Case Presentation: A previously healthy 4-year-old female born in Mexico was sent to the emergency department for elevated blood pressures noted at her routine outpatient clinic visit. On arrival, her blood pressure was 161/126. The patient reported polydipsia, polyuria, and weight loss. Her initial physical exam was unremarkable and her vitals were otherwise within normal [...]

Background: When left untreated tuberculosis has the potential to cause significant morbidity and mortality. In many instances adequate microbiologic therapy does not exclude chronic respiratory complications. Bronchostenosis is an under recognized complication with potentially far reaching complications. Methods: Patients with evidence of bronchial stenosis and lung volume loss who were previously treated with pulmonary tuberculosis [...]

Background: Clinicians encounter sudden death among aortic stenosis (AS) patients especially after they become symptomatic. Mortality is 50% at 1 year and 70 to 80% at 2 years without aortic valve replacement. However, there have been few studies that investigate the predictor for short-term sudden cardiac arrest in patients with severe AS. We investigated the [...]

Background: Severe aortic stenosis (SAS) had been identified as being at elevated risk for non-cardiac surgery. However, two reports demonstrated that SAS did not increase mortality of intermediate to high risk non-cardiac surgery. The European Society of Cardiology guideline states non-cardiac surgery of low to intermediate risk can be safely performed among patients with SAS. [...]

Background: Transcatheter aortic valve replacement (TAVR) is an increasingly common procedure. While it is currently recommended for patients with severe aortic stenosis with high or intermediate surgical risk, it is currently being studied in lower risk patients. If approved for expanded use, it stands to become even more commonplace in hospitals around the country. We [...]

Background: Severe aortic stenosis (SAS) had been identified as being at elevated risk for non-cardiac surgery. However, two reports demonstrated that SAS did not increase mortality of intermediate to high risk non-cardiac surgery. The European Society of Cardiology guideline states non-cardiac surgery of low to intermediate risk can be safely performed among patients with SAS. [...]

Case Presentation: A 57-year-old incarcerated male with end stage renal disease (ESRD) on hemodialysis, coronary artery disease (CAD), and Gastroesophageal reflux disease (GERD) presented to the emergency department with several episodes of hematemesis, shortness of breath and fatigue for the past 2 days without any associated abdominal pain, dysphagia, or odynophagia. On exam, he was [...]

Case Presentation: A 56-year old woman with history of ESRD on hemodialysis presented with loss of consciousness. She had an AV fistula placed in her left forearm 5 days prior to presentation. She started feeling discomfort and swelling of the left side of her neck during a transcontinental flight, associated with severe lightheadedness. She continued [...]

Case Presentation: A 25-year-old female presented with a 2-day history of right-sided abdominal pain, nausea and vomiting. She had multiple emergency department visits for lower back pain for the last 3 years. CT scan of abdomen showed right advanced chronic hydronephrosis secondary to ureteropelvic junction (UPJ) stenosis. Labs revealed normal renal functions. UPJ stenosis was [...]

Case Presentation: A 49-year-old woman of German ancestry without any prior medical history presented to the hospital with complaints of shortness of breath and right lower extremity for 2 weeks. Her examination was notable for tachycardia, notable loud systolic ejection murmur at cardiac apex. Labs revealed mild leukocytosis, elevated D-dimer, BNP, mild hepatocellular transaminitis and [...]