A 68-year-old male presents to the emergency department (ED) with one week of worsening shortness of breath. He has no known cardiac history and has rarely seen a physician. He reports shortness of breath with exertion, mild non-productive cough, and subjective fever. He is not having chest pain. He is a long-time smoker but denies other drugs. Vitals are as follows: heart rate (HR) of 102, blood pressure (BP) of 105/70, afebrile, 89% on room air (RA), respiratory rate of 20. On exam the patient exhibits labored breathing, crackles in bilateral lower lung fields and +1 pitting edema in bilateral lower extremities…

Cardiology, Community EM, Medical Education, UltrasoundConnor WilsonJuly 22, 2022EPSS, Ultrasound, Cardiology, Emergency Medicine, EM, Cards, ECHO, LVEFComment

Island Med: Challenges of Remote Healthcare

A 60-year-old man with a history of hypertension and smoking presents to the medical center with chest pain. Over the weekend, he developed chest pain while cleaning out his gutters that resolved with rest. This morning, he was working at his computer when he developed chest pain radiating to his left arm. It has since resolved, but he presents to the clinic for evaluation. An EKG obtained on arrival is unremarkable, but he soon develops chest pain again…

Cardiology, Community EM, Health Equity, Global EMChristina MatulisMay 20, 2022Island Med, Community EMComment

Using POCUS for Ejection Fraction Estimation

…The differential diagnosis included acute coronary syndrome, CHF exacerbation, pneumonia, and cardiac amyloidosis.

EKG showed sinus tachycardia with low voltage. Laboratory evaluation was unremarkable, with a negative troponin and high normal BNP. Chest radiograph showed bilateral infiltrates concerning for mild pulmonary congestion.

POCUS was obtained….

Ultrasound, Radiology, CardiologySean BilodeauSeptember 3, 2021ultrasound, cardiac amyloidosis, left ventricular ejection fraction, LVEF, EPSSComment

At The Bedside

Read the HPI and think about the questions on the title slide before watching the video. Put yourself at the bedside of this patient and form your own diagnostic and management plan. Designed to help you actually rehearse what you’re going to say and do at the bedside of a sick patient, keep tuning in each week for the same format but new and high yield Emergency Medicine pearls…

Medical Education, CardiologyMichael TcheyanApril 26, 2021Medical Education, Emergency MedicineComment

Utility of POCUS in Evaluating for Pulmonary Embolism

A 58-year-old woman with a past medical history significant for hypertension and hyperlipidemia presents to the Emergency Department with 3 days of dyspnea. She also endorses non exertional pleuritic chest pain, chills, and malaise that started on the morning of her presentation. Vital signs were notable for tachycardia of 110 beats per minute and an oxygen saturation of 93% on room air, but were otherwise normal. Physical exam revealed clear lung fields bilaterally and was otherwise unremarkable…

Cardiology, UltrasoundBenjamin HaganMarch 12, 2021Cardiology, Pulmonary EmbolismComment

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