Background: Hypertension occurs in up to 75% of hospitalized patients. However, less than 1% have “hypertensive emergency,” defined as severely elevated blood pressure (BP) with end-organ injury. Current guidelines support emergent treatment of hypertensive emergency but recommend against immediate reduction of severely elevated BP in patients without end-organ injury (i.e., asymptomatic hypertension). Recent literature suggests […]

Case Presentation: 39-year-old African American male presented with dyspnea and hematuria for one week. His past medical history includes stage 3 CKD and hypertension. In the emergency room he was found to be severely hypertensive with systolic blood pressures hovering around 240 mmHg. Initial laboratory tests revealed significantly elevated creatinine level from baseline and new-onset […]

Case Presentation: A 64 year-old male with a history of childhood polio leading to severe kyphoscoliosis presented to our hospital with four months of progressively worsening shortness of breath and was found to be in acute hypoxic and hypercapneic respiratory failure requiring noninvasive positive pressure ventilation (NPPV). On exam, he was altered and not responding […]

Case Presentation: A 49-year-old man with known history of class III obesity (body mass index 43), hypertension, hyperlipidemia, and insulin dependent diabetes presented to the emergency department with bilateral lower extremity swelling and dyspnea on exertion of two weeks duration. Pertinent vitals included blood pressure 161/74 mmHg, heart rate 99 beats per minute, and saturation […]

Case Presentation: A 57-year-old male with history of non-alcoholic steatohepatitis (NASH) cirrhosis complicated by recurrent hepatic hydrothorax (requiring approximately 15 thoracenteses) presented with dyspnea. Admission chest x-ray and subsequent computed tomography (CT) scan revealed a large pleural effusion with collapse of the right lower lobe. He underwent thoracentesis with removal of two liters of pink, […]

Case Presentation: A 77-year-old woman with past medical history of renal cell carcinoma with known liver metastases, status post left nephrectomy who was on Tivozanib presented with acute onset speech disturbances, headache, nausea, and vomiting. Patient reported intermittent, milder headaches and confusion over the previous three weeks, coinciding with the start of Tivozanib chemotherapy. Vitals […]