Case Presentation: A 57-year-old male with previous hemorrhagic stroke complicated by residual left sided deficits with vascular dementia, primary hypertension on a regimen of carvedilol 25mg twice daily, and recurrent urinary tract infections due to obstructive calculi presented with acute-onset lethargy and encephalopathy. Presenting vitals were notable for hypotension (64/53), bradycardia (43 beats per minute), […]

Case Presentation: A 60-year-old male with chronic kidney disease 3a, hypertension (HTN) and type 2 diabetes was found unresponsive at work. The patient’s home medications were carvedilol, nifedipine, spironolactone and valsartan for his resistant HTN. Initial evaluation revealed undifferentiated shock with an inappropriately low heart rate of 40 beats per minute. Labs showed potassium of […]

Case Presentation: A 78-year-old man with atrial fibrillation on amiodarone and rivaroxaban, heart failure with reduced ejection fraction (HFrEF) on metoprolol and furosemide, hypertension on amlodipine and lisinopril, type 2 diabetes on metformin, and chronic kidney disease, presented with several weeks of progressive lethargy and confusion in the setting of chronic functional and cognitive decline.He […]

Case Presentation: A 91-year-old male with history of coronary artery disease & heart failure with reduced ejection fraction presented with unresponsiveness. The patient collapsed onto the floor when he came into the kitchen for dinner. His wife could not feel a pulse, so she called emergency medical services (EMS) and started CPR. When EMS arrived, […]