Background: Over 5 million people in the United States are diagnosed with heart failure (HF) and many continue to be hospitalized for exacerbations of this disease. An estimated 20 million Americans have been diagnosed with some form of thyroid disease. Thyroid hormones significantly impact cardiac muscle functions and elevated levels of thyroxine (T4), as seen [...]

Background: Hyperthyroidism is a recognized risk factor for atrial fibrillation(AFib). Consequently, current recommendations include screening patients with new onset AFib for thyroid dysfunction by analyzing TSH, T3, and T4 levels. However, the yield of routine testing of patients hospitalized with Afib is less certain. In this study, we evaluated the testing and prevalence of thyroid [...]

Case Presentation: We report a 22 year-old male with no past medical history presented to the emergency department with acute onset of weakness, most pronounced in the lower extremities. The patient was last reported to be in his normal state of health the night prior to presentation in which he consumed approximately six beers. Upon [...]

Case Presentation: A 28 year old male presented to clinic with a painless, progressively enlarging mass in his right testis for 4-6 weeks.  On examination a large, firm, right scrotal swelling was present. Testicular ultrasound revealed a heterogeneous 6.2 x 4.1 x 6.5 cm solid mass in the right testes. Labs were notable for a [...]

Case Presentation: A 38-year-old man with untreated hyperthyroidism presented with two-week history of progressively worsening weakness and dyspnea along with a six-month history of unintentional 38 pound weight loss, diarrhea, and palpitations.  Exam was notable for confusion, cachexia, diffuse thyromegaly, jugular venous distension, exophthalmos, thyroid bruit, bilateral rales, and tachycardia (HR to 150s).  A transthoracic [...]

Case Presentation: A 47-year-old Hispanic female smoker presented with aone-week history of severe, intermittent substernal chest pain radiating tothe left arm. The pain was associated with palpitations and shortness ofbreath. She was afebrile with a heart rate of 100, a blood pressure of119/59, a fine tremor, and brisk reflexes. No lid lag or proptosis wasappreciated. [...]

Case Presentation: A 37-year-old male with anxiety presented to the ED in Maine after a week of warmth and irritability, followed by sudden onset nausea and vomiting, epigastric and chest pain with left shoulder radiation, and palpitations. He denied COVID exposures, loss of taste or smell, shortness of breath, dysphagia, changes in weight, or skin [...]

Case Presentation: An 18 year old Asian man presented with sudden paralysis after a fall from a lofted bed during sleep. On arrival he reported inability to move his arms or legs. He denied any neck or back pain and did not experience any bowel or bladder incontinence. He reported no alcohol or drug use. [...]

Case Presentation: A 39-year-old Hispanic male presented to his primary care physician with progressive fatigue, leg weakness, and occasional falls. His past medical history was unremarkable. A clinical diagnosis of disk herniation was made and treated conservatively.  Two weeks later, he presented to our emergency department (ED) with upper and lower extremity weakness, unable to [...]

Case Presentation: A 24-year-old Hispanic female with a past medical history of diabetes mellitus and hyperthyroidism presented with slurred speech for one day that was associated with left-sided upper and lower extremity weakness. She did not use tobacco, alcohol, or illicit drugs. She had sinus tachycardia at 170 beats per minute and was febrile with [...]