Case Presentation: A 56 year old man presented to the emergency department with sudden onset of severe chest pain that radiated to his back. He had an initial HR of 72 and BP of 208/114. CT angiogram of the chest and abdomen revealed a large type B aortic dissection (AD). The patient was treated with [...]

Case Presentation: A 46 year-old man with a past medical history of untreated hypertension presented with right ptosis and miosis. The patient was in his usual state of health until one month prior to presentation, when he developed right retrobulbar pain in the absence of additional upper airway or constitutional symptoms. The patient subsequently noticed [...]

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 50-year-old man with a history of hypertension presented to the emergency department with a three-day history of nonstop hiccups. His systolic blood pressure was more than 200 and chest x-ray imaging was unremarkable. Over the next several days, his blood pressure remained elevated despite multiple medication additions, and he continued to complain [...]

Case Presentation: A 59-year-old woman presented with acute worsening of chronic abdominal pain and nausea. Her past medical history included a stable type-B aortic dissection. Over the previous year, she had multiple hospitalizations for postprandial abdominal pain associated with nausea and vomiting. The pain had been increasing in severity and had led to a 10-pound [...]

Case Presentation: A 32 year old female presented with 2 month history of acute onset pressure-like chest pain occurring after yelling at her children and radiating to the back. The symptoms recurred and become progressive while doing house chores. The pain was relieved by rest. Family history was positive for premature coronary artery disease, dyslipidemia [...]

Case Presentation: This is a 37-year-old Cambodian male with a past medical history of chronic untreated hypertension and recent methamphetamine use presents with acute onset “tearing” chest pain. Physical exam was remarkable for tachycardia and tachypnea with increased work of breathing. In addition, the patient appeared in severe distress. CT examination showed that he had [...]

Case Presentation: Spontaneous coronary artery disease (SCAD)—an uncommon cause of coronary syndrome and sudden cardiac death—has been studied and described in greater detail in recent years. However, it still represents a diagnostic challenge with a high degree of uncertainty for proper management.A 37-year-old Hispanic female presented to the emergency department at another facility for sudden [...]

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: Our patient is a 62-year-old Eastern European female with no significant past medical history who was brought to the emergency department after a sustaining a syncopal episode. At the time of exam, she was largely asymptomatic, and her review of systems was positive for a brief isolated episode of mild chest pain that [...]