Background: Coronary Computed Tomography Angiography (CCTA) is a common anatomic modality for detection of cardiac ischemia in the setting of chest pain hospitalizations. However, invasive coronary angiography (ICA) is the gold standard for diagnosing ischemic coronary artery disease. Research showed that CCTA has a high sensitivity but lacks the specificity and accuracy component of Fractional [...]

Case Presentation: An 85-year-old female with a medical history of hypertension, hyperlipidemia and tobacco abuse presented to the ED with a several day history of intermittent, non-radiating substernal chest pain that occurred at rest. Physical exam revealed normal vital signs, regular cardiac rhythm, no murmurs or gallops, clear lungs, and no jugular venous distention or [...]

Case Presentation: A 71-year-old man with a history of coronary artery disease (CAD) and percutaneous coronary intervention (PCI) presented to our hospital with unstable angina. He was urgently taken for coronary angiography (CAG) using a trans-radial approach, which revealed three-vessel CAD and severe in-stent restenosis of the left anterior descending artery. Balloon angioplasty was performed [...]

Case Presentation: We present the case of a 74-year-old female with a past medical history of colon cancer status post left hemicolectomy who presented with severe abdominal pain for the past six hours associated with non-bloody loose stools. She was tachycardic but hemodynamically stable. The abdomen was soft and non-tender with hypoactive bowel sounds. However, [...]

Case Presentation: We have a 63 year old female with a history of spontaneous coronary artery dissection (SCAD) of the left anterior descending artery (LAD) 2 years prior that was found on a left heart catheterization after she presented to the ER with a complaint of chest pain with associated dyspnea. On a physical exam, [...]

Case Presentation: A 62-year-old male with no significant medical history presented to our clinic after new diagnosis of atrial fibrillation. He had no associated symptoms and endorsed great exercise tolerance. Transthoracic echocardiogram (TTE) was ordered and he was started on metoprolol 25 milligram two times daily. TTE demonstrated normal global systolic function with severely dilated [...]