Case Presentation: A 40 year old woman (G4P4A0) with hypertension and hypothyroidism presented with sudden onset, severe, substernal chest pain while lifting heavy garbage bag. She was diagnosed with NSTEMI in the context of typical ischemic chest pain with trending troponins and EKG with T wave inversions in anterior leads. Transthoracic echocardiography revealed apical and [...]

Case Presentation: A 63-year-old woman with a history of Lynch Syndrome who presented with acute chest pain. Her Lynch Syndrome manifested with invasive moderately differentiated adenocarinoma of the sigmoid colon managed with hemicolectomy as well as 9 cycles of Leuocoverin, 5-Fluorouriacil (5-FU) and oxaliplatin (FOLFOX) and prophylactic total hysterectomy and bilateral salpingo-oophorectomy. She completed her [...]

Case Presentation: A 33-year-old woman with no cardiac risk factors, who was 8-weeks post-partum with an unremarkable peripartum course, suddenly collapsed at a park. Bystander CPR was initiated and the initial cardiac rhythm, which was ventricular fibrillation (VF), converted to sinus rhythm after defibrillation. While in the emergency department, she had another episode of VF, [...]

Case Presentation: A 22-year-old woman, gravida 1, para 1, with an unremarkable medical history, presented with sharp left-sided chest pain radiating to the left arm, two weeks postpartum. Initial evaluation revealed stable vital signs, T wave inversions on lateral leads in the EKG, and elevated troponin levels (23.271 and 23.173). Coronary catheterization exposed near 100% [...]

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 39-year-old woman presented with 15 minutes of sharp, substernal chest pain four days after an uncomplicated vaginal delivery. Blood pressure was 158/84 mmHg, and the rest of the vitals were within normal limits. Labs and physical exam did not meet diagnostic criteria for preeclampsia. EKG and serial troponins were normal. CT scan [...]

Case Presentation: A 56-year-old post-menopausal female with no prior medical history presented to the ED with two days of substernal chest pain radiating to the left shoulder, worsened 1-2 hours prior, and associated with fatigue. Two days earlier, she experienced significant emotional stress during a custody-related phone call, during which her husband observed her becoming [...]

Case Presentation: A 40-year-old woman with a history of asthma presented with progressive shortness of breath and acute onset chest pain. Following a severe asthma exacerbation, she reported increasing dyspnea on exertion that slowly worsened over the subsequent 2 weeks, which she attributed to her asthma. On the day of presentation, she reported mild, asthma [...]

Case Presentation: A 33-year-old male presented to the emergency department (ED) after abrupt onset left anterior chest pain with associated diaphoresis, nausea, and abdominal pain one hour prior to arrival. He denied aggravating or relieving factors. Vital signs were stable and physical exam, including cardiac and respiratory exam, were unremarkable. Patient denied a history of [...]

Case Presentation: A 48-year-old female with an unremarkable past medical history presented with intermittent, dull, substernal chest pain for several hours, associated with diaphoresis and bilateral arm paresthesia, worse with exertion. Patient’s symptoms improved with sublingual nitroglycerin in the Emergency Department. EKG showed subtle ST-segment elevations inferiorly. Troponin was initially negative at 0.01, trended to [...]