Author: Esteban Davila, MD and Dante Robinson, MD Editor: Esteban Davila, MD Case: A 77-year-old male with a history of hypertension and diabetes is brought into the ED by EMS after being found unresponsive. According to the patient’s daughter, the patient had been growing weak and complaining of pain on Read more…
Author: Esteban DavilaPeer Editor: Alec FeuerbachIllustrations: Vincent Xiao This is a continuation of Part 1.Key Initial StepsABCs and Supportive CareLike any other resuscitation, attention should be primarily towards assessing the ABCs. Patients with impaired awareness, airway secretions, aspiration, worsening respiratory distress, or status epilepticus may require intubation.[1] However, attempts to aggressively Read more…
Author: Esteban Davila Peer Editor: Alec Feuerbach The Case You’re having a relatively quiet morning when you hear EMS bringing in a patient. The patient is an 18-year-old male who collapsed on the route of a half marathon. You reflect that this day is particularly warm and humid. EMS reports Read more…
Co-authors: Taylor Murtaugh MD, Esteban Davila MD We’re back after a short hiatus for part 2. You can find part 1 here. The Case Continued History and Physical When suspecting hypertrophic cardiomyopathy (HCM), the history should focus on overall fitness as well as adverse responses to exertion such as chest pain, Read more…
Co-authors: Taylor Murtaugh MD, Esteban Davila MDThe CaseA 59-year-old male with a past medical history of hypertension, hyperlipidemia, and gastroesophageal reflux disease was brought in by EMS to the ED with severe chest pain. EMS administered 324 mg of aspirin. The patient endorsed left-sided chest pain while ambulating with associated Read more…
Co-Authors: Esteban Davila, Hemil Chauhan This is part 2 of a 2-part series focusing on BRASH. Part 1 can be found here. Patient Presentation A 70-year-old male with a past medical history of diabetes, hypertension, and chronic kidney disease (baseline creatinine 2-3 mg/dL) is brought in by EMS after being Read more…
Co-Authors: Camilo Galeano Londono, Esteban Davila This is part 1 of a 2-part series focusing on BRASH Syndrome The little black phone in the Cardiac Care Unit (CCU) room rings. The cardiology fellow is on the other end of the line informing you of a new admission. The patient is Read more…
Co-authors: Balal Aslam MD, Esteban Davila MD Edited by: Alec Feuerbach MD Case: An 82-year-old female with a past medical history of diabetes and hypertension presented to the ED after a syncopal episode. The patient stated that she was walking to the shower when she felt weak, had a “strange Read more…
Author: Jamie Pospishil, MDEditor: Philippe Ayres, MD; Esteban Davila, MDCase:A 68-year-old male with a past medical history of hypertension, insulin-dependent diabetes, and dyslipidemia presents to the ED with chest pain that is intermittent, sharp, “stabbing”, lasting up to one minute at a time, and occurring several times over the past Read more…
Authors: Esteban Davila, MD and Ian S. deSouza, MD Background Ketamine has many known cardiovascular properties both on the myocardium and the autonomic nervous system through central sympathetic stimulation and inhibition of catecholamine reuptake. The ketamine-induced hyperadrenergic state causes transient elevations in heart rate and blood pressure.[1] We present a Read more…