Posts in Ultrasound
An Uncommon Cause of Shortness of Breath in the Emergency department: Acute Mitral Regurgitation
An Uncommon Cause of Shortness of Breath in the Emergency department: Acute Mitral Regurgitation

By: Russell Prichard MD and Melanie Lippman MD

CASE

The patient is a 52 year-old female with a past medical history of hypertension, hyperlipidemia, hypothyroidism, and a 2 pack a day smoking history who presented to the emergency department in respiratory distress.

When EMS arrived to the patient’s home, she was hypoxemic with a pulse oximetry reading of 70s on room air and hypotensive with systolic blood pressures in the 80s. She was placed on nasal cannula with improvement in her saturations and she was given aspirin, fentanyl, and nitroglycerin without relief.

Upon arrival her vitals were significant for respiratory rate of 34, pulse oximetry of 98% on 6L NC. She was noted to be in acute distress.

The patient was placed on positive pressure ventilation via BiPAP and broad blood work, chest X-ray and electrocardiogram (ECG) were obtained.

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Critical Care, Community EM, Respiratory, Resuscitation, Ultrasound, CardiologyRussell Prichardcardiology, Critical Care, RespiratoryComment
Rounding Out A Case of Acute Pancreatitis
Rounding Out A Case of Acute Pancreatitis

An otherwise healthy 6 year-old female presented with lower abdominal pain and non-bloody, non-bilious emesis since 11:00 PM the previous night. Several hours prior to the onset of her symptoms, she was playfully thrown into a pond where she was swimming. She subsequently had take-out brown rice and vegetables with her family. Nobody else developed symptoms. Her pain was worse with ambulation and bumps in the road. She has had no diarrhea, constipation, fevers, urinary symptoms, or other acute complaints. She had similar but less severe episodes of these symptoms in the past. The patient’s father had a history of a “blood disorder” requiring abdominal surgery…

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Pediatrics, UltrasoundSean Reidpancreatitis, pediatrics, spherocytosisComment
Brown Sound: Necrotizing Soft Tissue Infection
Brown Sound: Necrotizing Soft Tissue Infection

A 60 year-old male with history of poorly controlled diabetes, congestive heart failure, chronic kidney disease, and a prior MI presented as a transfer from an outside hospital for surgical management of suspected necrotizing fasciitis/Fournier’s gangrene. He reported symptoms of diarrhea, nausea, vomiting, and severe pain in the scrotum and perineum for several days. This began after he sustained a small cut to the area. He denied fevers, urinary discharge, respiratory symptoms, chest pain, but did endorse chills and night sweats…

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Ultrasound, GUHannah ChasonUltrasound, fournier's gangrene, Necrotizing Fasciitis, surgery, UrologyComment
Ultrasound Case of the Month: Hydatidiform Mole
Ultrasound Case of the Month: Hydatidiform Mole

A 32-year-old female with no significant past medical history presents to the emergency department with complaints of nausea, vomiting, and bloating. The patient reports her last menstrual period was about 2 months prior to presentation. She was evaluated about one-month ago, at which time she was told that a pelvic ultrasound revealed an intrauterine gestation sac without a fetal pole or yolk sac, suspicious for early pregnancy failure. The patient subsequently developed vaginal bleeding, associated with abdominal cramping, nausea, and vomiting. She interpreted these symptoms as a miscarriage. The patient states that the vaginal bleeding has since subsided, but she endorses continued and progressive nausea, vomiting, and bloating. She is unable to tolerate oral intake. She denies fever, headache, abdominal pain, back pain, vaginal discharge/odor/pain, dysuria, or diarrhea…

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Ultrasound, OB/GynErica LashMolar pregnancy, Pelvic ultrasound, OB/GynComment