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• Case of the Week - Case # 90

  A 54-year-old male presents with a significant UGI bleed. He seeks his care at an outside hospital and you have no records for him at your hospital. Due to his GI bleeding, you want to fluid resuscitate the patient but are concerned due to his CHF history. You perform a focused echo to assess for global LV function and note the following…... Posted Aug 25 2008, 09:25 AM by Rob with | with no comments Filed under: Beginner, Intermediate, Advanced, Cardiac, CVP

• Case of the Week - Case # 73

  74-year-old white female presents with dyspnea for two days. On examination, you notice that her heart sounds are muffled and you performed a focused ultrasound to assess for pericardial effusion...... Posted Apr 30 2008, 02:09 AM by Rob with | with no comments Filed under: Intermediate, Advanced, Cardiac

• Case of the Week - Case # 68

  Elderly male presents from the nursing with fever and cloudy urine. His vitals are as follows: BP 100/48, P 128, R 30, T 39.4. The patient has never been seen before at your institution but the transfer sheet reports that the patient has a history of CHF. The patient has already received 2 liters of IV fluids. Do you give more fluids?... Posted Mar 21 2008, 03:27 PM by Rob with | with no comments Filed under: Intermediate, Cardiac, CVP

• Case of the Week - Case # 67

  An elderly male presents with chest pain. The patient has history of lung cancer. On examination, his heart tones are muffled and you are asked to scan the patient for a possible pericardial effusion/tamponade.... Posted Mar 12 2008, 04:52 PM by Rob with | with no comments Filed under: Intermediate, Cardiac

• Case of the Week - Case # 55

  An 86-year-old nursing home patient presents to the ED with dyspnea and low blood pressure. Her EKG reveals low voltage QRS complexes and your resident is concerned that the patient has a pericardial effusion/tamponade. Your resident is also concerned that "something doesn't look right in the right ventricle." You perform a bedside ultrasound and note the following:... Posted Dec 17 2007, 01:16 AM by Rob with | with no comments Filed under: FAST, Beginner, Cardiac

• Case of the Week - Case # 46

  A 22-year-old male presents to the ED after having been shot in the left chest during an attempted carjacking. The bullet entered into the left chest just medial to the left shoulder. Initially, the patient was awake and alert with BP 124/64, HR 92 and RR 16. His chest xray revealed several bullet fragments in the left chest and one fragment in the right chest. The cardiac silhouette was normal. His blood pressure subsequently decreased to 82/54. You perform a FAST exam (his abdominal windows were negative and thoracic windows demonstrated no evidence of a pneumothorax) and note the following:... Posted Oct 07 2007, 11:41 PM by Rob with | with no comments Filed under: Intermediate, Cardiac

• Case of the Week - Case # 40

  A 15 y.o. hispanic female presents to the ED 4 days after delivery of her first child with difficulty breathing and edema. Her prenatal course was complicated by preeclampsia but she had an uneventful delivery and was discharged home on postpartum day number 2. She noticed swelling in her legs since coming home and she has been unable to lay flat. She denies any other PMH and does not take any meds. Her vitals are: BP 124/78, HR 100, RR 24, PO 94% on RA, and T 37.1 orally. On exam you note that she has bilateral LE edema, diminished breath sounds at the bases, and positive JVD. You perform a bedside ultrasound and note the following...... Posted Aug 18 2007, 12:51 PM by Rob with | with no comments Filed under: Beginner, Intermediate, Cardiac, Pregnancy

• Case of the Week - Case # 37

  A 54-year-old black female with a history of lupus presents to the ED with cough and pleuritic chest pain. Her vital signs are stable and she is afebrile. On examination, you think you hear a pericardial rub. You perform a focused echo and note the following...... Posted Jul 29 2007, 11:09 PM by Rob with | with no comments Filed under: Intermediate, Cardiac, CVP

• Case of the Week - Case # 35

  54 y.o. male presents s/p accidental precordial stab wound with a box cutter at a construction site. The patient’s vitals are stable and he is in no acute distress. The only wound you find on the patient is in the left precordial region over the left pectoralis muscle. It is 1.0 cm in length and there is no active bleeding. His cardiac and pulmonary exams are normal. Upright chest radiograph at the bedside was unremarkable. Due to your concern of possible cardiac injury, you perform a focused cardiac ultrasound.... Posted Jul 12 2007, 11:23 PM by Rob with | with no comments Filed under: Intermediate, Cardiac

• Case of the Week - Case # 34

  An 82-year-old male presents with dyspnea worsening over the past three days. He has a history of prior MI, hypertension, renal insufficiency and type 2 DM. He is from out of town and is just in town for a wedding. He is on a boatload of medications and doesn't know anything else about his history. You are concerned about CHF and you perform a bedside echocardiogram.... Posted Jul 07 2007, 09:00 PM by Rob with | with no comments Filed under: Intermediate, Cardiac

• Case of the Week - Case # 30

  A 67-year-old male presents via EMS after being found unresponsive by the wife. EMS reports that the patient seems aphasic and is only moving his right side. The patient's blood pressure is 82/40 and his heart rate is 100. The patient has a PMH of hypertension and coronary artery disease. On examination, you confirm the findings given to you by EMS. Due to his hypotension, you perform a medical FAST examination to better evaluate the patient. ... Posted Jun 06 2007, 08:59 PM by Rob with | with no comments Filed under: Aorta, Beginner, Intermediate, Cardiac

• Case of the Week - Case # 29

  A 64-year-old white female with a PMH of metastatic breast CA, hypertension, osteoarthritis and peripheral vascular disease presents to the ED after being noted by family to have mental status changes.... Posted May 30 2007, 11:27 PM by Rob with | with no comments Filed under: Advanced, Cardiac

• Case of the Week - Case # 22

  A young woman is dropped off at the ambulance entrance by friends after being shot once in the right chest during a robbery attempt. On arrival she is minimally responsive and is noted to have a single GSW to the right lateral chest. Her blood pressure is 118/74 and her heart rate is 104. She is emergently intubated and a portable CXR is performed. After performing the ABCs, you perform a bedside cardiac ultrasound. You note the following...... Posted Apr 11 2007, 12:00 AM by Rob with | with no comments Filed under: Intermediate, Case, Cardiac, trauma

• Case of the Week - Case # 17

  A 28 year-old male with PMH of AIDS presents with pleuritic chest pain. The patient denies history of trauma or infectious symptoms. On examination, the patient appears relatively comfortable and has stable vital signs other than a heart rate of 108. There is no evidence of trauma or stigmata of a DVT. On cardiac exam, there appears to be a friction rub. You are concerned that the patient has pericarditis. You perform a focused echo of the heart to evaluate for the presence of a pericardial fluid collection...... Posted Feb 28 2007, 12:00 AM by Rob with | with no comments Filed under: Intermediate, Case, Cardiac

• Case of the Week - Case # 15

  68 y.o. male presents via EMS in full cardiac arrest. This was a witnessed arrest per medics and the patient was in ventricular fibrillation on EMS arrival. After several minutes of ACLS the rhythm changed to a narrow QRS complex with a rate in the 50’s. Upon arrival to the ED... Posted Feb 07 2007, 02:17 AM by Rob with | with no comments Filed under: Beginner, Case, Cardiac, ACLS