**Figure 1.** Still images from point of care echocardiography of patient noting a dilated aortic root, early RV diastolic collapse in the context of a pericardial effusion, and an aortic dissection flap. Left: aortic root measuring 5.3cm; Right: early RV diastolic collapse with dissection flap

Cool County Cases - Aortic Dissection with Hemopericardium and Cardiac Tamponade

September 15, 2023

The Case:

A 40-year-old man with no known past medical history presented for evaluation of chest pain. According to the patient’s fiancée, the patient was experiencing chest pain one day prior to presentation. He continued to have chest pain and was seen at an urgent care clinic, where he was referred to the Emergency Department for an abnormal EKG and chest radiograph. While in the waiting room, the patient had a syncopal episode and was brought back to a station. The patient has no significant surgical or family history. He is a lifelong nonsmoker and occasional social drinker.

Vladimir Bernstein MD

The Weekly Cheese 2.0: Inotrope Selection in Cardiogenic Shock

February 24, 2022

Background: The management of cardiogenic shock is complex, often requiring tandem use of vasopressors and inotropes to stabilize hemodynamics. But what inotrope is more effective, dobutamine or milrinone?

Are Central Lines *really* Central for Pressors?

PharmD Pearls: Are Central Lines Central for Pressors?

December 16, 2021

Are central lines central to pressor administration?

the County Consult