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 [...]

Pneumopericardium is a medical condition in which air is present within the pericardial space.  This condition has been recognized most commonly in preterm neonates. In adults, pneumopericardium may occur spontaneously or in conjunction with hemopericardium or pericardial effusion. Also, it may follow penetrating wounds to the chest or upper abdomen, or wounds or fistulous communications [...]

Case Presentation: A 76-year-old male with past medical history of atrial fibrillation s/p ablation, recent pacemaker placement, heart failure with preserved ejection fraction (HFpEF), type 2 diabetes, leukemia, and colon cancer presented to the emergency department for weakness and dyspnea on exertion. Patient appeared volume overloaded with bilateral lower extremity edema with labs remarkable for [...]

Case Presentation: A 67-year-old female with hypertension, hyperlipidemia, diabetes, chronic kidney disease, sarcoidosis in remission, and rheumatic fever in childhood, presented to emergency department (ED) with right ear fullness and bloody discharge. During ED evaluation, she was found to have junctional rhythm at 50 beats per minute without evident P-wave, prompting admission for observation and [...]

Case Presentation: A 65-year-old female with a history significant for persistent atrial fibrillation, on apixaban, aortic and mitral bioprosthetic valve replacement, dual-chamber permanent pacemaker (PPM) implantation for heart block 2 weeks prior presented with worsening shortness of breath, dry cough, and generalized weakness for 4 days. Initially, she was found to be hemodynamically stable. Labs [...]

Case Presentation: Our patient is 78-year-old female with a history of mitral regurgitation, left ventricular outflow tract obstruction (LVOT) with systolic anterior motion (SAM) of mitral valve, migraines, and hypertension presented with lightheadedness. She had increased blood pressure at her recent office visit few weeks back necessitating an increase in dosage of verapamil. At presentation, [...]

Case Presentation: A 63-year-old female with paroxysmal atrial fibrillation managed with apixaban status post biventricular pacemaker implantation a year ago presented with persistent chest pain and worsening dyspnea over the past week, accompanied by bilateral lower extremity pain. She reported a persistent “poking” sensation in her chest, particularly with movement. Vitals were stable and afebrile. [...]

Case Presentation: 65-year-old female with past medical history of chronic myeloid leukemia (CML) and peripheral arterial disease (PAD) requiring drug eluting stent placement presented with symptoms of bradycardia and episodes of dizziness ongoing for 3 days. Of note, the patient was recently admitted in the hospital for pre-syncopal episode where cardiac workup was negative. Patient [...]

Case Presentation: A 77 year old man with a history of first degree heart block, hypertension, type II diabetes, and alpha thalassemia trait presented with one day of lightheadedness and palpitations. Several days of fatigue, myalgias, sore throat, rhinorrhea, and headache preceded his symptoms. His exam was notable for bradycardia but was otherwise normal. Labs [...]