Background: Metabolic dysfunction-associated steatotic liver disease (MALSD) is a recent classification that better reflects the cardiometabolic factors contributing to the condition, while reducing stigma associated with previous terminology. Characterized by triglyceride accumulation, MALSD can progress to inflammation and fibrosis if untreated. Although the FIB-4 score is commonly used to assess liver fibrosis, its association with [...]

Background: According to the Global Burden of Disease (GBD) study, 523 million (95% UI: 497 to 550 million) people worldwide had cardiovascular diseases (CVDs) in 2019, resulting in a significant increase in DALYs and years of life lost, mostly due to ischemic heart disease. There are various accurate and economical gold standard tests to identify [...]

Background: Ultrasound guided peripheral IV (USGPIV) placement is a critical skill that currently requires placement by providers or critical care nurses at Yale-New Haven Hospital. In particular, our Liver and Kidney Transplant unit requires frequent support for IV access placement from our Hospitalist Procedure Team (HPT) and critical care nursing intervention (SWAT team). There are [...]

Case Presentation: A 36-year-old female with past medical history of endometrial polyp and lumbar degenerative disease presented with chest pressure, lower extremity swelling, and shortness of breath for four days. Physical examination revealed increased work of breathing, bilateral crackles, and trace lower extremity edema. Lab work showed elevated NT-Pro-BNP of 5930 pg/ml, mildly elevated creatinine, [...]

Case Presentation: A 36-year-old woman with a past medical history of postural tachycardia syndrome (PoTS), seizure disorder, left ICA aneurysm status post embolization, presented due to short 30-second episodes of syncope with concurrent hypotension and bradycardia for the past few years. The patient had multiple episodes of bradycardia and hypotension requiring pressors. The physical exam [...]

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: Lemierre’s disease is a rare and deadly infection caused by the Fusobacterium species which results in bacterial pharyngitis that spreads through pharynx soft tissues into the carotid arteries, resulting in widespread bacteremia and thrombosis. Outcomes are reliant on early diagnosis and initiation of treatment, with mortality rates as high as 20%. The rarity [...]

Case Presentation: The patient is a 52 year old male with a history of GERD on omeprazole therapy. In the period of one month, the patient developed significant exertional symptoms without any evidence of concomitant illness. The patient sought out further work up and evaluation by a cardiologist. Due to the presenting symptoms, an echocardiogram [...]

Case Presentation: An 81-year-old woman was referred with a 1-month history of subacute progressive bilateral leg edema and a 1-week history of pain and inflammation in both lower legs. She had no history of fever or weight loss. Physical examination revealed pitting bilateral edema with tenderness. No heart murmurs or jugular venous distention were noted. [...]

Case Presentation: A 72-year-old man with hypertension and tobacco use presented to the emergency room with three days of nausea, vomiting, substernal chest pain, and thoracic back pain, following weeks of worsening vertigo. He also described a year of progressive tinnitus, diplopia, unsteady gait, and restless legs. Vital signs were stable. Physical exam revealed bilateral [...]