Case Presentation: Heyde syndrome is a rare multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome (AVWS). The pathophysiology of AVWS in Heyde syndrome is thought to be due to the increased circulatory shear forces resulting from AS, leading to cleavage of large VWF multimers and loss [...]

Case Presentation: We present a 59-year-old male patient with a medical history significant for heart failure with a reduced ejection fraction who underwent aortic root replacement and transaortic valve replacement for severe aortic stenosis and an ascending aortic aneurysm. His postoperative course was complicated by cardiogenic shock requiring impella and inotropic support. He was transferred [...]

Case Presentation: A healthy 18-year-old male presented to the emergency department with headache, confusion, projectile vomiting, blurring of vision, and gait imbalance which he developed three days prior while working out at the gym doing “shoulder shrugs”. Imaging revealed a large evolving acute left cerebellar infarct with obstructive hydrocephalus and vertebral artery dissection at the [...]

Case Presentation: A 40-year-old male presented with acute-onset left back and flank pain radiating to the lower abdomen, along with nausea and vomiting. His initial presentation was most concerning for nephrolithiasis and CT Abdomen/Pelvis was obtained. Imaging demonstrated bulky retroperitoneal lymphadenopathy with a large paraaortic conglomerate, measuring up to 14cm in diameter. The mass was [...]

Case Presentation: Dolichoectasia is a rare disorder of the cerebral arteries known to causes tortuosity, elongation, and dilation of the affected vessel. Most commonly involved vessels are those of the vertebrobasilar circulation, with an elevated risk of ischemic infarct. Here we have a case of such a rare presentation of ischemic stroke in the setting [...]

Case Presentation: A 69-year-old woman with stage IV breast cancer presented with new onset abdominal pain, dyspnea on exertion, and fatigue causing her to present to our hospital. She denies chest pain currently but admits some in past 2 weeks. Denies palpitations, orthopnea, fevers, chills, recent illness, or exposures. CT abdomen showed an incompletely visualized [...]

Case Presentation: A 77 year-old male with a past medical history of Parkinson’s disease and hyperlipidemia presented to the emergency department with a two week history of constipation, abdominal pain and distension. His medications include carbidopa-levadopa, entacapone, ropinirole, selegiline and atorvastatin. He also reported taking daily milk of magnesia for the past two weeks. On [...]

Case Presentation: A female patient in her 70s, with a history notable for hypothyroidism who initially presented to an outside hospital with complaints of left-hand paresthesia, numbness, and dizziness. She underwent an extensive work up for CVA with no acute findings on non-contrast MRI brain or cervical spine. During her hospital course she developed worsening [...]

Case Presentation: 73 year old male veteran with hypertension and stroke presents with progressive anasarca and dyspnea. The patient’s blood albumin level was < 1 g/dL, and his urine protein to creatinine ratio was > 5.5 grams per day, leading to a diagnosis of nephrotic syndrome. Renal biopsy revealed Immunoglobulin Light-Chain (AL) Amyloidosis. He responded [...]

Case Presentation: A 46 year old man living in southwestern Maine with a history of hypertension, hyperlipidemia, and obesity presented in late September with 2 days of numbness in the right foot that progressed to bilateral lower extremity weakness, numbness, and difficulty ambulating. Patient denied any recent illnesses, vaccinations, travel or known bites the month [...]