Let us set the scene: You have a patient complaining of shortness of breath. The patient gives a poor history, but your spidey sense tells you this is obstructive pulmonary disease vs. new-onset heart failure. His corpulent body habitus is limiting your ability to reliably hear heart or lung sounds. Read more…
Dr. Sinert graciously hosted Food & Journal this week at his outdoor courtyard in Brooklyn. Over barbecue and veggies, we spent the first half of the night discussing a new paper on syncope management and the second cheering Usain Bolt to a speedy Olympic victory with some choice cupcakes from a Read more…
You are sitting in the Critical Care area of your ED and the walk-in triage nurse approaches you with an ECG and a patient. She tells you he is a 60 year-old male with a PMH of cardiac stents presenting with 5 days of shortness of breath. At triage his Read more…
You have just come home from an exhausting 12- (really 13) hour shift and left with the final two perpetual decisions residents must face before sleep:
Both choices are easy. As the water begins to boil for your ramen, you turn on Arrested Development and are greeted with your favorite never-nude, analyst and therapist – Tobias Funke. His blue legs reminds you of a DVT you saw earlier this month that seemed especially concerning…
A young woman presents to your ED with shortness of breath and pleuritic chest pain. She states she got off a long plane flight from the Philippines. She is mildly tachycardic. OK, you think, let’s just whip out the ol’ Well’s criteria and get to work. You pull up her Read more…
Here’s the scene: A 60 year-old man with a recent NSTEMI is admitted for pneumonia. The nurse suddenly calls you to the bedside, because the patient is unresponsive. He has no pulse, so you start chest compressions. Initial rhythm is PEA so you give epinephrine and continue compressions as the Read more…
Diagnosis: PE Is he discharged yet? Written by Dr. Ferrari, Edited by Dr. deSouza Case: 44 year-old man with PMH of PE 5 years ago presents with shortness of breath and chest pain x 2 days. It started the day after returning from California by plane. It is worse with Read more…
By Dr. C. Sterling M.D. Pathophysiology of Right Ventricular Failure The most common cause of pulmonary hypertension in the U.S. is left-sided heart failure, but many cases of pulmonary hypertension remain undocumented. Pulmonary arterial hypertension is a specific category of pulmonary hypertension and is a relatively rare disease. In the ED, we Read more…
Guess what? It’s an election year! You are excited. And nervous. And kind of sick of the nonstop new coverage. In fact, you are having palpitations watching these candidates gore out each others’ figurative hearts and roast them over a public pit of shame, name-calling, and general stupidity. But still… Read more…
Post a comment or answer one of the questions below and not only help your peers, but get asynchronous credit! OK, here’s the case! 78 year-old woman with atrial fibrillation presents with chest pain; her HR is 145, ECG shows the rhythm is irregular. Her blood pressure is 90/50. Her baseline BP is Read more…