the use of sacubitril/valsartan, which induced cardiac recovery within three weeks. While sacubitril/valsartan has been proven to improve outcomes in heart failure patients, its use should proceed with caution in peripartum patients.