Case Presentation: 45 year old female with history of pulmonary embolism seven years ago not on anticoagulation presented with chest pain of 4 weeks. Chest pain was sharp, retrosternal, radiating to left upper extremity, neck & back. Chest pain was also positional, worse laying flat but improved on sitting up. It started 48-72 hours of […]

Case Presentation: An 80-year-old woman with a history of hypertension, pre-diabetes, chronic kidney disease (stage 3b), and remote ischemic stroke without residual deficits presented to the emergency department complaining of several hours of epigastric discomfort and malaise. An EKG revealed >1 mm ST segment elevation in leads V4-6 (Fig. 1). The troponin I was elevated […]

Case Presentation: A 32 year old South Asian man with a history of hyperlipidemia presented to the emergency department (ED) for severe, crushing, mid-sternal chest pain associated with nausea and diaphoresis that awoke him from sleep. In the ED, he was found to have a troponin elevation to 1.159 ng/ml (normal < 0.055 ng/ml) and […]