Background: Acute heart failure (AHF) is the major cause of hospital admission and death. Furthermore, patients admitted with AHF have high readmission rates and  postdischarge mortality. Although there have been some reports, which demonstrated the predictive factors of death among patients of acute heart failure in the USA and Europe, there has been no studies [...]

Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but deadly thrombotic microangiopathy (TMA) that is caused by ADAMTS13 deficiency. The PLASMIC clinical scoring system was developed and validated to determine the pretest probability of severe ADAMTS13 deficiency in cases of suspected TTP. We studied the role of the PLASMIC score in guiding use of the [...]

Case Presentation: A 62 year-old man presented to the emergency room with recurrent, colicky generalized abdominal pain. He had presented with similar abdominal pain in the preceding 6 weeks, requiring two hospital admissions. Admissions were accompanied by asymmetric lower limb swelling and pain on one admission, and swelling of lips on this admission. Six weeks [...]

Case Presentation: A 66-year-old female with newly diagnosed diabetes mellitus type 1 (DMT1) and hypertension was evaluated for severe hypokalemia on routine labs. Associated symptoms included generalized fatigue, muscle cramps, bilateral lower extremity edema. Physical exam was remarkable for moon face, bibasilar crackles, and lower extremity edema. Initial workup showed sodium of 151 mEq/L, potassium [...]

Case Presentation: 59-year-old male with history of hypertension, insulin dependent diabetes mellitus type two, alcohol abuse, and depression/anxiety presented to the Intensive Care Unit by emergency medical service after being found down by his neighbors with multiple empty alcohol bottles around him. Vital signs were significant for heart rate 115. Lab data included sodium 146, [...]

Case Presentation: A 26-year-old man with a past medical history of depression and chronic pain presented to the hospital with severe shortness of breath, chest pain, diffuse numbness, nausea, and vomiting. Questioning revealed the symptoms began after inhaling Dust Off for a cumulative 3 hour period. His vital signs showed BP 98/85 mmHg, HR 160 [...]

Case Presentation: A 67 year old female with no past medical history presented to our emergency department for new onset shortness of breath, chest pain, and palpitations for 90 minutes. Of note, she reported 8 pound weight gain, generalized fatigue, and abdominal distension for several months prior to presentation. Physical exam revealed a heart rate [...]

Case Presentation: A 67 year old Caucasian male with history of squamous cell carcinoma of the lower lobe of the left lung was admitted to the hospital after his pre-chemotherapy laboratory work at his oncologist showed elevated liver enzymes (AST 162, ALT 141), elevated CK (2856), CK-MB (104) and elevated troponin (0.83). The patient had [...]

Case Presentation: A 29-year-old woman with a past medical history of mild intermittent asthma treated with albuterol and morbid obesity status post gastric sleeve surgery presented to the emergency department with sharp epigastric pain of two days duration. The patient was initially seen at an urgent care center and empirically treated for gastritis with omeprazole, [...]

Case Presentation: A 39 year old woman with history of GERD presented to the ED for unretractable abdominal pain with nausea and vomiting despite chronic treatment with omeprazole. She also noted dyspnea on exertion, fatigue, and paler skin with a 80 pound weight loss over the past year. She described her vomitus as dark coffee [...]