Background: It has been routine practice to keep patients undergoing cardiac stress testing nil per os (NPO) until the results of the test were reported. The rationale is to enable left heart catheterization the same day if the stress test is positive, thereby reducing time to coronary intervention and length of stay (LOS). Often, NPO [...]

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial access and 2.8% of femoral access PCIs, respectively. While there is a standardized protocol for obtaining a blood type and [...]

Case Presentation: A 75-year old female with controlled Type 2 Diabetes Mellitus and Stage 3 Chronic Kidney Disease was admitted to our hospital for anginal symptoms secondary to hypertensive emergency and subsequently diagnosed with NSTEMI. Blood pressure was 206/90 on admission and labs significant for troponin of 0.043 ng/mL that downtrended afterwards. Her symptoms resolved [...]

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As an outpatient, right heart catheterization revealed a pulmonary arterial pressure (PAP) of 76/24 mmHg, mean PAP of 41 mmHg, wedge [...]

Case Presentation: A 36 years old female with past medical history of IV drug abuse, presented with dyspnea, nasal congestion, tactile disturbances, diarrhea, body aches and generalized weakness for 1 day. She was recently treated for tricuspid valve endocarditis. A Transthoracic Echocardiogram (TTE) obtained at that time showed ejection fraction (EF) of 55-60%. On presentation, [...]

Case Presentation: A 22-year-old African-American man with no medical history presented to the emergency department after an episode of sudden onset palpitations and left sided chest pressure lasting an hour. He endorsed radiation of his discomfort to his jaw and left arm as well as accompanying diaphoresis, shortness of breath and pre-syncope. Physical examination was [...]

Case Presentation: A 79 year old man with a history of prostate cancer s/p transurethral resection of the prostate complicated by urethral stricture, urinary retention, and incontinence, congenital unilateral kidney, recurrent deep vein thromboses (DVT) not on anticoagulation, and bilateral knee replacements presented with swelling and redness of his right leg following a 6-hour drive [...]

Case Presentation: 56-year-old female presented to ED with a two-week history of fever, chills, headache, intermittent nausea and vomiting, mild abdominal pain. Her comorbidities included Diabetes mellitus, Morbid obesity, and Hypertension. She had mild leukocytosis on complete blood count and had physical examination significant for bilateral rhonchi in chest auscultation. She was admitted under the [...]