Case Presentation: 43 year old male with history of HTN and HLD presented to the emergency room with abdominal pain, nausea, vomiting, and tongue numbness two hours after ingesting one centimeter of “Jamaican stone”. He reported more than ten episodes of non-bloody, non-bilious emesis. He denied chest pain, shortness of breath, headache, fevers or chills. Vital [...]

Case Presentation: 56-year-old Caucasian male with history of atrial flutter/fibrillation, heart failure with preserved ejection fraction, coronary artery disease status post coronary artery bypass graft surgery, mechanical aortic valve replacement presented to the emergency department with progressive generalized weakness, fatigue and shortness of breath for 5 days. He was on metoprolol and verapamil for rate [...]

Case Presentation: A 54-year-old man with congestive heart failure, chronic kidney disease and atrial fibrillation (on digoxin 0.125 mg daily for 3 years) presented to the emergency department with fatigue, weakness, vomiting, poor oral intake and whole body “involuntary sudden movements.” Neurological exam revealed generalized symmetrical choreiform movements more pronounced in the head, upper torso [...]