Background: Academic medical centers and other quaternary hospitals struggle with capacity challenges that manifest in longer ED wait times, delayed or cancelled elective surgical procedures, and delayed transfers from community hospitals[1]. The Hospital at Home model is an obvious and elegant solution to increase capacity[2], but its nationwide implementation has been limited due to lack [...]

Case Presentation: A 66-year-old Hispanic male with a history of primary hypertension and type 2 diabetes mellitus presents to hospital with 3 months of progressive fatigue, poor appetite, watery diarrhea, dizziness, and vomiting. Vital signs were notable for postural hypotension (BP 146/84 sitting, BP 118/72 standing). Physical examination was normal with no skin or mucous [...]

Case Presentation: A 38-year-old Caucasian male with no significant prior medical history presented with an acute CVA based on the presence of fatigue, blurry vision, ataxia, headache, and numbness. His MRI showed “multiple small foci of high DWI/ADC signal” in the bilateral cerebral and cerebellar hemispheres consistent with small acute infarcts. Unremarkable CTA brain/neck, ECHO, [...]

Case Presentation: An 89-year-old man with coronary artery disease, hypertension, and osteoarthritis presented with acute-onset severe posterior neck pain, with no viral prodrome. The patient reported experiencing generalized weakness and associated headache, but denied any fevers, chills, cough, myalgia, joint pain, ulcers or rashes. Additionally, he did not report any photophobia, phonophobia, changes in vision, [...]

Case Presentation: A 23-year-old man with cystic fibrosis presented to the Emergency Department with a two-day history of gradual, persistent, right sided abdominal pain associated with dark, tarry stools. He was afebrile with unremarkable vital signs. Exam was notable for generalized abdominal tenderness most noticeable in the right lower quadrant and a normal rectal exam. [...]

Case Presentation: A 27-year-old G6P4 female at 28 weeks of gestation presented with fever, headache, myalgias, nausea, vomiting, and diarrhea. Medical history was significant for polysubstance use, hepatitis C, anxiety, and depression. On the evening of presentation, she reported new-onset central chest pain. Vitals were significant for rectal temperature 93 F, blood pressure 95/58, and [...]

Case Presentation: A 54-year-old male with a history of obesity, asthma, alcohol use disorder, tobacco use disorder, and hepatic steatosis presented with anasarca. Transthoracic echocardiogram did not demonstrate evidence of heart failure, urinalysis revealed trace proteinuria, and liver ultrasound showed patent vasculature. Albumin was 2.5. The anasarca persisted despite diuresis. Over the next two months, [...]

Case Presentation: An 80-year-old man presented to the hospital with recurrent falls and generalized weakness over six months. Past medical history was notable for dementia, hypertension, and peripheral polyneuropathy. This was his fifth admission for weakness and falls with elevated CPK concerning for rhabdomyolysis, previously treated with intravenous fluids, physical and occupational therapy, and discharged [...]

Case Presentation: An 86-year-old man with a history of stroke on apixaban and metastatic renal cell carcinoma on ipilimumab/nivolumab presented to our emergency room with lightheadedness. Transthoracic echocardiogram (TTE) for stroke evaluation performed 3 years prior revealed a patent foramen ovale (PFO). Vital signs were significant for hypoxemia to 85% on room air requiring high-flow [...]

Case Presentation: A 62 year old male presented with severe recurrent pleural effusions. He has a history of End Stage Renal Disease (ESRD) on hemodialysis (HD), Coronary Artery Disease (CAD), Atrial Septal Defect (ASD) status post repair one month prior to presentation, pericarditis and recurrent pericardial effusion status post pericardial window, and diet-controlled diabetes mellitus [...]