Background: ST-segment elevation myocardial infarctions (STEMI) is a significant cause of morbidity and mortality in the United States. Inter-hospital transfers (IHT) are becoming the standard for treatment of ST-elevation myocardial infarctions (STEMIs) as specialized care is often concentrated at tertiary centers. The American Heart Association and the American College of Cardiology (AHA/ACC) recommends door-to-balloon time […]

Background: ST elevation MI is an acute event that mandates immediate intervention. Often, resources play a major role to enable prompt intervention. Our study aims to elaborate any differences that may exist between weekend and weekday outcomes at a national level. Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (HCUP-NIS) database. Patients […]

Case Presentation: A 19 year old female with a history of systemic lupus was found at home unresponsive by family and brought to a local ED. At the ED she was hyperthermic to 106F and hypotensive then transferred to Vidant Medical Center fevers and septic shock. Of note she had recently been discharged from Duke […]

Case Presentation: A 62yo female with history of Combined Variable Immunodeficiency (CVID), Cirrhosis and Immune Mediated Colitis presented to the hospital with a 7-10 days history of confusion, ataxia, polyuria, and polydipsia. Her medications included Budesonide (9mg po once daily). Patient had no history of diabetes, and non-fasting blood glucose where in normal range 3 […]

Case Presentation: A 65 year-old man with a past medical history of CAD s/p CABG, ischemic cardiomyopathy with EF 35%, bicuspid aortic valve stenosis s/p aortic valve replacement, and asbestosis presented to the ER for evaluation of anterior neck swelling, dyspnea on exertion, dysphagia, and a 30 lb unintentional weight loss over 5 months. On […]

Case Presentation: A 35-year-old non-smoker male with a past medical history of hypertension presented to the hospital with worsening left-sided chest pain for 2 days. The chest pain was intermittent and associated with exertion. The patient denied any fever, cough or recent illnesses.On exam patient was slightly hypertensive with blood pressure 154/96, pulse rate of […]

Case Presentation: A 40-year-old G2P2 woman with a history of systemic lupus erythematosus (SLE) that has been serologically and clinically quiescent for 15 years, lupus nephritis at 25-years-old that was treated with cyclophosphamide, and HELLP syndrome during her first pregnancy, presented with fatigue and dyspnea one month after her second son was delivered via C-section. […]

Case Presentation: A 90-year female with a recent onset of vancomycin induced hypersensitivity reaction presents to the ED with sepsis and generalized disseminated rash. She recently underwent a surgery that was complicated with pseudomonas infection and was treated with vancomycin and Zosyn. However, she developed a pruritic, erythematous macular rash on her abdomen and vancomycin […]

Case Presentation: A 68-year-old Chinese man was admitted for giddiness, lethargy and lower limb oedema for 1 day. He had no significant past medical history. Clinical examination revealed that he was dehydrated and hypotensive, with a systolic blood pressure of 70 mmHg. Examination of his cardiovascular, respiratory and abdominal systems was unremarkable. Blood investigations were […]

Case Presentation: A 67 year old male with a past medical history of recurrent pericarditis, hypertension, psoriatic arthritis, and gout presented with diffuse chest pain. Patient stated that the pain was substernal, 10/10, sharp in nature, and non-radiating. Pain was aggravated by exertion and alleviated with rest, nitroglycerin and morphine. Pain was associated with shortness […]