Background: The treatment of acute decompensated heart failure (ADHF) and comorbid acute kidney injury (AKI) can be quite challenging. Many times the etiology of AKI in this setting is multifactorial and may involve cardiorenal syndrome (CRS). Arterial underfilling, sympathetic nervous system upregulation, and systemic venous congestion contribute to impaired glomerular filtration rate in ADHF patients. [...]

Background: Hyperlipidemia is a recognized risk factor for incident acute myocardial infarction (AMI) and acute decompensated heart failure (ADHF), and no such documented association with pneumonia. However, the influence of hyperlipidemia on long-term mortality after AMI, HF, or pneumonia has not yet been fully understood. The objectives are to estimate the effect of hyperlipidemia and [...]

Background: Heart rate (HR) assessment is a vital component in the neonatal resuscitation (NR) algorithm. Research has consistently found auscultation to be an inaccurate means of assessing neonatal HR and may lead to incorrect resuscitation interventions. Current Neonatal Resuscitation Program (NRP) recommendations include auscultation for initial HR determination. Whether HR assessment via auscultation during NR [...]

Background: Heart failure is a deadly epidemic with over 37 million people affected worldwide with a multitude of physical, psychological and financial implications on patients and the healthcare system. The progression of heart failure can be prevented by appropriate and persistent medication therapy however previous research has estimated forty to sixty percent of patients with [...]

Background: Lung ultrasound (LUS) is emerging as a useful diagnostic tool for several lung pathologies. Some studies have found its accuracy in diagnosing pulmonary edema surpasses that of chest x-ray (CXR) but the available evidence is conflicting. CXR currently receives a Class I recommendation by the AHA in the evaluation of decompensated heart failure. Given [...]

Background: HEART and TIMI risk scores that include 12-lead electrocardiogram (ECG) changes and troponin I (cTnI) have been used to stratify patients presenting with chest pain that may indicate the presence of an acute coronary syndrome (ACS). It has been shown that the 12-lead electrocardiogram (ECG) can be derived (dECG) from 3 measured leads displayed [...]

Background: Heart failure (HF) is a major public health concern that affects over 5 million adults in the US. HF is among the most common reasons for hospital admissions and presents a considerable cost burden to the medical system. Patients are stabilized and carefully monitored at the hospital but often go home without adequate follow-up [...]

Case Presentation: A 23 month old female with minimal primary care visits presented to the ED after a syncopal episode. She was found to be tachycardic, tachypneic, and hypoxic. Physical exam revealed an irritable, pale child with a 3/6 systolic murmur and hepatomegaly. CBC was significant for a Hgb of 1.5. CXR revealed cardiomegaly. Due [...]

Case Presentation: A 30 year old well male presented with one day history of multiple episodes of loss of consciousness. Each episode lasted several minutes with no preceding warning. There was no limb jerking, tongue biting or confusion. One week prior, he was treated for shingles with oral acyclovir. His temperature was 37.9° Celcius. He [...]

Case Presentation: 72-year-old male with history of hypertension, Stage IIIB squamous cell cancer of the right lung status post chemo-radiation presented to the clinic for a routine annual physical. He was found to be bradycardic with heart rates in the 40s and was subsequently transferred to our hospital for further management.He was asymptomatic with a [...]