Background: The Choosing Wisely campaign discourages CT imaging in low-risk patients with suspected pulmonary embolism (PE) (e.g., low clinical probability and negative d-dimer). Few studies have investigated patient, provider, or operational characteristics associated with overuse of CT imaging. One possible approach to this research question is to examine variability in diagnostic yield (i.e., the percentage […]

Background: Pulmonary embolism (PE), refers to obstruction of the pulmonary artery or one of its branches by material (thrombus, tumor, air or fat) that originated elsewhere in the body.Wells criteria must be part of the clinical assessment for PE. With these criteria, we can classify patients as high probability (>6 pts), moderate (2 to 6 […]

Background: Until the advent of novel oral anticoagulants (NOACs), Warfarin was the only oral agent available for the treatment of deep venous thrombosis (DVT) and Pulmonary embolism (PE). Bridging with parenteral anticoagulation until warfarin reaches a full therapeutic level often results in prolonged hospitalization. Rivaroxaban, Dabigatran, Apixaban, Edoxaban were approved by the FDA for DVT […]

Case Presentation: A 62-year-old male with past medical history of type 2 diabetes mellitus, coronary and peripheral arterial disease, heart failure with reduced ejection fraction, history of peripheral arterial embolism, history of stroke, vascular dementia and hypertension who presented with sudden onset of shortness of breath associated with cough and chest pain for one day. […]

Case Presentation: The patient was a 38 year old male with a 5 year history of ulcerative colitis (UC) who presented with a flare of symptoms during the past year, resulting in a 60 lb weight loss. He had been having up to 42 bloody bowel movements per day. The patient was found to have […]

Case Presentation: A 61-year-old female with a past medical history significant for hypertension well controlled on carvedilol and left elbow fracture status post fixation 2.5 weeks prior presented to the hospital secondary to lightheadedness. Patient had been experiencing waxing and waning lightheadedness for 3 days, worse when standing from the seated position and walking. She […]

Case Presentation: A 57-year old man was found down at home one day prior to admission. Three days prior, he experienced intermittent “stabbing” chest pain and dizziness. Past medical history was significant only for multiple sclerosis treated with Copaxone. On admission, he was afebrile, heart rate 113bpm, blood pressure 104/71 mmHg, respiratory rate 19 breaths […]

Case Presentation: A 72 year old woman with a history of recurrent, metastatic breast cancer complicated by pembrolizumab-related immune-mediated colitis presented to our hospital with sudden onset dizziness and shortness of breath. Four weeks prior to presentation, she suffered a colitis flare and was treated with a rapid 40 mg prednisone taper along with dapsone […]

Case Presentation: A 51-year-old female with pseudomyxoma peritonei was admitted to the hospital for surgical debulking. She was started on Lovenox post-operatively. A week later she became hypotensive with acute hypoxic respiratory failure. She was intubated and started on vasopressor therapy with an improvement in her hemodynamics. CT angiogram of the chest depicted a pulmonary […]

Case Presentation: A 58-year old female with history of breast cancer and uterine fibroid, presented to the ED with worsening right leg pain and swelling associated with red skin discoloration and blanching skin. There was no history of fever, dyspnea, coughs, chest pain, hemoptysis, diaphoresis, palpitations, oral contraceptives or tobacco use. She has family history […]