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A Tale of Two Valves

To the Editor: Radiation heart disease is associated with a high level of morbidity and mortality. Its natural history is not well understood. Its management is difficult. We report a case of radiation heart disease with dramatic disease progression over 11 years, captured on echocardiography. Case Report A 66-year-old woman presented with increasing dyspnea on […]

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Necrotizing Sarcoid Granulomatosis: Clinico-Radio-Pathologic Diagnosis

A 30-year-old man was referred to the rheumatology outpatient department and seen urgently after developing diplopia over a 4- to 8-hour period and an isolated left fourth cranial nerve palsy associated with a bifrontal and left temporal headache and episodic vertigo. Magnetic resonance imaging of the brain at that time was unremarkable. The following week […]

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Subcutaneous Lesion in an Oncologic Patient

A 40-year-old Caucasian woman presented to our university hospital after she noticed a mass in the right supraclavicular area. The lump was easily palpable, sized 1-1.5 cm, firm, and rather immovable, with surrounding edema (Figure 1). She had noticed the lesion approximately 2 weeks earlier, and during that time the mass was gradually enlarging. Her personal […]

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Recurrent Pneumothoraces: Making the Link to Catamenial Pneumothorax

A 44-year-old woman with history of endometriosis on ovulatory suppressant therapy and right spontaneous pneumothorax treated with tube thoracostomy 2 months prior, presented with dyspnea and pleuritic chest pain. Physical examination was remarkable for decreased breath sounds and hyperresonance over the right hemithorax. Her labs were unremarkable. Chest radiography revealed a right pneumothorax (Figure 1). Her […]

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Tele-Ultrasound to Guide Management of a Patient with Circulatory Shock

A 65-year-old man with a medical history of chronic obstructive pulmonary disease and ethanol abuse presented to the emergency department with tachypnea, tachycardia, and an altered mental status. He was hypotensive at 90/60 mm Hg. Examination of the patient showed confusion and decreased left-sided breath sounds. The serum laboratory values were significant for a urea […]

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