Case Presentation: A 58-year-old female presented to the emergency department with severe acute abdominal and bilateral flank pain. Medical comorbidities included hypertension and obesity.On arrival, she was hemodynamically stable and labs were notable for an elevated D-dimer. Due to concern for pulmonary embolism (PE), a heparin infusion was started. Soon afterwards, she developed acute hypotension. [...]

Case Presentation: We describe a 59-year-old male treated for a ruptured sinus of Valsalva aneurysm (SVA) causing multiorgan failure. The patient presented to the emergency department (ED) with acute chest pain, dyspnea, palpitations, nausea, weakness, and diaphoresis after lifting heavy boxes a day prior. The ED evaluation revealed sinus tachycardia, tachypnea, elevated troponin, acute kidney [...]

Case Presentation: A 69-year-old male with a complex medical history including coronary artery disease, abdominal aortic aneurysm, and polyarthralgia was hospitalized for treatment of lower extremity necrotizing fasciitis and refractory ulcers. During hospitalization, the patient developed intermittent melena. Upper endoscopy was unremarkable. Contrast-enhanced CT revealed biliary dilation with evidence of blood in the biliary system [...]

Case Presentation: A previously healthy53-year-old male, who had undergone dental treatment one week before, was transfered to our hospital with the symptoms of acute-onset cephalgia and right homonymous hemianopia. Upon physical examination, cardiac auscultation revealed a pan-systolic murmur (Levine 2/6), with maximal intensity at the apex. Laboratory analyses revealed leukocytosis with a white blood cell [...]

Case Presentation: A 91-year-old Japanese man was referred to our institution for the management of a ruptured thoracic aortic aneurysm. Two days prior, he had been admitted to another hospital with a one-week history of fever. Chest computed tomography (CT) revealed fluid accumulation around the descending aorta and a left pleural effusion, which was bloody, [...]