Background: Pulmonary embolism (PE) and atrial fibrillation (AF) may coexist. The association and impact of AF on PE have not been well studied. Methods: We queried the 2018 National Inpatient Sample (NIS) database to identify PE and AF hospitalizations using appropriate ICD-10 codes. PE with AF group was compared to PE without AF. Chi-square test [...]

Background: Approximately 10% adults with Sickle Cell disease (SCD) has Pulmonary hypertension (PHTN). There are several etiologies like hypoxia driven and microvascular obstruction contributing to PHTN. However, the in-hospital outcomes of PHTN on SCD has not been well studied. Methods: We queried 2018 National Inpatient Sample (NIS) database to identify SCD and different types of [...]

Background: D-dimer is one of the most commonly used tests because of its high sensitivity, but a high false positive rate prevents healthcare providers from efficiently diagnosing pulmonary embolism (PE). This leads to many patients unnecessarily undergoing CT pulmonary angiography (CTPA) scans in the emergency department (ED). This study sought to determine if there is [...]

Case Presentation: A 59-year-old female with a history of Asthma, COPD and tobacco use, unknown to have malignancy, presented to the emergency department complaining of dyspnea, cough and back pain. She had tachycardia, tachypnea and oxygen saturation was 91% on 2 liters oxygen. Physical exam was significant for bilateral wheezing.Initial workup showed a high white [...]

Case Presentation: A 47-year-old female with no significant medical history, however, a strong family history of venous thromboembolism presented to the hospital after a witnessed episode of syncope. On presentation she was hemodynamically stable, saturating well on room air and in no active distress. Initial workup revealed elevation of troponin, BNP, and d-dimer. Electrocardiogram showed [...]

Case Presentation: This patient was a 32 year old male with one week of fevers, coughing, and shortness of breath. On examination, the patient was tachycardic with an oxygen saturation of 85%. He had increased work of breathing with accessory muscle use, but no crackles or wheezing. Complete blood count showed leukocytosis. CT angiogram showed [...]

Case Presentation: A 48-year-old male with a history of hypertension and type 2 diabetes was sent to the emergency department for a “prostate x-ray” by his primary care physician due to elevated creatinine, hyponatremia, and two-day history of gross hematuria. The patient denied dysuria, fevers, chills, night sweats, and cough. He did note weight loss [...]

Case Presentation: A 22-year-old male with a history of substance abuse presented with a non-healing wound to the right lateral ankle. The wound began as a blister several months prior and had been worsening. Review of systems was negative for fever, chills, cough, fatigue, malaise.Physical examination was significant for a 5 cm annular hyperpigmented fungating [...]

Case Presentation: A 60-year-old man with no history of diabetes presented with right sided facial swelling and was found to have HbA1c of 14%. He was treated for sinusitis with augmentin and discharged with close follow-up for new-onset diabetes mellitus type 2. A few days later, he developed new left eye blindness necessitating readmission. On [...]

Case Presentation: A 48-year-old female with no known medical history presented after a syncopal episode and one week of malaise and fatigue. She was diagnosed with high output heart failure complicating severe pulmonary hypertension. Hemoglobin was 2.7 g/dL with MCV of 50 fL. She denied menorrhagia, melena, hematuria or hematemesis as well as weight loss [...]