Case Presentation: A 57 year old man with a history of heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD) and hypertension presented with two weeks of exertional dyspnea and lower extremity edema, followed by 4-days of progressive tongue swelling. One-month prior, he was initiated on an ACE inhibitor (ACEi) and experienced tongue [...]

Case Presentation: A 82 year old Caucasian male with history of long standing well controlled diabetes mellitus type 2 since 2010, gastroparesis, and GERD presented to the ED with 2 episodes of “dark, tarry” stools for 1 day onset with resolution. On review of systems, the patient endorsed 32 pound weight loss over 6 months, [...]

Case Presentation: A 64 year-old woman with no significant past medical history presented with nausea, vomiting, 50 lb. weight loss and generalized weakness for the past 6 months. Her primary care physician had prescribed treatment for possible reflux; symptoms did not improve. Three months prior, the patient was admitted to a community hospital where CT [...]

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: 69-year-old-female with past medical history significant for Heart Failure with preserved ejection fraction (HFpEF), chronic lymphedema, and hypertension presented with 1 week of shortness of breath, melena and dysphagia. On admission, vital signs were notable for hypotension and physical examination revealed bibasilar rales and abdominal distension. Laboratory findings showed hyponatremia (129 mmol/L), elevated [...]

Case Presentation: A 70-year-old male presented with generalized fatigue and worsening shortness of breath with exertion. A diagnosis of acute exacerbation of heart failure was made. Initial evaluation with echocardiogram and MRI raised suspicion for amyloidosis. A PYP scan was performed, which was not suggestive for transthyretin amyloidosis (ATTR). Serum free light chain (sFLC) testing [...]

Case Presentation: An 81-year-old male with type 2 diabetes mellitus and emphysema visiting from Thailand presented to the Emergency Department for cough and shortness of breath over one week. Vitals included: 36.3C, 103/87 mmHg, 88 bpm. He was found to be hypoxic with an oxygen saturation of 69% on room air requiring non-invasive ventilation. Computed [...]

Case Presentation: A 53-year-old woman with a history of irritable bowel syndrome-diarrhea (IBS-D), chronic pain syndrome and years of nonspecific symptoms including chronic diarrhea and neuropathy, presented with bilateral lower extremity edema. Multiple outpatient visits and studies demonstrated nonspecific autoimmune condition with questionable monoclonal gammopathy of undetermined significance (MGUS) as well as a presumed diagnosis [...]