Background: New onset third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study was to analyze the clinical characteristics associated with ischemic versus non ischemic causes of complete [...]

Case Presentation: A 76-year-old male with metastatic renal cell carcinoma presented to the hospital due to multiple syncopal episodes. The patient was prescribed pembrolizumab by infusion every 3 weeks (last dose was a week and a half prior). His presenting vitals were significant for a heart rate of 30 beats per minute and systolic blood [...]

Case Presentation: A 45-year-old previously healthy male with a known history of polysubstance use (tobacco, ethanol, and cocaine) presented to the emergency department with sudden onset left-sided facial droop, hemiparesis, hemisensory loss, and dysarthria. The patient reported using cocaine twelve hours previously. On arrival, the EKG revealed complete atrial ventricular dissociation with a ventricular escape [...]

Case Presentation: A 29-year-old previously healthy male presented to an outside hospital emergency department with two days of flu-like symptoms including fever, chills, nausea, vomiting, abdominal pain, and recurrent episodes of syncope. On arrival, physical exam revealed a heart rate of 50 beats/minute and a blood pressure of 75/53 mmHg, elevated JVP, diminished right basilar [...]

Case Presentation: A 30 year old well male presented with one day history of multiple episodes of loss of consciousness. Each episode lasted several minutes with no preceding warning. There was no limb jerking, tongue biting or confusion. One week prior, he was treated for shingles with oral acyclovir. His temperature was 37.9° Celcius. He [...]

Case Presentation: We describe a patient with relapsing polychondritis (RPC) who developed a complete heart block, mitral valve insufficiency and aortic root dilation. A 72-year-old man with a history of RPC presented with fatigue, lightheadedness and syncope, which was secondary to the new onset complete heart block (CHB). Further investigation showed an elevated C-reactive protein [...]

Case Presentation: 72-year-old male with history of hypertension, Stage IIIB squamous cell cancer of the right lung status post chemo-radiation presented to the clinic for a routine annual physical. He was found to be bradycardic with heart rates in the 40s and was subsequently transferred to our hospital for further management.He was asymptomatic with a [...]

Case Presentation: An 82-year-old man with a history of hypertension and known aortic insufficiency presented with bilateral lower extremity rash, ankle edema, and bradycardia. The ankle edema began two weeks prior to presentation followed by an erythematous, pruritic rash on his anterior shins. He initially presented to urgent care and was found to have a [...]

Case Presentation: A 58-year-old male with medical history of resected melanoma presented to our hospital with fatigue and exertional dyspnea of 1-week duration. He was found to have complete heart block and a large pericardial effusion. A dual chamber pacemaker was implanted, and pericardial drain was placed. The pericardial fluid was negative for malignancy and [...]

Case Presentation: A 38-year-old male patient with a history of intravenous drug use was transferred from an outside hospital after initial presentation with persistent fevers, episodic flushing and swelling in right hand and forearm. Workup at the other hospital included blood cultures positive for unspeciated yeast, and a transthoracic echocardiogram with normal ejection fraction (65%) [...]