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the County Consult

A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.

Figure 1. Index ECG.

The Heart of the Matter - A Case of Exertional Dyspnea

November 1, 2024

A 59-year old-male with a past medical history of uncontrolled hypertension and polysubstance use disorder presents with exertional dyspnea that started 2 weeks ago. He reports associated bilateral lower extremity swelling, right greater than left, that started 2 days ago. An ECG is obtained on arrival (Figure 1).

Michael Hohl, MD

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In Cardiology
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Figure 1. Index ECG.

The Heart of the Matter - A Case of Central Chest "Irritation"

October 25, 2024

A 58-year-old male with no reported past medical history presents with central chest “irritation” and exertional dyspnea for 1 day. He his hypotensive and diaphoretic upon evaluation. An initial ECG followed by a right sided ECG is obtained (Figures 1 and 2).

Adam Roussas, MD

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In Cardiology
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Figure 1. Index point-of-care echocardiogram.

A Case of Cardiac Tamponade Secondary to Malignant Effusion

October 11, 2024

A 40-year-old man with no known past medical history presented with one week of fatigue and dyspnea on exertion. In the last week, the patient developed significant shortness of breath with only a few steps. The patient reported an unintended weight loss of 25 lbs in the last two months, as well as one month of intermittent epigastric abdominal pain and associated nausea. In the last week, the patient was seen by an outside clinic and diagnosed with H. pylori and started on treatment for H. pylori. He denies any other acute complaints or symptoms including orthopnea or paroxysmal nocturnal dyspnea.

Alejandro Ruiz, MD

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In Cardiology, Critical Care
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