Background: Systemic Sclerosis (SSc) is an autoimmune condition characterized by widespread skin fibrosis and/or end-organ damage. Previous studies have reported variable outcomes of the disease process, with males and patients of certain ethnicities suffering from the severe form of the disease leading to end-organ damage and an increase in mortality (1,2). The aim of this [...]

Background: Postmyocardial Infarction Syndrome (PMIS), also called Dressler syndrome or Post-pericardiotomy Syndrome, refers to a heterogeneous group of autoimmune-mediated conditions of pericardial, epicardial and myocardial inflammation following myocardial infarction. Generally considered to be rare in the reperfusion era, the features and risk factors of PMIS are less well characterized in the contemporary era. This study [...]

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 [...]

Case Presentation: A 60-year-old man with type 2 diabetes presented with dyspnea and chest pain for 5 days during the COVID-19 pandemic. He arrived in acute hypoxic respiratory failure, with an oxygen saturation of 45% on room air. Physical exam revealed coarse lung sounds bilaterally and accessory muscle use. Initial labs were notable for leukocytosis [...]

Case Presentation: A 38-year-old male presented to the hospital with fatigue and progressive exertional dyspnea. He had a childhood history of Kawasaki disease (KD) with no treatment or subsequent follow up. Physical exam revealed marked volume overload, JVD, bibasilar crackles, and an S3 at the left ventricular apex.  EKG was unremarkable. Chest x-ray showed pulmonary [...]

Case Presentation: Pharyngeal pain is typically associated with upper respiratory tract pathology; rarely is it considered the initial presentation of acute coronary syndrome (ACS). Delayed diagnosis and treatment of ACS in such cases can lead to poor patient outcomes and increased mortality (1). A 76-year-old male with a medical history of benign prostate hyperplasia and [...]

Case Presentation: A 32 year old female presented with 2 month history of acute onset pressure-like chest pain occurring after yelling at her children and radiating to the back. The symptoms recurred and become progressive while doing house chores. The pain was relieved by rest. Family history was positive for premature coronary artery disease, dyslipidemia [...]

Case Presentation: A 70-year-old woman with a past medical history of CKD stage IV, nephrolithiasis, Crohn’s disease presented to the Emergency department for two weeks of nausea, anorexia, dehydration, fever, chills, lightheadedness with right upper quadrant pain. Upon admission the patient was in shock, differentials included septic vs cardiogenic. BNP was 354 pg/mL and troponin [...]

Case Presentation: A 54-year-old female with no significant past medical history presented with lip swelling and shortness of breath following shellfish ingestion. She denied chest pain. Due to concern for angioedema, she received intramuscular epinephrine, intravenous methylprednisolone, diphenhydramine and famotidine. A 12-lead electrocardiogram revealed 2 mm ST segment elevation in leads II, III and aVF [...]

Case Presentation: A 63-year-old female with a past medical history of hypertension, atrial fibrillation, type 2 diabetes, multiple strokes with residual left sided deficit, and chronic kidney disease, who presented with altered mental status (AMS) after losing consciousness for 20 minutes during which family noticed left sided facial droop and dysarthria. The patient denied chest [...]