The COVID-19 viral infection, caused by the novel coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a currently ongoing global pandemic that, as of mid-October, 2020, has resulted in more than 38.7 million confirmed cases globally and has caused more than 1.1 million fatalities. COVID-19 infection is associated with severe life threatening respiratory and cardiac complications such as acute respiratory distress syndrome (ARDS), pneumonia, shock, cardiac arrhythmias, myocardial infarction and heart failure, particularly in the acute infectious stage. Acute myopericarditis is another reported cardiac complication of COVID-19. Case reports have been limited in reporting the effects of COVID-19 in the post-symptomatic period.
In this article, we present a case of acute myopericarditis resulting 6 to 8 weeks after testing positive for COVID-19. Here we will breakdown the initial emergency department (ED) presentation, with particular attention to the electrocardiogram (ECG) findings of acute myopericarditis. This case, to the our best knowledge and after an extensive literature review, depicts the first case of myopericarditis in the post COVID-19 infection recovery phase.
Background Education is undergoing a transformation. The traditional passive lectures are failing to capture and inspire the new generation of learners who value more active and collaborative learning techniques. Objective We sought to create a novel educational technique to integrate into our curriculum that would be more personalized, employ more active learning and collaboration, and allow for an effective assessment of resident strengths and weaknesses. Discussion We created a monthly assembly line education academic half-day that evolved to replace one of the typical in-classroom didactics each month. Faculty run small-group simulation rooms, procedure workshops, competitive ultrasound, and wellness stations through which residents and medical students rotate. Conclusion This novel education technique resulted in a more personalized approach that increased resident interest, sparked the creation of a very popular MedEd-Simulation elective, and allowed the faculty to gain a better sense of resident strengths and deficiencies.
The authors present a case of a fatal intentional acetaminophen (APAP) overdose and remind the physician how ubiquitous the drug is. This case presentation highlights the clinical presentation and treatment options for APAP overdose in unresponsive patients. In cases of massive APAP overdose (> 300 µg/ml plasma at four hours post-ingestion), prompt administration of N-acetylcysteine (NAC) and early hemodialysis are indicated.
The authors report a case of an elderly patient with left eye retinal detachment who presented to the emergency department (ED). Bedside ultrasonography of the retina revealed a hyperechoic, smooth, folded membrane within the vitreous, consistent with a diagnosis of retinal detachment. Ophthalmological consultation was obtained, and the patient healed well after surgical repair.
Implanted artificial pacemakers are groundbreaking pieces of technology that have a vast array of medical benefits. However, as with other electronic devices, these implanted cardiac devices are not immune to failure. One of the most common failures are lead fractures, which can lead to conduction issues that result in inappropriate or insufficient electrical stimulation to the myocardium or other myocytes. The authors present a classic example of this type of artificial pacemaker failure, with the hospital course of a female patient presenting with erratic muscle contractions due to improper electrical impulse generation and conduction.
The authors of this article report on a case of a patient who presented to the emergency department (ED) in anaphylaxis after receiving the Moderna® COVID-19 vaccine. The patient was hypoxic, with diffuse wheezing bilaterally to auscultation, flush skin, swollen face, and the feeling of her throat closing. Anaphylaxis can have wide range of presentation, the key is recognizing the symptoms and treating early. The incidence of anaphylaxis from COVID-19 vaccine is not well documented to date.
We present a case of electrical cardioversion used to treat a hemodynamically unstable wide complex tachycardia (WCT). The patient returned to normal sinus rhythm after being cardioverted with 100 joules (J) on the first attempt. He was admitted to the hospital for cardiac evaluation and ultimately discharged home on flecainide and nebivolol after a negative cardiac workup.
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