Case Presentation: 78 year old woman with persistent non valvular atrial fibrillation was admitted with palpitation and dyspnea. She was in atrial fibrillation with rapid ventricular rate. Given symptomatic atrial fibrillation after rate control, decision was made for transesophageal echocardiogram (TEE) and elective direct current cardioversion (DCCV). She was successfully converted to sinus rhythm with […]

Case Presentation: Patient presented to the ED in June 2019 with 6 month history of progressive proximal bilateral upper and lower extremity weakness, swallowing difficulty and 100 lbs. weight loss over 3 months. Exam was significant for decreased strength of bilateral hip flexors, knee flexors and knee extensors with intact reflexes. Labs were significant for […]

Case Presentation: As physicians, we frequently engage patients and families in goals of care discussions in the context of advanced serious illnesses. These discussions can be challenging for numerous reasons. We present an atypical case of a woman, who experienced acute onset of confusion, numbness, pre-syncope, chest pain, and abdominal pain, after initiating a discussion […]

Case Presentation: Patient is a 29 year old female with no significant past medical history who presented to our hospital with an unintentional 60 pound weight loss over 3 months and 4 days of palpitations, shortness of breath, leg swelling, and orthopnea. Physical exam revealed 4+ pitting edema, tachycardia (130 beats/minutes) and jugular venous distention […]

Case Presentation: Patient is a middle-aged African-American female with a history of hypertension and hyperlipidemia, for which she had been on atorvastatin for approximately four years. She originally presented to her primary care physician for evaluation of a one month history of progressive myalgias and proximal muscle weakness. Creatine phosphokinase (CPK) level was elevated to […]

Case Presentation: A 51-year-old Caucasian male presented for evaluation of worsening lower extremity muscle weakness and associated myalgias. He received a diagnosis of NAM after three months of progressive proximal, symmetric upper and lower extremity weakness with myalgias, and an initial creatinine kinase (CK) of 13,875 IU/L. He had been on Atorvastatin 40 mg for […]

Case Presentation: Vaping-induced organ injuries are increasingly seen in the clinical setting, as the use of vaporizers to smoke tobacco and marijuana has risen almost 150% in the past several years [1]. Cardiotoxicity from vaporizer use has not been reported, and thus the incidence of this phenomenon is unknown. Regular assessment of cardiac function may […]

Case Presentation: A 63-year-old female, otherwise healthy, initially presented to the hospital for acute onset of chest pain and weakness for several hours. She described it as the worst pain of her life, located in the midsternal chest, associated with shortness of breath and nausea. This pain and discomfort started during an interrogation from the […]

Case Presentation: A 27-year-old female with a history of PTSD, anxiety, and tobacco use initially presented to the emergency department with the worst headache of her life. Labs were significant for white blood cell count of 18.8 (normal 4.3 – 10.8 x 109 cells/L), troponin of 2.91 (

Case Presentation: 33-year-old male with metastatic germ cell testicular cancer to the lungs initially presented with worsening headaches. Imaging showed significant disease progression with new intracranial metastases in the right parietal and occipital lobes. He underwent autologous stem cell transplant complicated by pancytopenia. Three days later developed sudden onset typical chest pain at rest associated […]