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Yearly Trend Of Acute Venous Thromboembolism In Patients Admitted With Heart Failure In The United States., Sijan Basnet, Rashmi Dhital, Biswaraj Tharu, Dilli Ram Poudel, Anthony Donato Sep 2019

Yearly Trend Of Acute Venous Thromboembolism In Patients Admitted With Heart Failure In The United States., Sijan Basnet, Rashmi Dhital, Biswaraj Tharu, Dilli Ram Poudel, Anthony Donato

Reading Hospital Internal Medicine Residency

Introduction: Heart failure (HF) patients are at risk for venous thromboembolism (VTE) during the hospital stay. We aim to study the recent trend of deep vein thrombosis (DVT), pulmonary embolism (PE), and VTE in heart failure patients from years 2000-2013. Methods: We utilized the National (Nationwide) Inpatient Sample database and selected non-pregnant patients over the age of 18 years for this purpose. We selected HF, DVT, PE, and VTE based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We used STATA for analysis. Results: We noted an increase in prevalence of DVT, PE and composite …


Symmetrical Peripheral Gangrene Associated With Low Output Cardiac Failure., Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Ataul Qureshi Jul 2019

Symmetrical Peripheral Gangrene Associated With Low Output Cardiac Failure., Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Ataul Qureshi

Reading Hospital Internal Medicine Residency

Symmetrical peripheral gangrene (SPG) is a rare entity characterized by ischemic changes of the distal extremities with maintained vascular integrity. We present the case of a 64-year-old man with bilateral necrotic toes and deranged liver function tests. This was thought to be related to severely depressed ejection fraction from non-ischemic etiology, presumably chronic alcohol ingestion. We hope that awareness of SPG and association with a low output state will aid in early detection and prevention.


Low Voltage Criteria Ekg As A Harbinger Of Systemic Disease., Ian Garrahy, Daniel Forman, Sharon Swierczynski Jun 2019

Low Voltage Criteria Ekg As A Harbinger Of Systemic Disease., Ian Garrahy, Daniel Forman, Sharon Swierczynski

Reading Hospital Internal Medicine Residency

AL amyloidosis is due to deposition of protein derived from immunoglobulin light chain fragments. It is a systemic disorder in which deposition of plasma proteins can adversely affect function of the heart, liver, kidneys, and peripheral nerves. Deposition in the heart results in a decrease in the amplitude of the electrical activity of the heart and can be an early clue to the diagnosis. A 63-year-old male admitted for volume overload was found to have nephrotic range proteinuria, progressive renal insufficiency (Creatinine 4.0 increased from his baseline 0.9), and hypoalbuminemia. On exam, he had diffuse anasarca and peripheral neuropathy. A …


Stroke Risk Stratification In Atrial Fibrillation: A Review Of Common Risk Factors., Oreoluwa Oladiran, Ifeanyi Nwosu Apr 2019

Stroke Risk Stratification In Atrial Fibrillation: A Review Of Common Risk Factors., Oreoluwa Oladiran, Ifeanyi Nwosu

Reading Hospital Internal Medicine Residency

Atrial Fibrillation (AF) has become a major global health concern being the most common sustained arrhythmia in clinical practice. Risk factors for AF include congestive heart failure, hypertension, increasing age and diabetes. Many of these factors also increase the risk for thromboembolism and ischemic stroke in AF patients. Great efforts have been made from the latter part of the 20


Influence Of Abnormal Potassium Levels On Mortality Among Hospitalized Heart Failure Patients In The Us: Data From National Inpatient Sample., Sijan Basnet, Rashmi Dhital, Biswaraj Tharu, Sushil Ghimire, Dilli Ram Poudel, Anthony Donato Apr 2019

Influence Of Abnormal Potassium Levels On Mortality Among Hospitalized Heart Failure Patients In The Us: Data From National Inpatient Sample., Sijan Basnet, Rashmi Dhital, Biswaraj Tharu, Sushil Ghimire, Dilli Ram Poudel, Anthony Donato

Reading Hospital Internal Medicine Residency

Abnormalities in serum potassium levels have been associated with variable mortality risk among hospitalized patients with heart failure (HF). We aim to use a large database study to further characterize risk of mortality, demographic factors, and associated comorbidities among heart failure inpatients. Methods: Our sample population was from the US National Inpatient Sample database from the year 2009-2011. The inclusion criteria used to identify patients was those with a diagnosis of heart failure as per ICD-9 classification. Other demographic factors considered in data collection included income, and cardiac risk factors. Taking these factors into consideration, a univariate association of …


Quadricuspid Aortic Valve: Report Of Two Cases And Brief Review., Oreoluwa Oladiran, Ifeanyi Nwosu, Rashmi Dhital, Gbujie Ezioma Apr 2019

Quadricuspid Aortic Valve: Report Of Two Cases And Brief Review., Oreoluwa Oladiran, Ifeanyi Nwosu, Rashmi Dhital, Gbujie Ezioma

Reading Hospital Internal Medicine Residency

Quadricuspid aortic valve (QAV) is a rare congenital cardiac defect characterized by the presence of four aortic valve leaflets of equal or varying sizes. Even rarer is its clinical presentation with aortic stenosis. Diagnosis of QAV could be challenging but is of great importance as patients often present with progressive aortic regurgitation. We present 2 cases of QAV presenting differently: one with aortic stenosis requiring valve replacement and the other with aortic regurgitation requiring close monitoring.