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A 61-year-old man presenting with chest pain and the de Winter ECG pattern was found on emergency angiography to have proximal left circumflex artery occlusion rather than the classically associated LAD occlusion, representing only the second such case reported in the literature.

A single-institution case series of 13 biopsy-proven hydroxychloroquine cardiomyopathy patients documented variable outcomes after drug cessation, ranging from full functional recovery to progression requiring advanced heart failure therapies.

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This case highlights how Rapunzel syndrome may masquerade as a functional or sensory feeding disorder and emphasizes the value of magnetic resonance enterography as a radiation-free diagnostic modality in pediatric patients with unexplained weight loss.

Given that the patient lived 80 years with this congenital condition without right atrial or right ventricular enlargement or significant pulmonary hypertension, the decision was made to manage medically.

Progressive follicular miniaturization driven by DHT activity transforms terminal hairs into fine vellus hairs through shortened anagen phases, creating characteristic thinning patterns that respond to early intervention.